EMERGENCY MEDICINE AND SURGERY

Key learning objectives:

• Appreciate triage systems and detail a suitable initial patient assessment 

• Explain emergency vascular access techniques including sites, catheter placement, preparations and complications including jugular and intraosseous techniques   

• Recognise the principles of initial pain management, stabilisation, and monitoring (including the rule of Kirby) 

• Review health and safety concerns and precautions including managing a situation involving potential zoonoses and nosocomial infections in the ICU 

• Recognise the pharmacokinetics, potential interactions, and adverse effects of common therapeutics agents: anti-microbials and anti-parasitic drugs (CYTP450 mechanism, MDR1 mutation, species-specific enzyme mutation/deficiency) 

• Use of physiotherapy, general nursing of CIP 

• Recognise the administrative, legal and ethical issues involving the critically ill patient

Key learning objectives:

• Recognise the techniques to monitor organ function (arterial blood pressure, pulse oximetry, capnography 

• Identify the procedures to maintain the body temperature 

• Assess, recognise and treat shock 

• Develop a strategy for the treatment of shock 

• Develop your appreciation of the indications for the different types of fluid therapy with their advantages and disadvantages and the need for electrolyte supplementation

• Explain the need to monitor for complications during treatment and to record central venous pressure 

Key learning objectives:

• Recall sampling techniques, processing, storage,and data recording•
• Apply knowledge to using the microscope to examine blood smears, urinary sediment and basic cytology and be able to diagnose common acute conditions seen in general practice
• Assess haemostasis•Interpret clinical laboratory medicine information including haematology, biochemistry, electrolyte,and arterial and blood gas analyses
• Consider when transfusion should be considered
• Select appropriate blood products and protocols to minimise adverse outcomes
• Manage common conditions leading to haematological abnormalities requiring transfusion
• Define and explain the concept of massive transfusion
• Identify the diagnosis, pathophysiology,and treatment of acute traumatic coagulopathy

• Compare the advantages and disadvantages of sedation and anaesthesia 

• Approach to patient stabilisation prior to anaesthesia 

• Select an appropriate parenteral, inhalational or mixed anaesthetic regimes and appreciate their relative advantages and disadvantages 

• Recognise the main anaesthetic equipment and monitoring techniques, highlighting their advantages and disadvantages 

• Explore different analgesic techniques (NSAIDs, local anaesthetics, opioids and other analgesics) and when to use them in the emergency patient 

• Decide about the use of other drugs including neuromuscular blocking agents and sedatives in the emergency patient 

Key learning objectives:

• Describe how to perform a neurological examination 

• Select appropriate diagnostic tests and apply them to individual cases, including radiography and CSF analysis 

• Manage common neurological emergencies including head trauma, traumatic brain injury, MUO and seizures 

Key learning objectives:

• Triage poisoned patients, recalling the general principles of intoxication
• Recognise the clinical signs and management options fortoxicities caused byinsecticides, molluscicides, rodenticides, herbicides, household preparationsandplants
• Assess the prognosis of patients presented with the common poisonings

Key learning objectives:

• Apply diagnostic techniques including laboratory investigations and imaging to these cases 

• Investigate and manage common renal and urinary tract emergencies, namely urethral obstruction, ureteral obstruction and management of nonsurgical acute kidney injury  

• Recognise the principles of renal, ureteral, bladder and urethral surgery 

• Recall the steps to correctly perform a cystocentesis 

• Identify the limitations, principles of placement and maintenance of urinary catheters 

• Recall the normal reproductive physiology 

• Identify the physiological aspects involved in the conversion from foetal to neonatal circulation 

• Diagnose and establish a management plan for common reproductive and paediatric emergencies, namely C section, mastitis, pyometra and prostatitis 

• Diagnose and establish a management plan for common paediatric emergencies, including hypothermia, hypoglycaemia, failure in passive immunity and malnutrition 

Key learning objectives:

• Describe the cardiovascular assessment and management of patients presented with cardiovascular emergencies 

• Utilise and interpret a range of diagnostic techniques including ECGs, radiographs, echocardiographs, and laboratory data  

