Nurses Certificate in Emergency and Critical Care Nursing

1. Triage, monitoring, and stabilisation.

At the end of this module delegate should be able to:​​​​​​

1.1 Describe the triage process and explain how it benefits patients

1.2 Classify the principles and practical aspects of critical patient monitoring

1.3 Define the perfusion parameters and explain how these can be used to identify hypoperfusion and to monitor a patient’s response to treatment.

1.4 Implement the various mechanisms to assess perfusion and of monitoring of clinical parameters and be able to interpret their readings including ECG abnormalities.

1.5 Recognise dyspnoeic patients and be able to assess them for their degree of respiratory impairment.

1.6 Discuss the causes of respiratory disease and state the various oxygen supplementation techniques

1.7 Discuss the collection of arterial and venous blood samples for blood gas analysis and be able to explain their importance.

 Speaker: Elle Haskey RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

Elle Haskey

RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

I graduated in 2008 from the University of Bristol with an honours degree in Veterinary Nursing and Practice Administration. I worked in a mixed practice in the Midlands for 2 years before returning to the University of Bristol as Senior ICU nurse for 4 years. I gained the VTS(ECC) qualification in 2012. In 2013 I moved to join the Royal Veterinary College ECC team where I took on the role of head nurse for four years. In 2020 I stepped back into the team to focus on a clinical role working within the emergency and critical care unit and supporting the students on clinical rotations at the hospital.

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Fluid Therapy in the Emergency Patient.

At the end of this module delegates should be able to:

2.1 Define the difference between hypovolaemia and dehydration and how they are treated using fluid therapy.

2.2 Recognise the importance of electrolytes and their role in homeostasis.

2.3 Describe the different types of intravenous fluids including crystalloids, colloids, and blood products.

2.4 Recognise the different types of shock: hypovolaemic, maldistributed, septic, cardiogenic.

2.5 Solve administration calculations for the correct administration: Constant Rate Infusions (CRI’s), Crystalloids, Colloids, and Blood products.

2.6 Describe the importance of how blood transfusions should be safely administered and describe the contraindications of blood transfusions, and their associated adverse reactions.

 Speaker: Elle Haskey RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

Elle Haskey

RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

I graduated in 2008 from the University of Bristol with an honours degree in Veterinary Nursing and Practice Administration. I worked in a mixed practice in the Midlands for 2 years before returning to the University of Bristol as Senior ICU nurse for 4 years. I gained the VTS(ECC) qualification in 2012. In 2013 I moved to join the Royal Veterinary College ECC team where I took on the role of head nurse for four years. In 2020 I stepped back into the team to focus on a clinical role working within the emergency and critical care unit and supporting the students on clinical rotations at the hospital.

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Diagnostic imaging and the Trauma patient

At the end of this module delegate should be able to:

7.1 State the priorities for stabilising and treating traumatic wounds and fractures on initial presentation, and be able to implement effective assessment, lavage, and debridement of wounds.

7.2 Explain the principles and practical aspects of the latest advanced wound dressings

7.3 Identify how urinary trauma presents, and how patients are stabilized prior to surgery

7.4 Describe the pathophysiology of head trauma and their nursing requirements demonstrating the use of the small animal coma scoring scale

7.5 Identify how to deal with thoracic trauma patients, and prioritize their treatment

7.6 Understand the principles of ultrasound imaging and be familiar with how to set up and maintain the ultrasound machine and probes

7.7 Employ the principles of FAST scanning to triage emergency cases and identify specific equipment and materials required for ultrasound-guided procedures.

7.8 Explain the different radiographic techniques available, their pros and cons, and their uses in specific situations

7.9 Evaluate radiographic image quality to ensure diagnostic radiographs are available for interpretation, demonstrating basic film reading and be able to identify radiographic artifacts and faults.

