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Emergency and Critical Care

Emergency and Critical Care

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Published by: taner_soysuren on Dec 07, 2009
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05/29/2010

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Compendium 
May 199920TH ANNIVERSARYSmall Animal/Exotics
Highlights and Horizons in
E
mergency and critical care medicine isone of the most dynamic and rapidly developing specialties in veterinary medicine today. Although it is a relatively new field compared with other veteri-nary specialties, initial interest in this area dates back to the 1950s.
The Early Years
The first presentation on veterinary critical care was given in 1954 by Dr.Fred Sattler during the annual American Animal Hospital Association meetingin Miami, Florida. The topic was cardiopulmonary resuscitation (CPR), andthere were 15 participants in attendance. I have been told that the presentation was rather dramatic, with a demonstration of CPR on a dog. To place this intoperspective, the current recommendations for human CPR were not even inplace at that time. In fact, Dr. Peter Safar’s landmark paper, “Ventilatory efficacy of mouth-to-mouth artificial respiration,” would not be published in the
 Journal of the American Medical Association 
until 1958,the same year in which mouth-to-mouth respiratory resuscitation was first endorsed by the American Medical Association. Chest compressions for artificial circulation first saved a human lifein 1959, and the first presentation on human CPR as we know it today did notoccur until 1960
6 years
after 
Dr. Sattler
s demonstration!Some consider Dr. Sattler the father of modern veterinary critical care. He re-portedly had a great interest in electronics, which provided a solid backgroundfor him to develop and use technology in veterinary critical care. He evidently flew his own airplane loaded with
gadgets, catheters, monitors, and ventilators
all over the United States and Canada and
preached
veterinary critical care to
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20th 
ANNIVERSARY 
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Ken Drobatz, DVM, Diplomate ACVIM, ACVECC 
 Associate Professor, Critical Care University of Pennsylvania Philadelphia, Pennsylvania 
Early 1970s
Specific resources are allocated for defined emergency/critical care services in teaching hospitals.
1984
The VCCS and American  Association of  Veterinary Emergency Clinicians merge to  form the Veterinary Emergency and Critical Care Society (VECCS).
1988
The first International Veterinary Emergency and Critical Care Symposium is held in San Antonio, Texas.
Ken Drobatz
anyone who would listen.The first extensive patient-side mea-surementsof vital signsin veterinary medicine were done in 1957, and thefirst all-day surgery was performed in1962.
1
In this surgery, one veterinari-an and three staff members were working on the animal at all times.Monitoring was intense and continu-
Medicine 
Emergency&CriticalCare 
1983
The American Society of Veterinary  Anesthesiologists merges with the Veterinary Critical Care Society (VCCS).
 
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Small Animal/Exotics20TH ANNIVERSARY
Compendium 
May 1999
ous and included electrocardiogra-phy, temperature, arterial and ve-nous pressures, pH, carbon dioxidepartial pressure, and respiratory rateand volume; all of these measure-ments were recorded on a strip chart. Another significant event in theevolution of critical care was the allo-cation of specific resources towarddefined emergency/critical care ser-vices in teaching hospitals and itsemergence as a clinical rotation forstudents and veterinarians.
2
ColoradoState University, the University of Pennsylvania, the Animal MedicalCenter (New York City), and AngellMemorial AnimalHospital(Boston) were the first facilities to have dedi-cated intensive care units in the early 1970s.
Organization
 Although veterinary critical care was initially promoted by a smallgroup of individuals (Fred Sattler, William Whittick, Ira Zaslow,Robert Knowles), its acceptance intomainstream veterinary medicine didnot really begin until individuals in-terested in the field began organiz-ing. One of the first recognizedgroups to develop was the Veterinary Critical Care Society (VCCS), whichestablished its bylaws in 1978. The American Society of Veterinary Anes-thesiologists,established in 1970,merged with the VCCS in 1983.The most pivotal year in the con-tinued development of veterinary critical care medicine was 1984, theyear the Veterinary Emergency andCritical Care Society (VECCS) wasformed through the merger of theVCCS and American Association of Veterinary Emergency Clinicians. TheVECCS contained approximately 200 members at that point; 2 yearslater, there were 500 members. In1988, the first International Veteri-nary Emergency and Critical CareSymposium was held by the VECCSin San Antonio, Texas. This sympo-sium has become a biannual event, with nearly 2000 people participat-ing in1998.In 1990, the American College of Veterinary Emergency and CriticalCare (ACVECC) was given proba-tional status by the American BoardofVeterinary Specialties; there were19 charter diplomates. Full status asa specialty college was granted by the American Veterinary Medical Associ-ation in 1996. More than 60 veteri-narians are currently board-certifiedin veterinary emergency and criticalcare. The VECCS has sponsored thedevelopment of the Student Veteri-nary Emergency and Critical CareSociety (SVECCS) as well as the Academy of Veterinary Emergency and Critical Care Technicians(AVECCT), which held its firstqualifying examinations in late 1998.In addition, the VECCS and ACVECC work together to publishthe
 Journal of Veterinary Emergency and Critical Care 
, which is dedicatedto furthering the science of veteri-nary emergency and critical care.It is the organization of those in-terested in the specialty that hasbrought critical care to the forefrontof veterinary medicine and that, inmy opinion, has been the single mostimportant development in the field.The development of VECCS and itsextensive membership (now morethan 1700) has provided a frame- work for involvement in the specialty on all levels
from students to tech-nicians to veterinarians. Unlike hu-
s
Population Explosion! 
Pet owners
demands for quality emergency care for their animals haveskyrocketed since 1979. In the past20 years, the number of veterinary emergency clinics has grown fromperhaps a dozen in a few majorcities to more than 400 nationwide.
s
 A Star is Born.
The public
s growinginterest in veterinary emergency medicine is evident just by turningon the television. Critical carepractitioners are becoming TV 
snewest celebrities as their professionis highlighted in such popular cableseries as
Emergency Vets
and
 Wildlife Emergency 
on the Animal Planet network and indocumentaries, such as
 AnimalER,
which aired on the TBSSuperstation in November 1998 and was the highest rated documentary of that week on basic cable.
s
Insuring a Healthy Future.
Theimportance of emergency careto pet owners is also exemplifiedin the success of such companies asVeterinary Pet Insurance. Realizingthe importance of being able toprovide emergency (and routine)health care for their pets
butunable to foot the often pricey billsinvolved
owners are turning toVeterinary Pet Insurance for help.Founded in 1982, the company currently markets pet healthinsurance plans in 46 states plus theDistrict of Columbia, and morethan 750,000 policies have beensold to date.
Information obtained from the onlinetranscript of the March 29, 1999 editionof the ABC news show
20/20.
1990
The American College of Veterinary Emergency and Critical Care (ACVECC) is given  probational status by the American Veterinary Medical  Association (AVMA).
1996
The ACVECC is  granted full status as a specialty college by the AVMA.
1994
The Student Veterinary Emergency and Critical Care Society is formed (SVECCS).
1996
The Academy of Veterinary Emergency and Critical Care Technicians (AVECCT) is officially recognized as a technician specialty by the North American Veterinary Technician Association.
OWNERS’ OUTLOOK
1991
The 
 Journal of theVeterinary Emergency and Critical CareSociety 
is published (initially published in the 1970s as the 
 Journal of Critical Care
on a sporadic basis).

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