Something that they don’t tell you when you start on the road to become a vet is the amount of death that you will see. This week I have seen everything from the euthanasia of a 1 hour old puppy, through to the emergency slaughter of a cow that could not stand.
This morning started with an owner and a fellow student carrying in the limp body of their dog, this is where you go from 0 to 60 in seconds. I was sat with 3 doctors talking about eyes, yet within seconds eyes were forgotten. One was taking care of getting an airway into place with intubation, another worked to get a IV cannula into the dog, another started chest compressions and I prepped emergency drugs. Unfortunately today we had an unsuccessful outcome.
Here in clinic we do not have a defibrillator, and sometimes I wonder if we did would we see better outcomes in resuscitation attempts… There are not really any real statistics in veterinary medicine on the survival with defibrillation. However in human heart attacks where CPR is given using a defibrillator within the first minute gives a 90% chance of survival with this decreasing by 10% every minute after. If defibrillation is not performed within 10 minutes of the cardiac arrest then the survival becomes just a measly 2%.
With this knowledge from the human field you can understand why I wonder about our veterinary patients. Is it the same?
Since last Wednesday I have barely slept, have been in surgery long past midnight on several nights, and have had the pleasure on one day of seeing the sun rise as I stumbled home to take a shower before heading back in to more surgery.
It’s been a sleep deprived rollercoaster of emotion, I’ve seen some things I wouldn’t wish upon my worst enemy, yet have seen patients recover right from the edge of deaths door. Through a lot of the surgeries during this period I have taken the role of anaesthesiologist. When I first started in clinics one of the equine surgeons told me that I should learn anaesthesia, as without anaesthesia there cannot be surgery. This is something that I listened to and have become reasonable at, I’m capable of selecting and calculating drugs to put an animal asleep, keeping them asleep through the surgery and then waking them at the end. It’s been a very steep learning curve, however now I am looking at anaesthesia in different circumstances which is getting more interesting. However my goal is to become a great surgeon, anaesthesia has given me a way to find my way into really cool surgery which is pretty cool though.
Anyways the past 5 days have been very educational, yet have for me have pushed me to my limits both mentally and physically. One minute I was doing CPR on one dog, the next I was doing anaesthesia for emergency surgery on the next. After just getting home after food I was called back in at 11pm to run anaesthesia for an emergency surgery and arrived at the same time as another patient that had just been hit by a car that just randomly showed up.
Coffee has become my best friend, my feet and legs ache, my hands feel like lead but I still performed to the best of my ability. I like to be pushed, emergencies tend not to be a normal thing here, and I do not know why all of a sudden it went so crazy however it was an amazing experience and one that I wished repeated on a weekly basis.
Well today was another 8am start with the Equine service with wound checks for the hoof injuries and bandage changes. This has been fascinating for me as I have attended some very interesting lectures on equine wound management with The Webinar Vet which talked about the different treatment options. This has given me the theory, however experience is very important here, and so being able to see the healing progress is very interesting.
Equine wounds can look extremely nasty especially when covering large areas, and as owners seeing a wound each day the differences are miniscule so it is hard to believe that it is in fact getting better. Something that we as vets are recommended to do with the advent of camera technology is to take photo’s to compare the wound to – personally I think this should be extended to owners as well so you can remind yourself just how much better it is with each week. Now wound healing comprises different stages, however one of the most important factors is contraction which is where the wound gets smaller as it heals. This means that a large wound may eventually (months or even years later) leave a little tiny scar.
After this I then ended up in the Small Animal Clinic again, this time was going to be different however I discovered that Marie (aka Monkeycat) was being adopted today which I think is really cool as she is such a cutie (really struggled not to adopt her myself!)!
Anyways there was routine stuff happening until I am about to leave at around 5:30pm when I get asked to help bring a emergency in. Now this is a neuro case and I was working with one of my favourite doctors who really can explain things so that they are understood. I cannot say anymore about the case however monitoring the patient during stabilisation the heart stopped. Luckily I had both the the doctor and a senior student in the room with me when this happened who both swung into action immediately. Whilst I started chest compressions a ET tube was placed into the trachea to keep the airway open and emergency drugs were administered. Sadly the patient didn’t make it despite our best efforts – it’s the first time that I’ve been involved in a patient dying this way so was a new experience. The thing that got me the most was that the owner had stepped outside just before it happened, and returned halfway in… Though I couldn’t understand the words I could understand what they were feeling, yet because of my lack of Slovak couldn’t say anything to her.
I’ve learnt several lessons from this, including some of the more important words in Slovak that are used within a veterinary clinic!