Course Summary

Head trauma can be a daunting emergency to be faced with, however being prepared for the patient’s arrival and the monitoring required and knowing exactly what the clinical signs mean can make these cases extremely rewarding for the veterinary nurse. This 30 minute eCPD tutorial aims to give the veterinary nurse confidence for triaging and caring for these patients, including performing the modified Glasgow Coma Scale.

Course Tutor

Sam Bell BSc Cert VNECC RVN
Neurology Specialist Nurse, Cambridge Vet School

Course Length

The course is worth 30 minutes of CPD for UK delegates and 0.5 AVNAT points  for Australian and New Zealand delegates

The course is provided with unlimited lifetime access for on-demand learning

Course Notes

Unfortunately, course notes are not available with this tutorial

Module 1

Rabbit Handling and Anaesthesia

How do rabbits differ from other mammals we see in practice?

How can we accommodate their needs?

How can we improve their safety under anaesthesia?

Module 2

Ferret Handling and Anaesthesia

A nursing approach to care of the ferret in veterinary practice

How do ferrets differ from other small mammals we treat?

What anaesthetic considerations do we need to factor in?

Module 3

Small Rodent Handling and Anaesthesia

Minimising stress and appropriate handling for small mammals and rodents

Anaesthetic considerations

Post operative and peri operative care

Module 4

Small Mammal Emergencies

How to recognise emergencies in small mammal species

Triage and CPCR in small mammals

Common conditions and emergency presentations

Course Tutor

Tawny Kershaw BSc (Hons), RVN, DipVNZS, AFHEA
Swift Veterinary Referrals

Course Length

The course is worth 8 hours of CPD for UK delegates and 8 AVNAT points  for Australian and New Zealand delegates

The course is provided with unlimited lifetime access for on-demand learning

Course Summary

Lactate is a common laboratory parameter that is measured in the emergency patient. Have you ever wondered what it is and where it comes from? In this lecture In this eCPD case study we have a 12 minute tutorial, where we will discuss just that, along with how to treat it and why it matters. There is also a case based scenario quiz to test your knowledge and further reading articles.

The course involves a short eCPD tutorial, a quiz and further reading articles.

Course Tutor

Maddie Enderby ISFMDipFN CertVNECC FdSc RVN
ICU Nurse, Paragon Veterinary Referrals

Course Length

The course is worth 60 minutes of CPD for UK delegates and 1 AVNAT point  for Australian and New Zealand delegates

The course is provided with unlimited lifetime access for on-demand learning

Week 1

Mammary Tumours

Mammary tumours are a common tumour in cats which are often malignant, yet a small percentage are benign. Early detection and intervention can have a positive outcome and some patients go on to live disease-free lives, others require continuous treatment and monitoring.

Presentation and behaviour of mammary tumours

Diagnosis and staging

Treatment modalities and monitoring considerations

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

Explain the potential causes of mammary tumours in cats

List what investigative procedures may be necessary to secure a diagnosis and what safety factors should be observed when sampling masses

Understand which treatment modalities are most useful for which form of the disease

Describe the patient and client care considerations when managing cases of feline mammary tumours

Week 2

Lymphoma

Lymphoma is a cancer of the lymphocytes and/or lymphoid tissue, which is present in many locations within the body; presentation and treatment of these cases is dependant on location. This week we will cover:

Manifestation of feline lymphoma and categories of disease

Diagnosis, staging and prognostic indicators

Treatment options for feline lymphoma

Chemotherapy protocols, client expectations and how to create a feline friendly environment

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

List the common manifestations of feline lymphoma and the patient groups most affected

Understand the value of staging and monitoring the disease

Describe the subtypes of feline lymphoma and the difference in treatment approaches

Explain the rationale of a multimodal chemotherapy protocol and how it may impact on prognosis

Analyse personal skill set and determine how you could support feline patients with lymphoma using your practice facilities

Week 3

Squamous Cell Carcinoma

Squamous cell carcinoma is the most common form of head and mouth cancer in cats; the behaviour of this neoplasm is sometimes unpredictable and can be very invasive. On week three we discuss the presentation, investigation and treatment options available for these patients and look at some practices which are novel to veterinary medicine.

Presentation, diagnosis and staging of squamous cell carcinoma, including lymph node mapping

Treatment options and impact on prognosis

Surgical interventions, nursing support and rehabilitation

Introduction to electrochemotherapy and photodynamic therapy

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

Describe the different imaging techniques used to evaluate feline squamous cell carcinoma

List treatment options and prognostic indicators for feline squamous cell carcinoma

Understand the mechanism of action behind novel techniques for feline squamous cell carcinoma

Describe the common surgical interventions and post-operative patient considerations

Week 4

Soft Tissue Sarcoma

Feline injection site sarcoma (FISS) is one of the most common soft tissue sarcomas of cats. The disease may present as a minor mass to the owner but often this is just the tip of the iceberg. Week 4 looks at FISS in more detail and brings the courses learning materials all together in this last week

Soft tissue sarcoma pathophysiology overview

Diagnostic and staging processes

Treatment options, radiation and surgical management

Adjuvant (post-operative) chemotherapy and restaging

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

Describe the diagnostic approach to determining cancer diagnosis and tumour burden

Explain typical neoplastic behaviour of FISS and the impact of intervention on survival time

Understand the fundamental reasoning for adjuvant chemotherapy and the options for post-operative care

Week 1

The Orthopaedic Trauma Patient

Presentation

Triaging wounds

Initial wound management

Open fracture management

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

Prepare equipment for initial stabilisation of the trauma patient

Select dressings and materials for initial wound management

Understand the grading system for open fractures and how this affects management of these cases

Prepare all necessary items for treatment of open fractures

Week 2

Preparing the Patient for Surgery

Clipping and preparing the patient

Orthopaedic theatre nursing

Theatre set up

Instrumentation

Scrub nurse role

Cleaning and sterilising

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

Create an appropriate surgery schedule

Identify common orthopaedic surgical instruments and their use

Prepare and confidently check the theatre set up for a range of procedures, including equipment

Have a full understanding of orthopaedic equipment and how to care for it correctly

Understand the benefits a scrub nurse provides to the surgeon, the patient and the surgical procedure

Week 3

Orthopaedic Procedures – So Many to Choose From!

Surgery

Arthroscopy

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

Understand the options available for common orthopaedic conditions

Create a case study for a patient they have been involved in the nursing care of

Identify common surgical equipment, its use and how to prepare for surgery

Week 4

Fracture Repair – Internal Fixation

Fracture classification

Implants and consumables

Surgical instruments and equipment

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

Identify common surgical implants used in fracture repair

Understand how the method of repair used will impact on the care required for the patient post-operatively

Week 5

Fracture Repair – External Fixation

Implants and consumables

Surgical instruments and equipment

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

Identify common surgical implants used for external fracture repair

Understand the instructions required by owners for the ongoing care and management of patients with external fixators

Week 6

Recovery and the Post-Operative Period

Recovery from anaesthesia

Immediate therapy

Ongoing nursing care plans

Surgical complications

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

Create nursing care plans for post-operative surgical patients

Develop the team role for nurses in the rehabilitation of orthopaedic patients

Understand the key responsibilities for client communication and post-operative care

Identify common complications and how to ensure owners understand the potential consequences

Week 1

Recumbency Nursing

Common causes for recumbency

Nursing the recumbent patient

Common complications associated with recumbency

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

List some of the common causes for recumbency and how these conditions may be treated

Discuss the nursing considerations for the recumbent patient and how these can be implemented to help support the patient during their recovery whilst hospitalised

Describe the common complications associated with recumbency and how these can be prevented whilst the patient is hospitalised

Week 2

Nutrition in the Hospitalised Patient

Why is nutrition important?

Who needs nutrition?

When should nutrition be started?

Creating a nutrition plan

Assisted feeding options

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

Understand why nutrition is important for the recovery of hospitalised patients

Identify patients in needs of nutrition

Discuss when is the appropriate time to start nutrition in their hospitalised patient

Describe how to create a feeding plan including patient assessment, calculation of RER and implementation of the nutritional plan

List the common assisted feeding techniques and understand the indications and contraindications of each

Week 3

Sepsis

What is SIRS / sepsis?

