Week 1

Transfusion Medicine

This week we will look at indications for packed red cell and whole blood transfusions, in both cats and dogs, in the acute emergency setting.  The nurse’s role is vital in this field, including preparing the recipient, blood typing, cross matching and monitoring the recipient.  We will cover common reasons for transfusion and patient specific nursing concerns, as well as indications for auto transfusion and xenotransfusion.   Common coagulopathies will also be discussed, along with indications for the use of plasma products in small animal patients.

Learning objectives
After completion of this week, participants should be able to:

Select the correct blood product for the individual patient

Understand the monitoring these patients require and patient specific concerns

Explain the different transfusion reactions that can occur and how they are avoided and treated

List the indications for auto transfusion and xenotransfusion

Describe the main coagulopathies we encounter and the treatment options available

Week 2

Acute Kidney Injury

Acute kidney injury is a relatively common presentation in emergency and critical care, however, it can occur for a variety of reasons.  This week will look at the conditions that lead to acute kidney injury and how we reach that diagnosis.  We will look at treatment options including reviews of the evidence bases in terms of patients that are anuric. The nursing role in these patients is multi- faceted and it is vital we can monitor and nurse these patients effectively.

Learning objectives
After completion of this week, participants should be able to:

Understand the different reasons that AKI develops, including post-surgery, toxin related and obstruction of the urinary tract

Understand the monitoring and nursing requirements of these patients including fluid therapy, acid-base status and how we recognize when they are deteriorating

Explain how we manage anuric patients including evidence reviews of methods to force diuresis

Understand the basics of peritoneal and haemodialysis for these patients and the indications

Week 3

Diabetic Ketoacidosis

DKA is a complex disorder that can be life threatening for our patients, and the nursing team play a large role in the management and recovery of these patients. There are multiple considerations in nursing a patient with DKA that go well beyond administering insulin. We will review common reasons for a patient to develop this endocrine disorder as well as acid- base and electrolyte abnormalities we may see.

These patients need intensive monitoring including repeated blood work so we will discuss how to minimize the impact of this on their welfare. There will also be discussion on the different approaches to administration of insulin and ongoing management of these cases when they are discharged home.

Learning objectives
After completion of this week, participants should be able to:

Recognise the concurrent conditions that may lead to difficulty stabilizing the DKA patient

Understand how we reach the diagnosis and the treatment priorities for these patients

Understand the different approaches to insulin administration as well as the pros and cons of each method

Explain how to prioritise appropriate monitoring for these patients

Week 4

Acute Pancreatitis

The pancreatitis patient is a common presentation to any practice. It is an inflammatory condition that can be classed from mild to severe.  We will focus on the nursing care and assessment of the patients requiring hospitalisation for management.  Whilst we often consider these patients as just needing a couple of days of supportive care, there are some serious complications that can occur and contribute to mortality.

Learning objectives
After completion of this week, participants should be able to:

Understand common aetiologies in dogs and cats

Review pain management options including drug types and routes of administration

Discuss nutritional support options

Identify complications including development of SIRS

Week 5

Acute Respiratory Distress

These patients present many challenges to us in practice and need some special consideration in terms of monitoring and nursing care.  We will look at recognition of the patient in respiratory distress, the potential causes, and our priorities for treatment.  We will review the monitoring tools that may be beneficial and our approach to stabilising these patients.

Learning objectives
After completion of this week, participants should be able to:

Prioritise stabilisation techniques based on patient presentation

Determine which method of oxygen supplementation is most appropriate for specific patients

Appreciate the management of patients in brachycephalic crisis

Understand the different approaches to diagnostics and monitoring for these very fragile patients

Week 6

Addisonian Crisis

Known as the “great pretender”, Addison’s disease leads to a potentially life-threatening situation when the patient goes into crisis.  Whilst electrolyte abnormalities are present in a typical Addisonian we can see no electrolyte changes in atypical cases.  The patient with an Addison’s crisis has multiple abnormalities which we need to monitor and correct.  Consideration of management options for these patients as well as resolving the crisis will all be discussed.

Learning objectives
After completion of this week, participants should be able to:

Understand the aetiology, common clinical signs, and effects of this complex disorder

Identify and differentiate a patient that has Addison’s disease, with a patient in an Addisonian crisis

Understand the nursing considerations for these patients in the hospital environment, and appreciate the impact stress hormones have

Identify priorities for treatment and ongoing management