Transcript Tampa Bay Regional Disaster Symposium 2008

Small Animal Disaster Medicine:
Common Emergencies
Dr. Jo Ann Daniels
Central Pasco Veterinary Care
Director of Disaster Medicine
Suncoast Veterinary Association, PART
[email protected]
Common emergencies and how to
prepare for these at your practice
 Changes to plan ahead for.
 Tips to practice within these limitations.
 Common injuries and conditions.
 Supplies to pre-stock.
 Client and staff education to prevent these
emergencies.
 Re-open your practice as soon as possible.
Changes: Power Failure
 Radiographs
 Autoclave
 Surgical Monitors
 Laboratory Machines
 Air Conditioning
 Hot water/well pumps
 Refrigerators
 Rechargeable Equipment
 Generators
Changes: Power Failure
 Phone System
 Call your phone service provider
and “Call Forward” your practice
phone number to a cell phone.
 Purchase a hand crank rechargeable
lantern that has an outlet to plug
in your cell phone car charger.
($19.99 at Home Depot)
Changes: Limited Supplies
 Reordering of products
 Limited access by delivery drivers
 Limited storage of perishable supplies when power
fails
 Emergency care to patients may deplete supplies
quickly
 Be familiar with sampling programs from your
preventative care product representatives. Many have
programs for disaster aid.
Ocular
 Traumatic injuries
 Ulcers/erosion
 Foreign bodies
 Fight wounds
 Search and Rescue
 Herpes
 Allergies
Ocular
 Welch Allyn Ophthalmoscope/otoscope sets
 C-Cell converter for 3.5v power handles
- Part # 710168-501
- Remove the rechargeable module
and rechargeable battery; replace
with two c-cell batteries and the converter.
- $16.98 - $19.99
Welch Allyn also makes a “pocket” ophthalmoscope
Ocular Supplies
 Eye Wash
 Eye Stain
 Medicated Ointments
 Sterile Lube
 Eye Surgical Pack
 Ophtho suture material
 E-collars
Gastro-intestinal
 Foreign body ingestion
 Toxicities
 GI indiscretion
 Stress
 Diet Change
 Parasitism
 Viral and Bacterial
Your clients houses …
…and patients environments
Gastro-intestinal
 Client Education.
 Pre-stock of appropriate diet esp. prescription diets.
 Ingestion of debris during clean up process.
 Collapsable crates.
 Supportive and symptomatic care.
 Use precautions for contamination – Glove up !
 Drinking and eating sources.
 Deceased wildlife, contaminated drinking sources from
sewage, uncollected garbage piles, spoiled food
GI Supplies
 Dewormers
 Sucralfate
 Pepcid
 Metronizadole
 Albon
 Panacur Packets
 Caution with motility meds without radiographs
 Replacement Fluids – Normosol R
 Bland Diets - i/d, low residue
Integument
 Traumatic injury
 Lacerations
 Burns
 Impalements
 Fight wounds
 Infected wounds
 Necrotic lesions
 Allergies
 Parasitism
Integument Supplies
 Bandage materials
 Battery operated clippers
 Telfa pads
 Wound irrigation saline
 Penrose Drains
 Skin staplers
 Suture
 Lac-packs
 Antibiotics, analgesics, anti-inflammatories
Musculoskeletal
 Fractures
 Emaciation/dehydration
 Weakness
 Injuries from other animals
 Tendon/ligament tears
 Impalements
 Crushing Injuries
 HBC of roaming animals
Musculoskeletal supplies
 Splints
 Bandage supplies
 Surgery packs and suture
 Antibiotics
 Analgesics
 Anti-inflammatories
Other conditions
 Dehydration
 Hypoglycemia
 Non-regulated diabetes
 Addisonian crisis
 Heat stress and heat stroke
 Lost pets/found pets
 Pets with no identification
 Establish a plan for intake of pets
Diagnostics
 Battery powered glucometers
 Refractometer
 Urine Dipsticks
 Azo-Bun Sticks
 Jorgensen
 $27.00 for 25 pack
Diagnostics
 Heartworm Tests
 Idexx snaps can be removed from
the refrigerator and have a 90 day shelf life
 Felv/FIV Tests
 ACT Tubes
 Vet-Lab Supply 1-800-330-1522
100 pack for $65.00
Diagnostics
 Reference Laboratories – driver may have difficulty
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reaching your practice.