How to recognise sepsis in dogs

How to recognise sepsis in cats

Sepsis bundles

Recent sepsis research in human medicine

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

Know the definitions of SIRS / sepsis and the difference between them

List the patient observations used to help us be able to recognise sepsis in the dog

List the patient observations used to help us be able to recognise sepsis in the cat

Understand what a sepsis bundle is, and when they can be used in practice

Understand the recent research into sepsis in human medicine and how this impacts us in veterinary practice

Week 4

Acid Base / Electrolytes

What is acid / base?

What are electrolytes?

Electrolytes – Sodium

Electrolytes – Potassium

Electrolytes – Calcium

Glucose

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

Explain acid / base status

Understand which electrolytes we can measure in veterinary practice and why

Identify when a patient may become hypo or hypernatraemic, and describe the treatments that may benefit them

Identify when a patient may become hypo or hyperkalaemic, and describe the treatments that may benefit them

Identify why a patient may be hypo or hypercalcaemic, and describe the treatments that may benefit them

Identify why a patient may be hypo or hyper glycaemic, and describe the treatments that may benefit them

Week 5

Infection Control

How to create an infection control plan for the clinic

Assigning an infection control champion

Identify and develop protocols

Make an assessment

Staff education and training plans

Surveillance and compliance

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

Identify an infection control champion in practice and understand their role in the infection control plan

Discuss the common infection control protocols required in practice to minimise the spread of pathogens

Understand how to make an assessment of the protocols already in place and identify their strengths and weaknesses

Explain the importance of staff education and training when implementing infection control protocols

List the common surveillance techniques to ensure compliance to the infection control plan

Week 6

End of Life Care and Clinical Governance

Euthanasia

Palliative care

Mental health awareness

Clinical governance in practice

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

Understand the reasons vets and clients consider euthanasia, and learn ways to ensure the experience can be made as peaceful and calm as possible in practice for all involved

Understand the reasons that clients may choose to consider palliative care, and how we can help ensure the patients are comfortable within our role as veterinary nurses

Understand the impact of euthanasia and how the death of a pet can affect both the family of the patient and the veterinary staff involved

Understand the mental health implications of veterinary medicine on the team, and ways in which we can help our team and ourselves to cope

Describe what clinical governance is, what is discussed and why it may be beneficial to start holding these meetings in your practice

Week 1

What are we Monitoring and Why?

What anaesthesia does to the patient and what we can do about it

Monitoring depth of anaesthesia

Temperature monitoring

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

Understand why good monitoring is essential for safe anaesthesia

Understand the challenges of monitoring depth of anaesthesia

Appreciate the importance of monitoring body temperature and the consequences of hypo- and hyperthermia

Week 2

Monitoring the Respiratory System

Capnography

Pulse oximetry

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

Understand the physiology involved in the formation of the capnograph trace

Interpret normal and abnormal capnograph traces

Understand the physiology behind pulse oximetry, and its limitations

Confidently troubleshoot abnormal capnography traces and pulse-oximetry readings

Week 3

Monitoring the Cardiovascular System

Physiology of heart rate and blood pressure control

The electrocardiogram

Blood pressure monitoring

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

Understand the causes of heart rate and blood pressure changes during anaesthesia

Describe how the electrocardiogram is generated

Interpret the electrocardiogram

Understand the different techniques for measuring blood pressure

Interpret blood pressure readings and understand causes of inaccurate readings

Week 4

Monitoring with Blood Work and Troubleshooting Equipment

Blood gas and acid-base

Glucose monitoring and other tests

Monitor-related artefacts and technical problems

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

Understand when blood gas analysis is useful

Interpret blood gas analyses in the light of the patient’s history and clinical problems

Decide when glucose monitoring and other tests during anaesthesia are important

Troubleshoot monitor-related issues

Week 1

Broodmares:  Dystocia, Caesarean and Post-op Care

Define dystocia and recognise the stages of labour

Maternal causes of dystocia

Surgical and non-surgical interventions

Post-operative care of the mare

Post op complications and preventative measures

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

Know the definition of dystocia and be able to recognise the stages of labour

Understand the causes that can be attributed to the broodmare regarding disease status and/or anatomy

Understand when emergency treatment is required and what forms of intervention are recommended

Understand what critical care treatment and monitoring is needed to assist the mare in recovery

Week 2

Neonates:  Post Dystocia Resuscitation and Intensive Care Nursing

Foetal causes of dystocia

Emergency monitoring and treatment of the foetus in utero

Post dystocia neonatal resuscitation

Follow up intensive care nursing

 Emerging therapies for the post dystocia neonate

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

Know the foetal causes of dystocia and understand how they occur

Understand how foetal monitoring and treatments can help neonatal survival rates

Describe the resuscitation techniques used to revive foals

Become familiar with neonatal critical care techniques

Week 3

Colic:  The Nurse’s Role in the Assessment Workup

Diagnostic procedures

Laboratory analysis

Differential diagnosis – surgical or medical treatment?

When colic is not an intestinal condition

Preparing the patient for an exploratory laparotomy

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

Recognise the signs of colic and the reasons they occur

Understand the techniques the nurse can perform to assist in a diagnosis

Understand how to perform laboratory tests for colic patients

Understand what tasks are carried out to prepare the patient for surgery

Week 4

Colic:  Emergency Surgery and Post-op Care

Preparation of the patient in theatre

Anaesthetic risks in the seriously ill colic patient

Common surgical conditions of the small and large intestine

The immediate recovery period following colic surgery

Post op critical care nursing

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

Recognise how to prepare a colic patient in the theatre

List the common intestinal conditions that require surgical correction

Understand the steps required to safely recover a patient from colic surgery

Recognise how nurses provide intensive care to the post op colic patient

Week 1

From Conception to Weaning

Parent health prior to conception and how this may affect pregnancy, parturition, and offspring

Nutritional requirements during pregnancy

Nutritional adaptations required during lactation

Neonate nutritional requirements, including how to hand feed effectively

Weaning

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

Discuss how nutrition affects reproduction and key adaptations that are required

Have a clear understanding of how to promote health through nutrition during lactation

Identify the essential nutritional requirements for neonates

Understand how to hand feed neonates correctly

Week 2

Growth

Optimal growth

Effects of neutering

Nutritional considerations for large breed puppies

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

Correctly use growth charts to map growth

Identify when growth is not ideal and the necessary changes that are required to maintain a healthy weight to adulthood

Have a good understanding of the nutritional adaptations that will be required at the point of neutering

Week 3

Adult Maintenance

Promoting health in adults

Maintaining a stable weight

Treat management

Recognise key aspects of feeding working dogs

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

Understand nutritional requirements for adults and how these must be adapted for each pet’s circumstance

Identify points of concern and to make appropriate recommendations

Reflect on how nutritional requirement for working dog may differ from pet dogs

Week 4

Golden Oldies – Senior Pets

Defining ‘senior’ age as an individual process

Understanding age related changes and how these require nutritional adaptation

Environmental considerations for pets in their senior years

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

Confidently assess the needs of a senior pet

Identify environmental changes that may be required

Understanding of the dynamic changes to nutrition that are required for seniors to better support the pet and pet owner

Week 5

Diet Choices

Examination of the pet food label

Introduction to alternative diet types and how to have conversations with pet owners

How to manage pets fed an alternative diet within a hospital environment

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

Identify all key information on a pet food label and how this is used to determine a feeding amount

Have a broad understanding of the pros and cons associated with alternative diets that are now commonly fed

Appreciate methods for assessing the suitability of alternative diets and how to improve safety

Confidently talk to the pet owner who wish to feed an alternative diet type

Week 6

Maintaining an Ideal Weight

Assess ideal weight through body condition scoring and muscle condition scoring

Simple steps to ensure obesity does not occur, and what can help if it does

How to calculate a feeding quantity of dry, wet or mixed diet types

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

Confidently be able to body condition score and muscle condition score to identify an ideal weight and good health

Understand how simple food management in the home can prevent obesity occurring

Thoroughly understand calculations for determining a feeding amount to prevent over, or under feeding

Week 1

Dentistry Analgesia

Different analgesia drugs available

Dose selection

Routes of administration

Drug combinations

Local nerve blocks

Sides effects of drugs

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

Assist the veterinary surgeon in selecting appropriate analgesic drugs for different oral surgeries

Be aware of potential side effects of these drugs

Alongside the veterinary surgeon, create a tailored drug protocol for each patient to go home with

Comfortably calculate analgesic drugs at low doses

Be aware of what drugs are suitable as a combination

Understand the exclusion or reduced dose of some drugs, regarding co-morbidities

Use pain scoring methods and understand what analgesia the patient may need

Week 2

Anaesthesia – Airway Security and Hypothermia

How to maintain a patent airway

Patient positioning

To cuff or not to cuff?