 Speaker: David MacKenzie BSc(Hons) MA VetMB PhD CertVC CertAVP(SAM) CertAVP(ECC) PgCert(VPrS) MRCVS

David MacKenzie

BSc(Hons) MA VetMB PhD CertVC CertAVP(SAM) CertAVP(ECC) PgCert(VPrS) MRCVS

Dr David Mackenzie

BSc(Hons) MA VetMB PhD CertVC CertAVP(SAM) CertAVP(ECC) PgCert(VPrS) MRCVS

RCVS Advanced Practitioner in Emergency & Critical Care and Veterinary Cardiology

Referral Clinician in Internal Medicine & Emergency & Critical Care, Head of ECC

Eastcott Referrals, Swindon

David qualified from Cambridge in 2003 having already completed a degree in Physiology and a PhD in Neuroscience. After graduation, he worked as a clinical scholar at Edinburgh Vet School where he was involved in seeing referral cases in cardiology and small animal medicine. He spent the next eight years in general practice during which time he gained the RCVS certificates in Cardiology and Small Animal Medicine and developed a referral service in both of these areas.

David became Principal Vet at Vets-Now Aberdeen in 2014 and subsequently gained his certificate in Emergency & Critical Care (ECC) and Veterinary Professional Studies. From 2014 – 2018, he divided his time between running the ECC service at Aberdeen, leading the referral service in Cardiology at Chestergates Referrals in Chester (as well as contributing to the Medicine Referral Service and seeing ECC cases) and provided a Medicine referral service at Albavet in Dunfermline and Kirkcaldy in Scotland. He also spent time at Lumbry Park Referrals as a medicine clinician during this time.

David started work at Eastcott Referrals in 2018 as Medicine referral clinician, and also saw cardiology and ECC cases. He set up the ECC service and ICU at Eastcott which opened in February 2020. He is currently Head of the ECC Service at Eastcott, while continuing to see Medicine and Cardiology cases.

David is interested in all areas of ECC and Medicine. He has a particular interest in diagnostic imaging, especially in its use for emergency and critical care cases. He also lectures widely and gives CPD courses in this area. He was formerly the Programme Co-ordinator and examiner for the BSAVA postgraduate certificate in ECC, and is currently an examiner for the BSAVA certificate exams in medicine. He is also a member of the team developing the new BSAVA certificate in diagnostic imaging.

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Medical Emergencies

At the end of this module you should be able to:

3.1 Describe the measures of caring/treating for a patient presenting with cardiac disease

3.2 Classify the treatment of acute renal failure and the underlying causes of pre, renal and post-renal failure.

3.3 State the pathophysiology of endocrine and metabolic emergencies, including hypoadrenocorticism.

3.4 Discuss common poisons seen in companion animals list antidotes and treatments.

3.5 State the common acute medical gastrointestinal emergencies and discuss their treatment and management

3.6 Describe the pathpathology of a ‘blocked cat’ and the available treatment options including the associated nursing care.

3.7 Classify laboratory sampling techniques, processing, storage, and data recording. Apply knowledge to using the microscope to examine blood smears, urinary sediment, and basic cytology

3.8 Classify the most common neurological emergencies and their initial treatment

3.9 State the most common hematological abnormalities and their treatment

3.10 Discuss the treatment and nursing considerations of a patient with pancreatitis

 Speaker: David MacKenzie BSc(Hons) MA VetMB PhD CertVC CertAVP(SAM) CertAVP(ECC) PgCert(VPrS) MRCVS

David MacKenzie

BSc(Hons) MA VetMB PhD CertVC CertAVP(SAM) CertAVP(ECC) PgCert(VPrS) MRCVS

Dr David Mackenzie

BSc(Hons) MA VetMB PhD CertVC CertAVP(SAM) CertAVP(ECC) PgCert(VPrS) MRCVS

RCVS Advanced Practitioner in Emergency & Critical Care and Veterinary Cardiology

Referral Clinician in Internal Medicine & Emergency & Critical Care, Head of ECC

Eastcott Referrals, Swindon

David qualified from Cambridge in 2003 having already completed a degree in Physiology and a PhD in Neuroscience. After graduation, he worked as a clinical scholar at Edinburgh Vet School where he was involved in seeing referral cases in cardiology and small animal medicine. He spent the next eight years in general practice during which time he gained the RCVS certificates in Cardiology and Small Animal Medicine and developed a referral service in both of these areas.