Air card and lap-top computer may allow access to on
line results if fax machine is out of order.
Disaster relief sites may have federal response VMAT
that have in house diagnostic machines.
If you have a generator, you may have enough power to
use a microscope for fecal and blood film examination.
Most centrifuges will work from generators for manual
HCT/TP, UA sedimentation and sample preparation.
Diagnostics
 Most X-ray machines draw too much power load to
work with a portable generator.
 Establish relationships with other practices in the
surrounding areas that may have power for in-house
diagnostic machines - Hematology and Chemistry – or
they may have a working radiology suite.
Surgical Injuries/ Monitoring
 Battery Powered Doppler
 One 9v battery
 New Jorgensen
 Refurbished Medfurbish
 F air canisters to attach to your
anesthetic machine, if your
powered scavenger systems
is not operational.
 Battery SPO2/HR Monitor.
Surgery
 Gloves, Disposable Gowns, Masks
 Battery Powered Clippers
 Individual Scrub Brushes
(BD E-Z Scrub 205 Iodine)
Merritt Vet Supplies
1-800-477-5167
Surgery
 Penrose Drains
 60 cc syringes and red rubber catheters for suction
 Chest tube set-up
 Lighting Source
 Battery powered loops
Surgery
 Lac-Packs
 Individually wrapped mini packs of instruments to save
major packs for abdominal surgeries.
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Olsen Hegar, Brown Adson, Towel clamps, Metzenbaums,
curved forceps, blade handle, 4 x 4’s
 Consider Hemoclips for efficient ligation and skin
staplers for efficient closure
 Rica Instruments via Merritt Veterinary Supplies
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Rep. Fred VanNorman 813-477-0955
Fluid Therapy
 Without IV Pumps.
 Replacement fluids.
 Dextrose fluids.
 Dial-up drip sets (5 ml/hr – 250 ml/hr Abbott $5.97)
 Create a chart for macro and micro drip sets in your
treatment area to indicate ml/hours rate conversions
to drops per ml.
 Irrigation saline.
Heat Stroke
Heat Stroke
 Client Education
 Encourage clients to purchase a rectal digital
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thermometer and demonstrate its proper use
Board pets until their houses are powered again
Collapsable crates with fan if clients have their own
generator at home
Discourage use of walled kennels that offer minimal air
circulation
Ask clients to evacuate early so they are not stuck in
long traffic jams with their pets in a hot car.
Blood products
 Animal Emergency of Pasco Blood Bank
 8740 US 19, Port Richey 727-841-6575
 Packed rbc’s, fresh frozen plasma, frozen plasma
 If you generator supports a mini-fridge/freezer, stock
plasma for heat stroke and snake bite victims
 Whole blood products for traumatic injury, Packed
Rbc’s also available for canine and feline patients.
 Have blood collection sets on hand.
 Blood typing cards from Rapid Vet do not need to be
refrigerated
Other Supplies
 Water, water and more water
 Cardboard Carriers – inexpensive and easy to store
 Jorgensen product
 J-133
 $95.00 for 20 pack
 ($4.75 each)
Other Supplies
 Keep the shipping coolers and ice packs that your
vaccines arrive in. They make great temporary
housing for vaccines and perishable medications and
products during brown outs.
 Spare scrubs for a quick change after examining a
contagious patient.
 Staff care items – non perishable snacks and drinks,
hand sanitizers, baby wipes for hygiene
 Extra biohazard boxes in case your pick up service is
unavailable.
Other Supplies
 Disposable sanitation supplies
 Kennel Pads
 Disposable paper food bowls/trays
 Less dishes to wash if your don’t have running water
 Jorgensen J-974
 Manual Can Opener
 Disposable water bowls
 J-975
 Extra leashes
Other Supplies
 Disposable litter boxes.