Causes of hypothermia

Negative effects of hypothermia

Preventing and treating hypothermia

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

Understand different styles of ET tubes and their benefits and potential negatives

Understand appropriate ET tube cuff pressures and why this is so integral to protecting the airway

Appreciate techniques to protect the airway

Know the gold standard method to move patients under anaesthesia, whilst protecting their airway

List the common causes of hypothermia

Understand the negative effects of hypothermia

Have practical knowledge on how to prevent and treat hypothermia

Understand the risk of using some heating devices

Week 3

Anaesthesia – Managing Hypotension

Causes of hypotension

Negative side effects of hypotension

How to obtain accurate blood pressure reading

How to prevent hypotension

Fluid therapy

Anaesthesia drug choices

The use of vasopressors and anticholinergics

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

Obtain accurate blood pressure readings for cats and dogs under general anaesthesia for dentistry

Understand the limitations of blood pressure measurements and trouble shoot potential problems

Know what is deemed as an appropriate blood pressure reading under general anaesthetic

Know which drugs may interfere with maintaining blood pressure

Understand what could happen to our patients if left hypotensive

Feel more confident, alongside the veterinary surgeon, in making a treatment plan tailored to each individual patient, to treat any hypotensive episodes

Week 4

Post-operative Care

Immediate post op care once extubated

Care for patients in the recovery ward

Discharge instructions

Post op care at home

Post op checks

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

Maintain and monitor a patent airway in the immediate post-operative period

Understand the importance of close monitoring in recovery

Create a post-operative plan tailored to each individual patient

Feel confident to create discharge instructions for your patient

Confidently communicate with the owner about the anaesthesia and surgery the patient has received

Perform a thorough physical post-operative check, including the whole patient

Understand the best dental care an owner can provide at home, along with alternative options if these goals cannot be met

Week 1

Canine Hypothyroidism

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

Identify the clinical signs of canine hypothyroidism

Explain the role of hormones in the body

Explain the relationship between TSH and thyroid hormones

Describe what canine hypothyroidism is and why it occurs

Describe ways to support the client owning a canine with hypothyroidism

Week 2

Canine and Feline Diabetes

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

Name the 3 types of cell that contribute to the endocrine function of the pancreas

Name the two main types of insulin used in cats and dogs

Describe the reason dogs become diabetic

Describe the reason cats become diabetic

Explain some differences in the nursing considerations you would give cats compared to dogs and why

Week 3

Feline Acromegaly

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

Identify 3 major hormones that are lost when you remove the anterior pituitary gland

Explain how feline hypersomatotropism occurs

Discuss how excess growth hormone results in acromegaly

Explain the nursing considerations for a hypophysectomy patient

Explain the support that a client might need for a cat with FeHS

Week 4

Feline Hyperthyroidism

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

Discuss the clinical signs that a hyperthyroid cat might present with

Explain the effects of too much thyroid hormone on the body

Demonstrate an understanding of the treatment options available for the disease in order to support the client with the hyperthyroid cat

Describe the most commonly used test to diagnose feline hyperthyroidism and what that test is measuring

Explain the difference between free T4 and total T4

Week 5

Canine Hyperadrenocorticism (Cushing’s Disease)

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

Explain the reasons why canine hyperadrenocorticism (HAC) occur

Identify the clinical signs associated with a canine HAC patient

Discuss some of the common tests available for HAC and the reasons for their use

Identify 3 main forms of treatment for the canine HAC patient

Demonstrate an understanding of the nursing considerations for the patient with HAC

Week 6

Canine Hypoadrenocorticism (Addison’s Disease)

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

Explain the causes of canine hypoadrenocorticism

Identify some of the clinical signs that a patient may present with and why

Discuss the treatment options available to the client with the hypoadrenocorticism pet

Demonstrate an understanding of the nursing considerations for a canine with hypoadrenocorticism

Name some of the tests that a vet may ask you to carry out on the suspected hypoadrenocorticism patient and discuss why they may be required

Week 1

Nutrition and Husbandry at Home

Dietary requirements

Environmental needs

Incorrect feeding problems

Obesity

Tempting rabbits to eat hay

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

Discuss the nutritional requirements of rabbits and why these are important

Recognise problems related to incorrect or poor diet and the implications these have on health and welfare

Appreciate that rabbits need large enclosures, which allow them to exhibit normal behavioural patterns.  These are important from a health and welfare perspective. We will examine what rabbits need to be happy

Understand obesity and how to implement a weight loss programme for rabbits

List various methods to encourage picky rabbits to eat hay!

Week 2

Preventative Healthcare

Neutering – when and why

Vaccination – myxomatosis, RVHD1 and RVHD2

Endo and ectoparasites

Flea treatment

Worming treatment

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

Understand the best time to neuter rabbits

Appreciate why we should be neutering all rabbits – health, welfare and behavioural benefits

Know all the latest vaccination information and background on these fatal viruses

Know which endo and ectoparasites can affect rabbits and the clinical signs

Discuss if rabbits require prophylactic flea and worm treatment, and if so, when?

Week 3

Implementing Rabbit Clinics and Client Evenings in Practice

Setting up rabbit clinics

Running client evenings

What to discuss

Health checking

Benefits to the practice

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

Understand that client education is imperative but there is more than one way to deliver this

Discover the benefits of both rabbit clinics and client evenings

Know what should be discussed and the clinical examination to help detect problems

Appreciate why being a rabbit friendly practice is of benefit to you!

Week 4

Common Medical Diseases

Gastrointestinal stasis and blockages

Dental disease

Urinary tract disease

E. cuniculi

Myxomatosis and RVHD

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

Describe the common conditions that rabbits present to veterinary practices and require hospitalisation

Ascertain if a rabbit has gastrointestinal stasis or a blockage – differences and treatments

Identify clinical signs and causes

List the treatment options

Describe preventative measures to help ensure rabbits remain healthy

Week 5

Rabbits in the Practice

Reducing stress

Hospitalisation

Gold standard rabbit nursing

Medicating

Fluid therapy and blood sampling

Supportive feeding

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

Understand that everything that we do to rabbits whilst they are hospitalised induces some degree of stress.  Learn ways to reduce this, which are easily achieved in practice

Appreciate that hospitalised rabbits can require in-depth care which can be daunting. Learn how to effectively nurse rabbits to ensure optimum care

Learn how to medicate rabbits in an effective and safe manner is imperative, as well as how to syringe feed, deliver fluid therapy and acquire successful blood samples with minimal stress to the rabbit or nurse!

Week 6

Rabbit Anaesthesia and Analgesia

Signs of pain

Analgesia options

Making rabbit anaesthesia safer

Monitoring under general anaesthesia

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

Review rabbit anaesthesia and learn how to build up your confidence, including pre op, intra op and post op care. Anaesthetising rabbits can be overwhelming but doesn’t need to be!

Know the clinical signs rabbits show when they are in pain, and learn how to use the Rabbit Grimace Scale

Review the analgesics available for rabbit medicine

Understand the parameters monitored during anaesthesia – including CO_2, SPO_2,reflexes, HR, RR and BP readings

Week 1

What is Cancer?

