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Ready Area for Emergency Medicine in Animals

By

Andrew Linklater

, DVM, DACVECC, Lakeshore Veterinary Specialists, Glendale, Wisconsin;


Kayla R. Hanson

, DVM, DACVECC, CWPV, LakeShore Veterinary Specialists

Last full review/revision Oct 2020 | Content last modified Oct 2020
Topic Resources

Front desk and triage staff should be aware of presenting conditions that require immediate evaluation by a veterinarian. They are listed in the Primary Survey section of Evaluation and Initial Treatment of the Emergency Patient.

All members of the veterinary team must be familiar with the ready area and location of all necessary emergency equipment and medications.

Regular drills should be organized for emergency situations such as cardiopulmonary arrest (CPA) with subsequent CPR efforts to ensure everyone knows their role and to improve techniques. An emergency treatment or “crash” cart should contain materials necessary to perform CPR and/or institute other emergency therapy.

A ready area includes:

  • multiparameter monitor (ECG, ETCO2, BP, SpO2 , +/- invasive monitoring)

  • IV and/or IO catheter supplies (clippers, aseptic scrub, tape, catheters of various sizes)

  • crash cart (see below)

  • oxygen supply with masks, humidifier

  • +/- oxygen cages with environmental oxygen, CO2, humidity and temperature monitors

  • suction with Yankaur and whistle-tip suction attachments

  • materials to collect blood (syringes, blood tubes, etc)

  • IV fluids, sets, pumps, pressure bag, etc

  • access to rapid-acting injectable anesthetic agents

  • supplies for centesis (needles or catheters, IV sets, three-way stopcock, syringe, and bowls)

  • bandage materials

  • patient transport and restraint materials (muzzles, blankets, gurney)

  • tools to warm or cool a patient (circulating water blankets, warm air blower, IV fluid warmer, fans, etc)

  • charts

Contents of a crash cart

Crash cart contents:

  • endotracheal tubes of various sizes

  • laryngoscope with various sizes of blades

  • syringes of different sizes with 18- or 20-gauge needles attached

  • CPR drugs (minimally, epinephrine and atropine; additionally, reversal agents [atipamezole, flumazenil, naloxone], lidocaine, amiodarone, vasopressin, etc may be considered)

  • oxygen and a small and large bag-valve-mask apparatus or other ready access to oxygen (such as an anesthetic machine flushed free of anesthetic gas)

  • saline flush

  • bandage scissors

  • suction unit with sterile Yankaur and whistle-tip suction attachments

  • defibrillator with gel, internal and external paddles

  • CPR drug dosage charts and algorithm sheets

  • thoracostomy kit including sterile gloves, Mayo scissors, scalpel, Finochietto retractors, vascular clamps, large curved hemostats, red rubber or other materials for a modified Rummel tourniquet, etc

Key Points

  • The golden rule of emergency medicine is to treat the most life-threatening problems first.

  • Therapy must be implemented at the right time, in the right amount, and in the right order.

  • Patients, when stable, should be closely monitored for progression or resolution of disease or possible complications of therapy for the underlying disease.

  • Owners can be instructed to initiate basic first aid before transport.

  • Stocking and maintaining a "ready area" and crash cart is crucial for successful management of patients.

  • Analgesia should be administered when appropriate.

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