David became Principal Vet at Vets-Now Aberdeen in 2014 and subsequently gained his certificate in Emergency & Critical Care (ECC) and Veterinary Professional Studies. From 2014 – 2018, he divided his time between running the ECC service at Aberdeen, leading the referral service in Cardiology at Chestergates Referrals in Chester (as well as contributing to the Medicine Referral Service and seeing ECC cases) and provided a Medicine referral service at Albavet in Dunfermline and Kirkcaldy in Scotland. He also spent time at Lumbry Park Referrals as a medicine clinician during this time.

David started work at Eastcott Referrals in 2018 as Medicine referral clinician, and also saw cardiology and ECC cases. He set up the ECC service and ICU at Eastcott which opened in February 2020. He is currently Head of the ECC Service at Eastcott, while continuing to see Medicine and Cardiology cases.

David is interested in all areas of ECC and Medicine. He has a particular interest in diagnostic imaging, especially in its use for emergency and critical care cases. He also lectures widely and gives CPD courses in this area. He was formerly the Programme Co-ordinator and examiner for the BSAVA postgraduate certificate in ECC, and is currently an examiner for the BSAVA certificate exams in medicine. He is also a member of the team developing the new BSAVA certificate in diagnostic imaging.

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Surgical emergency procedures.

At the end of this module delegates should be able to:

4.1 Describe the correct preparation of the emergency patient for surgery.

4.2 Explain the importance of correct asepsis with preparing patients for Surgery

4.3 Describe the pathophysiology behind gastric dilatation and volvulus, the emergency and surgical treatment options.

4.4 Explain the term septic peritonitis and haemoabdomen, the potential causes and surgical treatment options, discussing the nursing care of these patients

4.6 Discuss the common important clinical signs associated with reproductive and pediatric/neonatal emergencies to include the pre-, intra-, and post-operative cesarean patient.

4.7 Describe the common ophthalmological emergencies, treatment, and nursing care

 Speaker: Thomas Towey

Thomas Towey

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Analgesia and Anaesthesia

At the end of this module delegates should be able to:

5.1 Identify common complications which can arise related to anaesthesia outcomes

5.2 Describe anaesthesia of patients with respiratory disease

5.3 Discuss the pathophysiology behind various cardiac diseases and how we may modify anaesthesia protocols for the cardiac patient.

5.4 Define the range of analgesics available, including opioids, NSAIDs, and local anaesthetics

5.5 Recognise pain in companion animals and gain confidence in the use of veterinary pain scoring systems.

 Speaker: Amy Homer RVN MScVAA GradDipVN NCertACC AFHEA

Amy Homer

RVN MScVAA GradDipVN NCertACC AFHEA

Amy qualified in 2008 and after a brief spell in referral nursing, she returned to a head nurse/ clinical team leader role in a busy first opinion practice in Bristol. She is currently a Lecturer in Veterinary Practice (Anaesthesia), at Bristol University, Langford. She enjoys all aspects of nursing, but has a special interest in anaesthesia and analgesia, having completed the NCert(A&CC), followed by the Graduate Diploma in Clinical Veterinary Nursing through the Royal Veterinary College. Amy Is currently in the final year studying towards the Masters Degree in Veterinary Anaesthesia and Analgesia through Edinburgh University.

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NEW FOR 2021!

Emergency and Critical Care in Exotic patients.

At the end of this module delegates should be able to:

7.1 Demonstrate and explain the importance of the techniques used to triage Rabbits, Guinea pigs, ferrets, small mammals, reptilians, and the avian patient.

7.2 Explain the anaesthesia & analgesia considerations of the emergency conditions of rabbits, ferrets, small mammal, reptilian and avian patients.