Pathophysiology of neoplasia

Common causes of cancer in animals

Classifications of cancer types

The difference between benign and malignant disease

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

Understand the alterations in the cell cycle that results in neoplastic disease

List the different types of cancer based on tissue origin

Describe the different causes of cancer in small animals

Explain how benign disease is different to malignant disease and the risks associated with both conditions

Identify higher risk categories of patients and analyse the research available in line with evidence-based medicine

Week 2

Diagnosis and Prognosis

Fine needle aspirates

Cancer cytology

Cancer staging

Specialist tests for cancer

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

List fine needle aspirate methods to optimise cytological yield

Evaluate a cytology sample in-house to ensure sample is of diagnostic quality

Understand the commonly preferred methods for staging patients with neoplasia

Describe the types of specialist tests required to further categorise cancer

Analyse personal skill set and determine if any modifications to current practice would be beneficial

Week 3

Common Chemotherapy Agents

Overview of common chemotherapy drugs

Administering chemotherapy

Chemotherapy safety

Adverse effects with administering chemotherapy

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

Understand how chemotherapy agents work

Explain how to correctly administer chemotherapy agents

List what safety factors should be observed when administering chemotherapy in practice

Describe how to manage an extravasation injury and reduce risk of chemotherapy associated nausea and vomiting

Evaluate practice protocols to standardise and promote best practice in line with most current information

Week 4

Client and Patient Support

Introduction to oncology clinics

Nadir checks

Managing adverse effects following chemotherapy administration

The Cancer Journey

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

Describe how and why a nadir check is performed

Identify common adverse effects associated with chemotherapy

Understand preventive and interventional treatment protocols for chemotherapy associated adverse effects

Explain the causes for likely outcome of treatment failure and the physiology behind this

Reflect over professional skill set and evaluate how you can further enhance your personal development to support clients of patients with cancer

Week 1

The Physiology of Pain

Pain definitions

The mammalian pain pathway

Different types of pain

Principles of analgesia

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

Outline the definition of pain and associated terminology

Describe the different stages of the pain pathway and sites for analgesia intervention

Understand the concept of multi-modal analgesia and pre-emptive analgesia

Week 2

Analgesia for the In-patient

Review the analgesia agents used to treat acute pain conditions:

Opioids

NMDA antagonists

Local anaesthetics

Alpha 2 agonists

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

Be familiar with the different systemic and local options for treating acute pain

Discuss balanced multi-modal analgesia plans for patients in the veterinary practice

Understand the mechanisms of action, effects and side effects of the listed analgesic agents

Week 3

Analgesia for the Out-patient

Review the analgesia options for managing pain on a longer term basis:

NSAIDs

Paracetamol

Tramadol

Gabapentin

Alternative therapies

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

Be familiar with the different systemic and alternative therapies for treating chronic pain

Discuss balanced multi-modal analgesia plans for patients at home

Understand the mechanisms of action, effects and side effects of the discussed analgesic interventions

Week 4

Pain Assessment Methods

Review the different pain scoring options for both in-patients and out-patients

Canine pain scales

Feline pain scales

Grimace scales

Chronic pain scales

Pitfalls and problems with pain assessment

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

Have a better understanding of the different pain assessment types

Appreciate where pain assessments can be beneficial for managing conditions and allowing for appropriate analgesia interventions in the hospitalised patient

Provide owners with the tools to monitor and assess their pet’s pain and quality of life at home

Describe the indications and contraindications for pain scoring

Week 1

Acute Kidney Injury

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

Describe the functional anatomy of the kidney

Understand and assess the origin of azotaemia in dogs and cats

Break down the terminology and pathophysiology of an acute kidney injury

Appreciate the clinical signs and tips on differentiating between AKI and CKD renal biomarkers and the importance of urinalysis for assessing renal function

Understand the nursing care that accompanies an AKI patient, including ins and outs, fluid therapy and the importance of bodyweight

Design a treatment plan for an AKI patient, including an in depth understanding of why we perform each task

Week 2

The Blocked Cat

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

Understand predisposing factors to the blocked feline patient

Recognise the most common clinical signs and presentation of these cases

Understand and be able to perform the initial diagnostic procedures commonly performed

Recognise the hyperkalaemic patient and understand the treatment required

Demonstrate an understanding of the treatment options available for these cases

Identify different types of urinary catheters used in feline patients

Explain the nursing considerations of these patients

Week 3

Chronic Kidney Disease

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

Understand the difference between CKD and AKI

Discuss the clinical signs, why they manifest and what we can do to provide supportive treatment to the CKD patient

Talk about the laboratory findings including electrolytes and how/when we should intervene

Break down urinalysis and what it can tell us

Understand the pathology behind hypertension in CKD patients, the side effects and how to achieve accurate measurements

Identify useful nurse clinic tips for CKD patients

Week 4

Laboratory Diagnostics in Renal and Urinary Patients

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

Recognise the common haematological, biochemical and electrolyte changes seen in patients with renal disease

Understand the International Renal Interest Society (IRIS) staging for chronic kidney disease

Explain the three key components of a urinalysis

Describe the classifications of proteinuria and understand possible underlying causes

Identify urinary crystals via microscopy

Understand external laboratory diagnostics to include: symmetric dimethylarginine and urine culture

Localise azotaemia in canine and feline patients

Week 1

Aetiology and Pathogenesis

Anatomy of the head

Tooth and periodontal anatomy, and oral soft tissues

Oral nomenclature

Tooth types, nomenclature and formulae

Eruption times

Occlusion

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

Identify tooth and periodontal structures

Explain the Modified Triadan System of numbering teeth in the dog and cat

Recognise normal occlusion

Week 2

Periodontology

Aetiology and pathogenesis of dental disease

Gingivitis

Periodontitis

Gingivostomatitis

Periodontal therapy

Scaling and polishing

Pocket control and therapy

Medications, homecare (brief), dental clinics (brief)

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

Describe how gingivitis develops and its progression to periodontal disease

Explain what gingivostomatitis is

Outline the process of safe ultrasonic tooth scaling and its purpose

Week 3

Oral Pathology and Treatment

Trauma and treatment options

Tooth fracture / discolouration / (sub) luxation

Dental diseases and treatment options

Tooth resorption / caries / periodontal disease

Malocclusion and treatment options

Traumatic / dental / skeletal malocclusions

Other conditions and treatment options

Enamel defects / dentigerous cysts / persistent deciduous / root dilacerations and abnormal morphology / tumours

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

Identify common pathologies associated with the teeth and oral cavity

Describe some potential treatment options for common pathologies

Week 4

Oral Examination and Charting

History taking and clinical examination – conscious oral examination

Pre-operative tests

Assessment under general anaesthesia – including anaesthesia induction, intubation, oral preparation, probing

Charting – what to fill in, disease scoring and making your chart work

Imaging and other investigations

Radiography – parallel and bisecting angle techniques

Biopsy

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

Confidently undertake a thorough conscious examination of a patient’s teeth
and oral cavity

Set up for and assist with assessment of the teeth and oral cavity in an anaesthetised patient

Accurately complete a dental chart which documents all pathology discovered upon examination

Week 5

Instrumentation and Dental Surgery

Instruments – use, care and maintenance

Dental machine and other powered equipment – use, care and maintenance

Ancillary equipment – use, care and maintenance

Preparation for and veterinary nursing assistance with surgery

Pre-, intra- and post-operatively, including analgesia

The role of intraoperative radiography

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

Differentiate between different instruments used for dental and oral procedures, and state what they are used for

Describe the proper use, care and maintenance of a range of dental instruments and equipment

Explain the benefits of oral radiography in veterinary patients and outline the basic, fundamental principles of the parallel and bisecting angle techniques

Week 6

Dental Clinics, Products and Homecare

What is an effective dental clinic

Types of patients attending dental clinics

Resources for dental clinic consultations

Products and interventions available to help with maintaining oral health

Oral homecare regimes

Effective dissemination of theoretical and practical oral hygiene advice

Client concordance and follow-up

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

Debate what makes a dental clinic effective

Explain the range of resources required to run an effective dental clinic, and the purpose of these resources

Describe how a range of products and interventions used to maintain optimal oral health work

Outline how to achieve and maintain client compliance with recommended oral homecare regimes