• Diagnose and manage acute canine congestive heart failure, feline cardiomyopathy, and aortic thromboembolism 

• Recognise and manage pericardial disease including pericardiocentesis 

• Identify and manage cardiac arrhythmias 

• Consider the predisposing factors likely to result in cardiac arrest, how this changes the approach to CPR and determining prognosis following CPR 

• Identify the various components of CPR (DABC) and their importance 

Key learning objectives:

• Detail the common metabolic conditions requiring urgent or emergency therapy 

• Recognise the impact of metabolic disturbances on the patient’s major body systems 

• Devise an approach to the diagnosis and management of common diseases including hypoadrenocorticism, DKA, thyroid storm and metabolic diseases related to hypoglycaemia  

• Appreciate the complications encountered during therapy, their prevention and management 

Key learning objectives:

• Recall the concepts and procedures involved in a general approach to dyspnoea  

• Triage and create a management plan for patients in respiratory distress 

• Utilise and interpret a range of diagnostic techniques for respiratory patients including auscultation, radiography, endoscopy and arterial blood gas analysis to localise the underlying cause 

• Appreciate the methods of oxygen delivery and be able to monitor the efficacy of treatment 

• Review the problems associated with oxygen delivery 

• Explain the techniques available for drainage of the pleural cavity 

Key learning objectives:

• Stabilise a patient prior to surgery, plan surgery and manage complications 

• Appreciate the indications for immediate surgical intervention 

• Define damage-controlled resuscitation and identify the cases where it applies 

• Recall surgical asepsis, theatre protocol and the rational use of anti-microbials in surgical patients 

• Approach the acute management of haemostasis, abdominal and respiratory trauma 

• Approach external soft tissue wounds, myocardial injury, and musculoskeletal trauma 

Key learning objectives:

• Interpret the practical findings of a physical examination 

• Formulate a diagnostic approach to common presentations of emergency conditions 

• Manage common emergency conditions 

• Approach the anaesthesia and analgesia of these species in emergency situations 

Key learning objectives:

• Describe how to perform a systematic ophthalmological examination 

• Recognise normal features and variants 

• Formulate a diagnostic approach to common presentations including the red eye, ocular pain, ocular discharge, blindness, proptosis and retinal detachment 

• Manage common ocular conditions including corneal ulceration, uveitis, and glaucoma 

• Identify ocular manifestations of systemic disease 

• Select ocular medications based on their therapeutical principles 

Key learning objectives:

• Approach the “acute abdomen” 

• Recognise common emergency conditions affecting the oesophagus, stomach, small intestine, large intestine, liver, and pancreas 

• Formulate a diagnostic plan, including the use of imaging modalities, and effective monitoring strategies for these cases 

• Select the appropriate surgical intervention 

• Assess acute malnutrition 

• Recognise the procedures to provide enteral, total parenteral and partial parenteral nutrition 

• Create a diagnostic and management plan to approach the refeeding syndrome  

Key Learning Objectives:

During this practical session you will have an opportunity to practise the following techniques: 

• CPCR 

• Feeding tubes placement  

• Arterial blood collection 

• Central venous catheter placement 

• Nasal cannula placement 

• Venous cut down 

• Tracheotomy and chest drain placement 

Key Learning Objectives:

During this practical session you will have an opportunity to practise the following techniques: 

• Emergency abdominal surgery including the approach to the acute abdomen and peritonitis, enterotomy and enterectomy 

• Gastric dilatation/ volvulus and gastropexies 

• Splenectomy 

• Perineal urethrostomy in the cat 

Key Learning Objectives:

• Recall the evolution of POCUS in veterinary medicine: from FAST to VetBlue protocol 

• Describe normal and abnormal images 

• Recognise pneumothorax, B lines (and their significance), shred sign and lung hepatisation 

• Review literature 

• Practical component: 

• The thorax 

• Review the different windows to perform a TFAST 

• Assess the pulmonary and cardiographic views 

• Recognise the glide sign, the curtain size and the caudal vena cava  

• Perform an approach to the heart considering La/ao view and ratio 

• The abdomen 

• Review the different windows to perform a AFAST 

• Interpret the scoring system