Life-saving strategies: Important considerations in emergency medicine - DVM
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Life-saving strategies: Important considerations in emergency medicine
A Q&A with emergency and critical care veterinary practitioner Susan Barnes


DVM: What are some of the best ways to deal with a distraught client when he or she brings in a pet during an emergency?

Barnes: You have to put yourself in the client's shoes. Most of us in veterinary care have pets, so we know what clients must be feeling. Be empathetic, show concern and communicate as soon and as often as possible. Include the client in the decision-making process when you can. Acknowledge the relationship the client has with his or her primary care practitioner. Communicate with the primary care practitioner often and regularly.

In short, listen to the client, show respect for the client and primary care practitioner, really hear clients' wishes and then — and this is important — document those wishes.

DVM: What should be avoided in client-management situations?

Barnes: Avoid delay in reuniting the patient with the client. Allow the client to see the pet as soon as possible. Also, don't get caught up thinking the client is somehow inconvenient. You're doing all of this for the client, for a family. Never, ever have the thought that the client is in the way.

Remember, words are powerful, so use them carefully. Don't resort to harsh words and don't be indifferent. Keep the client informed as best you can. Speak in a soothing voice. Be a "patient advocate" for the pet, your patient.

Finally, avoid bringing clients to an area that's barely cleaned. Pick up the fur balls and wipe the blood from the floor. It gives clients a good impression if the area is clean.

DVM: Are there any other key concepts to consider when dealing with emergency situations?

Barnes: Offer the best care, but have other options, too. We use whatever works, up to and including some alternative therapies such as acupuncture. Stay current on the latest trends in emergency and critical care.

Also, I recommend humane euthanasia only in two circumstances: When the patient is in inordinate pain that I can't manage via multiple options, or when the patient is suffocating and suffering, such as in cases of severe lung damage, cancer or end-stage heart disease. Sometimes there will be financial considerations that come into play with these. Sometimes all the money in the world doesn't matter.

DVM: As pets live longer, are you seeing a greater number of geriatric-related conditions? Can you describe your caseload in this regard?

Barnes: The number of older pets we see definitely is growing. Today, 33 percent to 45 percent of our patients are geriatric, and that's up from previous years. I attribute the increased longevity to better care throughout their lives. That's the beauty of the relationship between primary care practitioners and their clients and patients. Primary care practitioners are educating their clients. There's more information available for clients, and primary care practitioners are doing well in basic preventive care and wellness evaluations.

DVM: Are you noticing a tendency for clients to have stronger bonds with their pets in recent years?

Barnes: There's always been a strong bond, but, yes, it does seem to be getting stronger. For many, the human-animal bond is as strong as any bond with a human family member.

DVM: How do you foresee emergency medicine changing in the future? Any new technologies or practices you think hold promise?

Barnes: There are many exciting things happening in this field. Some are not so new but are just now becoming more widely known and available. For example, hyperbaric oxygen therapy increases oxygen delivery to cells and helps with healing. There have been some trials conducted with dogs that show response and real promise.

Advances in some interventional radiographic technologies are being applied to emergency medicine, and that's something to watch for in the future, as are advances in chronic renal replacement therapy or hemodialysis.

Editor's Note: Susan M. Barnes, DVM, is the medical director of Animal Emergency Critical Care Associates at The LifeCentre, a full-service veterinary emergency, critical care and specialty center in Leesburg, Va., and the immediate past president of the Veterinary Emergency and Critical Care Society.

Loyle is a freelance medical editor and writer in Philadelphia and the former primary editor of the North American Veterinary Licensing Examination.


Source: DVM360 MAGAZINE,
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