Week 1

Nutritional Assessment and Calculations

How to perform a nutritional assessment

Calculate energy requirements and how much to feed

Treatment regimens for inappetence

Instigating nutritional support

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

Perform a nutritional history and assessment of the animal

Calculate BER and RERs and apply this to how much to feed

Identify when nutritional support is required and how to do this

Week 2

Clinical Nutrition – Renal, Urinary, Liver and Cardiac

Clinical nutrition for renal, urinary, liver and cardiac disease

Look at each of the nutrient requirements for each of these management regimes

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

Make recommendations for clinical diets for renal, urinary, liver and cardiac disease

Understand the nutrient specifications for these diets

Discuss the benefits of these diets

Week 3

Clinical Nutrition – Gastrointestinal and Pancreatic

Clinical nutrition for gastrointestinal and pancreatitis

Look at each of the nutrient requirements for each of these management regimes

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

Make recommendations for clinical diets for range of gastrointestinal and pancreatitis

Understand the nutrient specifications for these diets

Discuss the benefits of these diets

Week 4

Nutritional Supplements and Trends

Supplements

Nutritional trends (including raw and homecooked diets)

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

Make recommendations for supplements for the diseases discussed in weeks 3 and 4

Look at the nutritional evidence behind nutritional fashions

Discuss raw and home cooked feeding with clients

Week 1

Performance Reviews and Appraisals

This first week, we will look at how to conduct appraisals and performance reviews. We will look at the different styles of checklists and forms that can be used to conduct these sessions, and we will discuss how to give feedback, whether good or bad. We will look at how performance reviews can be used to help with staff members who are not performing at an expected level.

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

Know how to give constructive feedback

How to set performance action plans

Design an appraisal form, in order to conduct an appraisal

Week 2

Quality Improvement

QI is an important part of clinical practice and it often lands on veterinary nurses to conduct clinical audits. We will explore what QI involves, how to develop evidence-based practice, what a journal club is, and how to implement clinical audits.

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

Understand the concepts of clinical governance, quality improvement and clinical audits

How to implement a clinical audit

Understand how to start a journal club

Week 3

Disciplinary Issues

We will look at what to do if you have a situation when a staff member that doesn’t arrive to work on time, has performance issues, or doesn’t comply to rules. We will look at how you can manage these people, how to set reviews and action plans, along with what to do if they don’t adhere to these action plans.

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

Set action plans and how to review these

Know how to conduct an investigation into conduct

Understand what the disciplinary process involves

Week 4

Finances

Part of being a head nurse is also knowing how the business works – having a basic understanding of how your role as head nurse affects profit/loss is important. Stock control, purchasing, pricing and charging correctly are a vital part of this

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

Understand the importance of stock control and how to implement a simple system to aid your stock takes

Understand the importance of charging and how making a few changes can make a difference

Know why it is important to charge for your time

Week 1

Approach to the Caesarean Patient

Brief overview of parturition

Complications of parturition

Caesarean section

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

Explain complications that might occur in parturition

Explain the reasons for intervening in these cases in order to perform a C section

Understand nursing of the caesarean patient

Week 2

The GDV Patient

Physiology of GDV

Diagnosis

Stabilisation of the GDV

Anaesthesia considerations

Post-operative nursing

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

Understand the physiology of a GDV and list some of the common risk factors associated with this condition

Describe how a GDV is diagnosed and which tests can help us to identify this condition in the emergency patient

List the common stabilisation techniques in the emergency patient including management of shock and commonly used gastric decompression techniques

Discuss anaesthesia considerations and how to make the patient a safe candidate for surgery

Describe the nursing considerations for the post-operative GDV case and the factors which need to be included in the care plan of the hospitalised patient

Week 3

Nursing the Septic Abdomen Patient

What are SIRS and sepsis?

Recognising sepsis

The use of diagnostic tools in the veterinary practice to help recognise a septic abdomen

Nursing management of a septic abdomen

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

Describe SIRS and sepsis and the difference between them

Understand how to recognise sepsis in veterinary patients

List the different tests we have available in practice that can be used to help identify a septic abdomen

Explain how patients with a septic abdomen can best be nursed in practice, pre-, peri and post operatively

Week 4

Haemoabdomen

Physiology of haemoabdomen

Diagnosis

Stabilisation of the haemoabdomen

Anaesthesia considerations

Post-operative nursing

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

Understand the physiology of a haemoabdomen and list some of the common causes associated with this condition

Describe how a haemoabdomen is diagnosed and which tests can help us to identify this condition in the emergency patient

List the common stabilisation techniques in the emergency patient including management of shock

Discuss anaesthesia considerations and how to make the patient a safe candidate for surgery

Describe the nursing considerations for the post-operative haemoabdomen case and the factors which need to be included in the care plan of the hospitalised patient

Week 1

Physiotherapy Toolkit (Modalities)

Electrotherapies

Therapeutic hot/cold packs

Manual therapies

Applied exercise therapies

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

Understand the principles and application of electrotherapy including:

K-laser

Transcutaneous electrical nerve stimulation (TENS)

Neuromuscular electrical stimulation (NMES)

Pulsed magnetic therapy (Biomag)

Therapeutic ultrasound

Understand the use of therapeutic hot/ cold packs

Understand manual therapy and its application including:

Massage

Effleurage

Coupage

Joint mobilisations

Graded stretches

Understand applied exercise therapy including:

Strengthening and stabilising exercises

Balance and proprioceptive exercises

Functional exercises

Hydrotherapy

Week 2

Patient Assessment

Musculoskeletal patient assessment

Neurological patient assessment

Respiratory / critical care patient assessment

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

Carry out a basic musculoskeletal, neurological, and respiratory physiotherapy assessment

Understand valid outcome measures to guide patient treatment

How to write SOAP (subjective, objective, analysis, plan) notes to progress patient treatment

Week 3

Physiotherapy and Hydrotherapy Treatment Techniques

Early phase rehabilitation 0-2 weeks

Mid phase rehabilitation 2-6 weeks

Late phase rehabilitation 6-12 weeks

Patient discharge or maintenance physiotherapy programme

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

Carry out early physiotherapy treatment including:

Early manual therapy techniques

Early phase hot and cold pack treatment

Early electrotherapies to improve healing and for pain relief

Mid phase gentle exercise programmes including hydrotherapy

Late phase exercise therapy to include advanced strengthening, proprioceptive, balance and functional exercises

Late phase electrotherapies for pain relief, soft tissue injuries and muscle strengthening

Week 4

Physiotherapy Progression Plans and Home Exercise Programmes

Patient rehabilitation plans

Discharge and maintenance programmes

Home exercise plans

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

Learn how and when to progress patient plans from early to mid through to late stage rehabilitation to optimise patient outcomes

Understand when to discharge a patient, or to continue with a maintenance programme for chronic cases or surgical complications

Design home exercise programmes for owners to carry out

Week 5

Musculoskeletal Case Studies

CCL reconstruction – TPLO or lateral suture

Soft tissue injuries (tendinopathies, iliopsoas strains)

Fracture repair

Conservative management of chronic conditions, including hip dysplasia and elbow dysplasia

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

Consider appropriate assessment, treatment plan and progression of a musculoskeletal case study

Consider appropriate assessment, treatment plan and progression of a soft tissue case study

Consider appropriate assessment, treatment plan and progression of a fracture repair case study

Consider appropriate assessment, treatment plan and progression of a chronic condition case study

Week 6

Neurological and Respiratory (Intensive Care) Case Studies

Hemi- laminectomy (HLE)

Fibrocartilage embolism (FCE)

Pneumonia

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

Consider appropriate assessment, treatment plan and progression of a surgical neurological case study

Consider appropriate assessment, treatment plan and progression of a non-surgical case study

Consider appropriate assessment, treatment plan and progression of a respiratory (critical care) case study

Week 1

What is an Anaesthesia Plan?

How to construct an individual anaesthesia plan

Common anaesthesia-related complications

What you need to know about the drugs

Very old and very young patients

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

Construct an individualised anaesthesia plan

Understand common anaesthesia and surgery related complications

Appreciate the important effects and side effects of drugs commonly used in the peri-anaesthetic period

Understand specific considerations for geriatric and paediatric patients

Week 2

The Anaesthetist’s Worst Nightmares!

