Approach to the Emergency Patient

In veterinary practice, we often see neurological emergencies. These can include seizuring patients, traumatic brain injury, tetanus or

Patients who have suffered a TBI may be at risk of seizures or increased .  It is important for any patient presenting after trauma to be assessed and administered decent analgesia as a first port of call

If a patient is seizuring, one of the first drugs to be administered is . This is an benzodiazepine and acts on the receptors in the brain, increasing chloride uptake and inducing CNS depression. Another antiepileptic drug (AED) we use is .

If a patient continues to seizure and is unresponsive to AEDs, we may administer propofol in order to safety nurse the patient until the AEDs start to work. By anaesthetising the patient, we can secure their , ensure they are ventilating appropriately and better manage their and recumbency.

Patient’s who have presented obtunded or stuporous may be at risk of raised ICP. It is important to monitor these patients carefully, including their heart rate and . Sometimes in order to compensate for the raised ICP, we see a with a hypertension. When the patient responds in this way, we call this Cushing’s

Patients with tetanus are often characterised by their tense facial muscles, often called a ‘sardonic grin’ or ‘ ’. Tetanic patients often present because they are having trouble eating or are perceived to be becoming stiff. Treatment of these patients may or may not include administration of the , but this is clinician and case dependant.

A patient presenting to the hospital with any suspicion of a fall from height or trauma must be immediately secured to a board to protect their spine.

Nursing of these patients can be very difficult due to the of recumbent patients and the sometimes severe and upsetting conditions they may be in; however it is because of the nature of the cases that they can also be the most rewarding cases to see through.