C-VA.3 Critical Care and Analgesia

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About the course

LEARNING OUTCOMES

This module will explore in greater detail the fundamental physiological and pharmacological tenets that underpin current knowledge and clinical practice of pain prevention and management.  This module will also entail a study of the theoretical and practical aspects of the intensive peri-operative care of small animals.  This will require a good understanding of the applied physiology of body fluids and electrolytes and acid base balance.  The ability to assess and treat appropriately fluid and electrolyte and acid base disturbances as well as and understanding and management of blood transfusion in animals.

Candidates must be able to demonstrate that they have had experience of peri-operative care of critically ill patients in the range of species normally encountered in clinical practice.  A general knowledge of current developments in the whole field of critical care will be expected so that relevant aspects of medical peri-operative care may be applied in animals.  Candidates should understand the function of apparatus used in intensive care.

At the end of the module, candidates should be able to:

  • Provide appropriate care for the sick and or debilitated patient, including support / maintenance of normal homeostasis.
  • Understand the fundamental and applied physiological principles that underpin current knowledge of the cardiovascular, respiratory and renal systems, as they apply to the management of critically ill patients.
  • Understand the fundamental and applied physiological principles that underpin current knowledge of body fluids, electrolytes and acid base balance.  Clinical practice of intensive peri-operative care - this will include a thorough understanding of the principles of respiratory and cardiovascular system support.
  • Competently assess and treat appropriately fluid and electrolyte and acid base disturbances.  Understand the fluid compartments in the body, factors controlling fluid shifts within the body, the different types of replacement fluids available and how to calculate fluid and electrolyte replacement requirements.
  • Understand the theory and practical aspects of managing blood transfusion in small animals.
  • Understand the theory and practical aspects of providing nutritional support to critically ill patients, including the use of parenteral and enteral feeding techniques, nutritional formulations, calculation of caloric and substrate requirements, and methods of controlling vomiting and ileus.
  • Understand the fundamental physiological and pharmacological tenets that underpin current knowledge and clinical practice of pain prevention and management.
  • Demonstrate knowledge of current developments in the field of pain perception and analgesia.
  • Demonstrate practical competence and experience of managing acute peri-operative and more chronic pain in the range of species normally encountered in their clinical practice.
  • Demonstrate familiarity with commonly performed regional nerve blocks as used to provide analgesia pre and postoperatively.
  • Understand the functional characteristics of anaesthetic breathing systems (“circuits”) and how they may be used for intensive care of unconscious small animal patients.
  • Appreciate the advantages and disadvantages of intermittent positive pressure ventilation, and how this may be delivered to support critically ill small animal patients.
  • Demonstrate a good general knowledge of the use of use of tracheostomy tubes and thoracic drains
  • Appreciate how electronic monitoring systems may be used to monitor vital functions in sick animals, and be able to interpret the information they provide.
  • Demonstrate understanding and experience of the management of sepsis and nosocomial infections in the context of critical care.
  • Demonstrate a good general knowledge of the principles of physiotherapy: and the nursing care of recumbent and debilitated patients including postural management, rehabilitation techniques and the maintenance of muscle tone.
  • Demonstrate experience of peri-operative care of critically ill patients in the range of species normally encountered in clinical practice.
  • Utilise their understanding of Evidence Based Medicine and Decision Analysis to develop practical diagnostic and treatment protocols for their patients.
  • Utilising knowledge to ensure effective communication with referring veterinary colleagues: writing clear, concise patient summaries, communicating suggestions for ongoing therapy and strategies for avoiding misunderstandings.
  • Review the outcomes of at least part of their clinical work, using the process of clinical audit to improve performance.
  • Recognise when a case is truly unusual, and become familiar with the information resources available to enable them to deal with such cases.
  • Recognise when a case is beyond their personal or practice capabilities, and provide an effective channel for referral.

 

Tutors

Karen Humm, MA VetMB MSc CertVA DipACVECC DipECVECC FHEA MRCVS 
Senior Lecturer in Emergency and Critical Care 
The Royal Veterinary College 

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