Brachycephalic dogs

Obese patients

Care! Difficult temperament

Some endocrine and medical conditions

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

Provide safe anaesthesia for brachycephalic and obese patients

Understand how to anaesthetise ‘aggressive’ dogs safely

Understand the priorities for sick patients and those with concurrent disease

Week 3

Let’s get Cutting – Abdominal Surgery

Anaesthetic considerations for laparotomy and laparoscopy

Case examples

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

Provide analgesia and local anaesthesia for abdominal surgery

Understand the effects of laparoscopy on the patient’s physiology and how to manage them

Discuss the considerations for some particular examples of abdominal surgery

Week 4

Heart and Lungs

Anaesthetic considerations for respiratory disease and thoracic surgery

Anaesthetising patients with common cardiac diseases

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

Know the requirements of patients with intra-thoracic disease

Understand how to manage a patient undergoing a thoracotomy

Appreciate the basics of controlled ventilation

Provide analgesia and local anaesthesia for thoracic surgery

Manage patients with common cardiac diseases

Week 5

Eyes, Brains and Spines

Anaesthetic considerations for neurology and ophthalmology patients

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

Understand practical and physiological considerations for ocular surgery

Explain the basics of neuromuscular blockade

Know how to provide analgesia and local anaesthesia for spinal surgery

Identify the pathophysiology of intracranial disease and how to manage it

Understand the particular difficulties of anaesthesia for magnetic resonance imaging

Week 6

Bringing it all Together – Case Examples

Complex procedures and sick patients, plus some orthopaedic procedures

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

Understand how to combine patient and procedure related requirements

Construct advanced anaesthesia plans

Understand how to prioritise the importance of different anaesthetic considerations

Provide analgesia and local anaesthesia for some orthopaedic procedures

Week 1

Monitoring Modalities

There are many advanced monitoring tools and nursing interventions that can be used in our patients, however, a key part of this is deciding when it is appropriate to employ them. We will discuss and compare different monitoring tools that we have available, including:

Blood pressure monitoring – invasive versus non-invasive

Central venous pressure

ECG

Blood gases – venous versus arterial

We will also explore when these monitoring tools may be beneficial compared with when their use might be contraindicated.

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

Determine which patients would benefit from more intensive monitoring

Understand how to conduct each kind of monitoring and explain the information we can obtain

Understand the difference between arterial blood pressure monitoring and central venous pressure

Understand the complications of using the more invasive monitoring tools

Week 2

Tubes and Drains

Various tubes and drains are commonly used in critically ill ICU patients, and it is vital we understand how to manage these safely and effectively. We will look at a variety of different tubes and drains including Jackson Pratt drains and active grenades, thoracic tubes, tracheostomy tubes and pericardiocentesis catheters among others.

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

Understand the different drains and their functions

Safely manage and nurse patients with various types of tubes

Understand the complications that may occur with various interventions

Confidently troubleshoot drain management

Week 3

Cardiovascular Support

Sometimes fluids just aren’t enough! There are a variety of issues we can encounter with our critically ill patients and cardiovascular support and monitoring becomes an important aspect of the RVN’s role. We will look at the different causes of cardiovascular instability and how we can address those including the use of vasopressors and inotropes.

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

Understand the methods of monitoring that can assist with determining both low and high-volume states

Identify cases where the use of vasopressors and inotropes are indicated

Explain the different conditions that lead to changes in cardiovascular function

Understand the ECG assessment and recognise the main life threatening abnormalities

Week 4

Constant Rate Infusions

Constant rate infusions are commonly used in the ICU, and it is really useful for RVN’s to be able to calculate these dosages. Whilst the maths can sometimes seem baffling, if you understand the basics, it is a very useful skill. CRIs are very beneficial for many of our patients and are attainable in any practice with an infusion pump.

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

Calculate ANY CRI from scratch!

Understand the benefits and issues associated with use of CRIs

Understand multimodal analgesia options for critically ill patients

Week 1

Vascular Access

Indications for IV placement

Different types of IV catheter

Different placement techniques

IV catheter management

Complications

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

List the indications and contraindications for IV catheter placement

Understand the difference between peripheral and central venous catheterisation

Describe the different IV catheter options currently on the veterinary market and their placement technique

Discuss how to manage IV catheters – both peripheral and central

Describe the common complications associated with IV catheters and how to minimise them

Week 2

Urinary Catheters

Indications for placing urinary catheters

Different types of urinary catheters

Placement of urinary catheters

Urinary catheter management

Complications

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

List the indications and contraindications for urinary catheter placement

Describe the different urinary catheter options currently for veterinary use

Explain how urinary catheters are placed

Discuss how to manage urinary catheters in practice

Describe the common complications associated with urinary catheters

Week 3

Chest Drains

When chest drains are placed

Different types of chest drain

Different placement techniques

Chest drain management

Complications

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

List the indications and contraindications for chest drain placement

Describe the different chest drain options currently on the veterinary market and their placement techniques

Explain how to drain the chest drain and what options are available should the patient have a continuous pneumothorax

Discuss how to manage the chest drain and how to identify a drain that is ready for removal

Describe the common complications associated with chest drains and how to minimise them

Week 4

Tracheostomy Tubes

Indications for tracheostomy tube placement

Different types of tracheostomy tubes

Placement of tracheostomy tubes

Management of tracheostomy tubes

Complications

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

List the indications and contraindications for placing tracheostomy tubes

Understand the different types of tracheostomy tubes available for veterinary use

Describe how tracheostomy tubes are placed

Explain how to manage tracheostomy tubes in situ

Describe the common complications associated with tracheostomy tubes in practice

Week 1

Preparation and Monitoring of Critical Cases

Preparedness

Considerations

Invasive blood pressure monitoring

Blood gas analysis

Spirometry

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

List generalised considerations for preparing to anaesthetise emergency cases

Setup and use invasive blood pressure monitoring and how this relates to oscillometric and doppler techniques

Interpret a basic blood gas analysis and outline how this abnormality may have occurred

Explain what spirometry is and how it differs from capnography

Week 2

Abdominal Surgical Emergencies

Gastric dilatation and volvulus

Haemoabdomen

The acute abdomen

Epidural anaesthesia

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

Understand the physiological disturbances caused by gastric dilatation and volvulus

Understand the physiological disturbances caused by haemoabdomen

Understand the physiological disturbances caused by the acute abdomen

Suggest considerations for these surgeries and list possible complications that may arise during anaesthesia

List the total and relative contraindications for epidural anaesthesia

Week 3

Thoracic Surgical Emergencies

Pyothorax

Penetrating injuries

Diaphragmatic rupture

Mechanical ventilation

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

Understand the physiological disturbances caused by pyothorax

Understand the physiological disturbances caused by a penetrating injury

Understand the physiological disturbances caused by diaphragmatic rupture

Suggest considerations for these surgeries and list possible complications that may arise during anaesthesia

Feel confident to safely choose ventilator settings for use during non-emergency surgery

Week 4

Caesareans

Physiology

ASA categorisation

Anaesthesia protocols

Anaesthesia infusions (TIVA)

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

Understand the physiological considerations for caesarean section

Assign and justify the choice of an ASA category to the caesarean section patient

Suggest a safe protocol for caesarean section, with variation based on differing drug availability depending on clinical setting

Understand the basis of total intravenous anaesthesia infusions

Week 5

What’s Happening?  What Should I do?

Hypoxia

Hypocapnia

Hypotension

ECG Abnormalities

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

List possible causes of, and suggest treatments for hypoxia and hypocapnia

List possible causes of hypotension and discuss the physiology of both pharmacological and non-pharmacological treatment options

Interpret the most common ECG abnormalities seen and understand how these rhythms will affect the patient, and have an understanding of possible treatment options

Week 6

CRASH!