 Contractor Bags for debris collection.
 Shed supplies
 Plywood
 Chainsaw
 Tarp and nails to cover roof damage
 Duct tape
Record Keeping
 Paperless practice – need pink and blue hand written
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medical records.
All practices need pre-printed prescription labels so
directions can be hand written below hospital
information.
Patterson Office Supplies 1-800-637-1140 Item 073-2594
Treatment Flow Sheets
Stray and clients pets identification bands
Digital Camera
Record Keeping
 Off site information back up monthly service
 Portable external hard drive.
 Set on timer
 Automatic
 Daily
 Best Buy or Dell
 $100- $150
Finances
 Credit Card Machines
 Call merchant services company and order a manual
imprinter. ($22.00-$24.00)
 Utilize cell phones to
call in authorizations.
Finances
 Care Credit
Pre-print out care credit applications to phone in
authorization requests – you may not have access
to the web applications.
 Keep records of any products used and services
performed during disaster aid for your end of year
accounting.
Insurances
 Meet with your insurance agent
 Building damage
 Review your lease for your responsibilities
 Do you have wind insurance
 Contents Insurance
 Professional Overhead
 Short-term/ Long term disability
 General Liability
 Professional Liability and Animal Bailee
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www.avmaplit.com
Hospital Policies
 Create a Severe Weather Guidelines chapter to your
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employee manual. Have each member of your staff
read and sign these policies.
Create a flexible schedule so staff can rotate duties to
allow time for them to get home for their own pets.
Discuss job responsibilities with staff for before,
during and after disaster events.
Do not offer boarding to clients if you are in an
evacuation or flood zone.
Choose one media representative from your practice.
Use caution with interviews.
Staff Education
 Schedule a staff meeting
to go over disaster guidelines
and client education.
 Provide staff with resources
 brochures
 phone lists
 website addresses
 www.hsus.org
 $20.00 for 100 pack
Staff Education
 Educate staff of universal precautions and for isolation
protocols.
 Prevent contamination of your hospital by limiting
one staff member to interact with isolated patients
during a shift.
Client Education
 Post disaster preparedness
guidelines on your website.
 For an example, visit
www.CentralPascoVetCare.com
please cut and paste any
portion of this guide.
Client Education
 Ask clients if they live in an evacuation zone
 Familiarize your clients with your boarding policies.
 Brochures and practice handouts.
 List of pet-friendly hotels in the area.
 www.petfriendlytravel.com
 Get involved in your community.
 Write an article for your local paper.
 Offer first aid classes at your practice.
Client Education
 Discuss proper identification for all pets
 Scan all patients on very visit to assess microchip
function, inquire if registration is current and
demonstrate to clients what we would look for if their
pet was micro-chipped and lost.
Res Q Universal Scanner
Bayer 1-800-633-3796
$200.00
Client Education
 Collars on all pets
 ID tags on all pets
 Include name,
 Address
 phone numbers
 alternate contact number
Reopen as soon as it is safe to
 Follow local emergency service coordinators directions
for safe return to the practice.
 GPS Coordinates of your practice forwarded to the
FVMA and AVMA – street signs are gone
 Go to http://maps.google.com/
 Type in your practice address, city, state and zip
 Right click over your exact location and scroll down to
‘center map here.’ Coordinates will appear in location
box.
Resources
 Attend your local VMA and regional FVMA meetings
to introduce yourself to fellow veterinarians and
establish a network of resources.
 Discuss disaster plans with other hospital owners and
managers to see if resources can be consolidated.
 Know the emergency hospital policies in your area so
you can educate your clients accordingly.
 The American Veterinary Medical Foundation accepts
applications for disaster relief funding.
Disaster Relief Sites
Dr. Jo Ann Daniels
Central Pasco Veterinary Care
17945 State Road 54
Lutz, FL 33558
813-926-1126
[email protected]