7.3 Describe and implement the Critical Care and nursing techniques for the avian, reptilian and small mammal emergency patient

7.4 Sate and explain the effects of the common poisons appliable to the avian patient

7.5 Demonstrate CPR in all exotic patients

 Speaker: Richard A. Saunders BSc (Hons) BVSc FRSB CBiol DZooMed (Mammalian) DipECZM(ZHM) MRCVS  RCVS Specialist in Zoo and Wildlife Medicine (Mammalian) European Specialist in Zoological Medicine (ZHM)

Richard A. Saunders

BSc (Hons) BVSc FRSB CBiol DZooMed (Mammalian) DipECZM(ZHM) MRCVS  RCVS Specialist in Zoo and Wildlife Medicine (Mammalian) European Specialist in Zoological Medicine (ZHM)

Richard Saunders is a Staff Veterinarian at Bristol Zoo Gardens and Clinical Teacher at the University of Bristol. Additionally, he sees referral exotic pets at Highcroft veterinary Referrals, Bristol, and is the veterinary adviser to the Rabbit Welfare Association and Fund. He qualified in 1994, obtaining his DZooMed (Mammalian) in 2010. He has authored numerous articles on rabbits, rodents and other wild and exotic species, and has contributed to a number of textbooks, including co-authoring "Notes on Rabbit Internal Medicine", as well as several chapters for the new editions of the BSAVA Rabbit Manuals, and has co-authored "Rabbit behaviour and Welfare".

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Nursing the critical patient

At the end of this module delegates should be able to:

6.1 Classify the requirements and management of recumbent patients

6.3 State the nutritional requirements of trauma and critical care patients

6.4 Explain the different techniques for administering enteral nutrition to patients including:

• Nasogastric tubes

• Oesophagostomy tubes

• Gastrostomy tube

6.5 Identify and explain the use of Total parenteral and Partial parenteral Nutrition is used

6.6 Understand how to manage a variety of catheters and drains in an aseptic manner including urinary catheters, thoracic drains, and tracheostomy tubes.

6.7 Perfect your knowledge of the importance of maintaining effective infection control protocols when dealing with critical patients in order to prevent hospital-acquired infections (HAIs).

 Speaker: Elle Haskey RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

Elle Haskey

RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

I graduated in 2008 from the University of Bristol with an honours degree in Veterinary Nursing and Practice Administration. I worked in a mixed practice in the Midlands for 2 years before returning to the University of Bristol as Senior ICU nurse for 4 years. I gained the VTS(ECC) qualification in 2012. In 2013 I moved to join the Royal Veterinary College ECC team where I took on the role of head nurse for four years. In 2020 I stepped back into the team to focus on a clinical role working within the emergency and critical care unit and supporting the students on clinical rotations at the hospital.

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CPR and Key practical skills

At the end of this module delegates should be able to:

8.1 Discuss the new approach to veterinary CPR and implement effective CPR within a team-practical (dry lab).

8.2 Demonstrate correct suturing techniques relevant to emergency patients including tracheostomy tube placement and thoracic drain placement – wet lab (cadavers)

8.4 Describe and demonstrate the techniques for administering/supplementing oxygen, e.g. placement of nasal oxygen cannulas, transtracheal oxygen administration – wet lab (cadavers)

8.5 Interpret and explain the correct placement of various feeding tubes, e.g., nasogastric, oesophagostomy tubes – wet lab (cadavers)

8.6 Discuss the role of the veterinary nurse and the end-of-life care of a patient.

 Speaker: Elle Haskey RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

Elle Haskey

RVN BSc(hons) PGCert FHEA VTS(ECC) VPAC A1

I graduated in 2008 from the University of Bristol with an honours degree in Veterinary Nursing and Practice Administration. I worked in a mixed practice in the Midlands for 2 years before returning to the University of Bristol as Senior ICU nurse for 4 years. I gained the VTS(ECC) qualification in 2012. In 2013 I moved to join the Royal Veterinary College ECC team where I took on the role of head nurse for four years. In 2020 I stepped back into the team to focus on a clinical role working within the emergency and critical care unit and supporting the students on clinical rotations at the hospital.

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