Recover CPR guidelines

Crash box

Basic life support

Advanced life support

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

List the vital components of a crash box

Perform safe and effective chest compressions in a variety of patient sizes and conformations

Understand how to monitor the effectiveness of CPR in the clinical setting

Interpret the most common ECG rhythms seen during CPR

Understand what drug treatment options are available during CPR

Week 1

Feline Heart Disease

Prevalence, aetiology and pathophysiology of feline heart disease

Classification systems used to diagnose and treat feline cardiomyopathies

Nursing care and treatment aims

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

Explain the pathophysiology of feline heart disease

Understand the American College of Veterinary Internal Medicine (ACVIM) classification system as it applies to feline cardiomyopathies

Be familiar with the best approach to a nurse a cat with heart disease and heart failure

Week 2

Canine Heart Disease

Prevalence, aetiology and pathophysiology of myxomatous mitral valve disease (MMVD) and dilated cardiomyopathy (DCM)

Classification systems used to diagnose and treat MMVD

Staging systems used to diagnose and treat DCM in dogs

Nursing care of dogs with heart disease and heart failure

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

Explain the pathophysiology of MMVD and DCM

Understand the ACVIM classification system as it applies to MMVD and the staging system as it applies to canine DCM

Be familiar with the best approach to nurse a dog with either MMVD or DCM

Week 3

Electrocardiography (ECG) – Theory

The ECG machine and settings

Achieving a good quality ECG trace

How to interpret an ECG

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

Set up an ECG and understand the settings

Apply theory to achieve a good quality ECG trace

Understand how to interpret an ECG, using an algorithmic system

Week 4

Electrocardiography (ECG) – Application

Application of theory from week 1 to cases

Anaesthesia and ECGs

Life threatening arrhythmias

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

Apply theoretical learning to practical cases

Understand the role of anaesthesia and surgery upon ECGs

Identify life threatening arrhythmias

Week 5

Heart Failure

Pathophysiology of heart failure

Acute life threatening and chronic management

Management of patients with heart failure

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

Understand how heart failure can occur

Identify patients with heart failure and nurse them appropriately

Recognise drugs used in the treatment of heart failure

Week 6

Diagnostic Tests and the Cardiac Patient

Diagnostic tests used in cardiac patients

How to approach the test and the patient

Evaluation of diagnostic tests in cardiac patients

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

Perform or assist with diagnostic tests with confidence

Apply best practice methods to achieve reliable and repeatable results

Understand the purpose of diagnostic tests used in cardiac medicine

Week 1

Preparing for Surgery

Organisation of rooms and equipment in the theatre area

Scheduling and planning surgical caseload

Infection control related to the surgical theatre

Preparation of the patient for surgery

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

Understand the basics of infection control in the operating theatre

Identify the correct order of surgical procedures based on availability of equipment, personnel and rooms

Prepare the patient for a range of procedures, including preparation of skin, eyes and mucous membranes

Develop infection control protocols relating to procedure in their own practice

Week 2

The Theatre Nurse’s Role

Circulating nurse duties

Preparing the surgical team

Surgical hand preparation

Scrub nurse role

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

Understand the key qualities and requirements for the circulating nurse and scrub nurse roles

Identify the correct products and techniques for an effective surgical hand preparation and be able to demonstrate those

Choose appropriate protocols for the preparation of the surgical team

Correctly position patients for a range of surgical procedures

Week 3

Instrumentation and Sterilisation

Common surgical instrumentation

Taking care of your instruments and equipment

What happens after surgery!

Cleaning, disinfection, and sterilisation

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

Identify common surgical instruments and understand their use

Develop the skills to take apart and reassemble surgical equipment for the cleaning process

Understand the key sterilisation techniques used in veterinary medicine

Week 4

Bringing it all Together – Surgical Skills for Nurses

Suture material – what to use and when??

Common suture patterns

Surgical skills

Developing the surgical nurse’s role in practice

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

Identify properties of suture material and understand how that helps guide the choice of which one to use

Demonstrate common surgical suture patterns that could be performed by a veterinary nurse

Understand relevant surgical skills for veterinary nurses and how these can benefit your practice

Week 1

Age Related Disease and Nursing Considerations

Age related diseases commonly seen in cats from the age of 7 years upwards

Findings from the Feline Healthy Ageing Clinic

How nursing care differs in ageing cats

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

Be aware of commonly seen age related diseases

Adapt nursing care for the ageing patient

Prepare hospitalisation for the ageing cat

Week 2

Creating and Running Ageing Cat Clinics

How to set up and run ageing cat clinics

Owner education and compliance

Feline friendly handling for the ageing patient

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

 Create and run ageing cat clinics

Create an owner questionnaire

Understand the importance of owner education

Adapt handling skills to suit the ageing patient

Week 3

Nutritional Considerations

Nutrition for ageing life stages

Nutrition for specific age related disease

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

Make nutritional recommendations for the ageing cat

Make nutritional recommendations for age related diseases

Discuss the benefits of different diets and nutrient specifications

Week 4

Quality of Life and End of Life Care

Quality of life tools

Supporting the palliative patient

Euthanasia considerations

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

Understand the importance of using quality of life tools

Feel confident using quality of life tools

Communicate sensitively to owners surrounding end of life

Carry out euthanasia with consideration for the patient as well as the owner

Week 1

Radiation Physics and Safety

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

Understand the properties of x-rays

Explain how an x-ray tube works

Explain how digital x-ray systems work

Explain the risks of working with radiation

Explain the principles of radiation protection and how this is implemented in veterinary practice

Week 2

Radiographic Anatomy and Physiology in Small Animal Patients

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

Understand the normal radiographic anatomy of the thorax

Understand the normal radiographic anatomy of the abdomen

Understand the normal radiographic anatomy of the spine

Understand the normal radiographic anatomy of the thoracic limb

Understand the normal radiographic anatomy of the pelvis and pelvic limbs

Week 3

Radiographic Techniques (Positioning and Contrast Studies)

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

Understand and implement the optimum positioning for thoracic radiographs

Understand and implement the optimum positioning for abdominal radiographs

Understand and implement the optimum positioning for spinal radiographs

Understand and implement the optimum positioning for pelvic

Understand and implement the optimum positioning for thoracic limb radiographs

Understand and implement the optimum positioning for pelvic limb radiographs

Explain specialised orthopaedic views (TTA / TPLO / stressed / flexed / extended)

Understand contrast media and its usage

Describe contrast and dynamic studies (IVU / retrograde urethrocystogram/angiography)

Week 4

MRI and CT – Physics and Safety

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

Describe the basic principles of how CT works

Describe the basic principles of how MRI works

Explain safety concerns when working with CT

Explain safety concerns when working with MRI

Compare differences between CT and MRI

Week 5

MRI Techniques and Acquisition

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

Understand how to position small animal patients for spinal imaging

Understand how to position small animal patients for brain imaging

Explain which sequences are commonly utilised in small animal imaging

Understand commonly seen MRI artefacts

Week 6

CT Techniques and Acquisition

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

Understand how to position small animal patients for commonly performed CT studies (Spine / Thorax / Abdomen / Elbow)

Explain which reconstruction algorithms can be utilised and when

Understand commonly seen CT artefacts

Week 1

Feline Cardiomyopathies

Cardiovascular anatomy and physiology

Common cardiomyopathies affecting cats

Treatment of feline cardiomyopathies

The owners role in monitoring cardiomyopathies

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

Describe the normal physiology of the heart

Describe common disease processes which affect the feline heart

Understand the role of diet within feline cardiomyopathies

Discuss various treatment options available for feline cardiomyopathies

Understand the role nurses and owners can play in monitoring these cases

Week 2

Feline Triaditis

Brief review of gastrointestinal, pancreatic and hepatic anatomy and physiology

Pathophysiology of triaditis in the cat (inflammatory bowel disease, pancreatitis and cholangitis)

Advanced imaging and diagnostic techniques

Treatment options available both as an inpatient and an outpatient

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

Discuss the disease process of triaditis including the associated clinical signs

Understand how nurses can support patients through advanced imaging (flexible endoscopy / abdominal ultrasound)

Understand how to assist with the collection of pathological samples in these cases

Discuss the long term management of triaditis and the potential for ongoing disease

Week 3

Feline Asthma

Overview of respiratory anatomy and physiology

Predisposed breeds

Computed tomography and bronchoscopy

Treatment of feline asthma

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

Describe the clinical pathological changes associated with feline asthma

Discuss advanced imaging techniques that can be utilised in the work up of these cases

Confidently and competently support the general anaesthesia of a cat with respiratory disease

Discharge a patient to owners and confidently discuss the treatment of asthmatic cats

Week 4

Feline Infectious Peritonitis

The pathophysiology of FIP including both ‘wet’ and ‘dry’ forms

Transmission of FIP

Treatment options available for FIP

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

Understand the predisposing factors for the development of FIP

Discuss the clinical signs associated with FIP

Indicate the importance of infection control

Identify treatment options and protocols currently available

Advise owners how to limit the potential for disease transmission within households

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

Week 1

Preparation, Priorities and Checklists

Patient safety

The anaesthesia plan and patient priorities

Preparation and checklists

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

Understand how preparation and use of checklists improve patient safety

Prepare individual anaesthesia plans for sick patients and/or complex procedures

Understand how to prioritise important considerations

Understand how to prepare the patient and equipment to minimise harmful delays and mistakes

Construct and use relevant patient safety checklists

Week 2

Ventilation, Capnography and Neuromuscular Blockade

Physiology of spontaneous and controlled ventilation

Ventilators

Capnography

Neuromuscular blockade

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

Understand in which situations it is appropriate to use controlled ventilation

Understand how to set up a ventilator and what all the buttons do!

Understand the physiology and technology of capnography

Understand how to interpret different capnograph traces

Understand how to use and monitor neuromuscular blocking drugs

Week 3

Advanced Monitoring and Cardiovascular Support

Physiology of heart rate and blood pressure

The electrocardiogram

Measuring blood pressure

Treating hypotension and arrhythmias

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

Have a better understanding of ECG interpretation and when to worry

Understand how to interpret blood pressure measurements

Understand when and how to treat common arrhythmias

Understand different ways of treating hypotension

Week 4

Perioperative Analgesia

Analgesic drugs in the peri-anaesthetic period

Multimodal analgesia

Analgesic infusions

Using local anaesthetic techniques

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

Have an understanding of the pharmacology of analgesic drugs

Understand which drugs are useful in which situations

Select and prepare analgesic drugs for intravenous infusions

Understand and select appropriate local anaesthetic techniques for different procedures

Week 1

Patient Assessment and Triage

The concept of triage

Preparedness

Primary survey

Secondary Survey

Emergency history

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

Understand the triage process and how it can be utilised to prioritise emergency care

Describe how to make their team and environment prepared for when the emergency patient arrives

List how to carry out a primary survey during the initial assessment of the patient

Explain how to carry out a secondary survey assessment in order to list their concerns with the patient

Discuss how to communicate with the client including telephone advice, informed consent and emergency history

Week 2

Shock

Classify shock

Emergency database

Blood pressure

Oxygen therapy

The use of multiparameter monitors

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

Identify a patient with shock and classify which type of shock they have

Explain which parameters may be tested during an emergency database and how these can help to identify shock in the emergency room

Understand the physiology of perfusion and ways in which blood pressure can be monitored in the emergency patient

List the different ways that oxygen therapy can be delivered to the emergency patient

Understand the uses and limitations of multiparameter monitors and their role in monitoring perfusion trends

Week 3

Fluid Therapy

Patient assessment

Identifying a fluid deficit or change in volume

What fluids are available

Managing a change in content

Identifying a change in fluid distribution

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

Explain how to assess the patient’s fluid status using clinical exam and blood work

Discuss how to create a fluid plan to treat a fluid deficit such as hypovolaemia or dehydration

List what fluid options are available and which fluid might be preferred in which situation

Understand how fluid selection or the fluid plan can be altered to account for an electrolyte abnormality

Describe how to manage the patient with fluid overload or peripheral oedema

Week 4

Neurological Emergencies

Neurological assessment

Coma scoring

Raised intracranial pressure

Seizures

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

Describe how to perform a neurological assessment of an emergency patient

Describe how to perform a coma score and understand how these may be used in neurological patients

Understand methods of identifying raised intracranial pressure and the physiology behind this

Recognise a seizuring patient and understand their management, from initial presentation and stabilisation of mild seizures through to the management of a patient in status epilepticus

Week 5

Approach to the Trauma Patient

Assessment of wounds

Wound management

Management of fractures

Other injuries associated with trauma

Analgesia

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

Identify different wounds based on the patient history and appearance of the wound

Understand the principles of wound management and common techniques used to flush and debride wounds

Describe how to identify and manage fractures in the trauma patient

List other common injuries associated with trauma and how these should be managed

Implement an analgesia plan for the trauma patient based on pain assessment

Week 6

Common Toxicities

Common toxins seen in emergency practice

Renal toxins

Hepatotoxins

Anticoagulants

Neurotoxins

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

Describe the different ways toxins can enter the body

List the most common renal toxins and understand the treatment of these patients

List the most common hepatotoxins and understand the different treatments for each of these

Understand the physiological effects of anticoagulant ingestion and the treatment of these patients

Identify the most common neurotoxins seen in practice and understand the treatment of these patients

Week 1

Lymphoma

Lymphoma is a cancer of the lymphocytes and/or lymphoid tissue, which is present in many locations within the body, hence making the presentation of these cases typical or atypical depending on location. Specialist tests have been developed to categorise this cancer and treatment is determined by these findings.

Manifestation of lymphoma and categories of disease

Diagnosis, staging and specialist tests for lymphoma

Treatment options for lymphoma

Chemotherapy protocols, client expectations and the cancer journey

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

List the common manifestations of canine lymphoma and the patient groups most affected.

Understand the value of specialist tests required to further categorise cancer

Describe the subcategories of lymphoma and the difference in treatment approaches

Explain the rationale of a multimodal chemotherapy protocol and how it may impact on prognosis

Analyse personal skill set and determine how you could support patients with lymphoma using your practice facilities

Week 2

Osteosarcoma

Canine osteosarcoma of the weight bearing bones often manifests in pain and/or lameness in affected patients.  Once a diagnosis has been determined, the behaviour of this neoplasm is predictable, yet still individual to the animal.

Osteosarcoma pathophysiology overview

Diagnostic and staging processes

Treatment options, radiation and surgical management

Adjuvant (post-operative) chemotherapy and restaging

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

Describe the diagnostic approach to determining cancer diagnosis and tumour burden

Explain typical neoplastic behaviour of canine osteosarcoma and how it is a model for comparative medicine

List the different treatment options and their impact on survival time

Understand the fundamental reasoning for adjuvant chemotherapy and the options for post-operative care

Week 3

Melanoma

Oral melanoma is the most common form of cancer of the mouth in dogs; there are various forms and the behaviour of this neoplasm is sometimes unpredictable. On week three we discuss the presentation, investigation and treatment options available for these patients and look at some practices which are novel to veterinary medicine.

Presentation, diagnosis and staging of oral melanoma, including lymph node mapping

Treatment options and impact on prognosis

Surgical interventions, nursing support and rehabilitation

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

Describe the value of different tissue sampling and specialist imaging techniques

List treatment options and prognostic indicators for canine melanoma

Describe the surgical technique, complications and post-operative care required for oral melanoma cases

Understand the mechanism of action behind current research for canine melanoma and apply to evidence-based medicine within nursing practice

Week 4

Mast Cell Tumours

Mast cell tumours are a form of skin cancer in dogs, which depending on their grade and affected site, can have an impact on neoplastic behaviour and prognosis. Many patients go on to live disease-free lives, others require continuous treatment and monitoring.

Presentation and behaviour of mast cell tumours

Diagnosis, staging and specialised tests

Treatment modalities and monitoring considerations

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

Explain which breeds of dogs are commonly affected by mast cell tumours and how the patient may present

List what investigative procedures may be necessary to secure a diagnosis and what safety factors should be observed when sampling masses

Describe which treatment modalities are most useful for which form of the disease

Understand the use of tyrosine kinase inhibitors and “metronomic chemotherapy” as a method for controlling cancer growth