Clinical Connections  –  Spring 2019

Stefano Cortellini, Lecturer in Emergency and Critical Care

Trauma is a common occurrence in pets and accounts for up to 10% of the cases that are presented to our emergency services.

Most trauma cases can be managed in primary care practices, however some of them require more advanced care, such as blood transfusions, critical care facilities, advanced imaging procedures and clinical expertise from a multidisciplinary range of specialists.

In many cases, the key to a successful outcome is early treatment of injuries before organ damage is irreparable – in what is sometimes referred to as the “golden hour.” Given the complexity and severity of injuries in some cases, clinical expertise may be required from a host of different specialities within hours of the patient sustaining trauma, or in the ensuing days.

Having a centre with specialists readily available and trained to deal with traumatic injuries and critical patients, 24 hours a day and seven days a week, is essential in ensuring the best standard of care is available to our patients.

The passion and focus on delivering the best care possible to trauma patients has led to the creation of a network of advanced hospitals that have been recognised and accredited as Veterinary Trauma Centres (VTCs) by the American College of Veterinary Emergency and Critical Care (ACVECC). This global initiative was spearheaded by ACVECC’s Veterinary Committee on Trauma (VetCOT) and currently spans three continents and 23 veterinary hospitals.

The RVC’s Queen Mother Hospital for Animals, in its continued commitment in providing the best care to patients and affirm its position as centre of excellence, has recently been awarded 5 Outstanding awards in the RCVS Practice Standard Scheme. It has also achieved a Level 1 Veterinary Emergency and Critical Care Society (VECCS) Facility award and is the only ACVECC certified Level 1 Veterinary Trauma Centre outside of North America. It was first awarded trauma centre status is 2016.

For a hospital to become part of the ACVECC VetCOT network it requires a full complement of advanced resources, and an array of clinical expertise that provides the highest level of care and meets every anticipated need of a trauma patient from the moment that patient arrives. The ethos is one of holistic care, with every need provided in one facility.

For example, upon arrival a patient with significant injuries will be triaged by a specialist Emergency and Critical Care nurse and taken to the emergency room, where a team of emergency vets and nurses will initiate immediate care to stabilise the patient. Within minutes of arrival, patient-side ultrasound can be performed and the extent of injuries can be assessed. In situations where there are extensive wounds, the patient can be anaesthetised and their wounds addressed by expert surgeons. Advanced imaging, such as CT or MRI scans, can be used to plan delicate surgical procedures. Following surgery, the patient receives physiotherapy as part of its recovery plan.

A key aspect of the creation of this trauma centre network is not only to provide the clinical support to traumatised patients but also drive improvement of trauma care in veterinary medicine through research and continuous education. Each trauma centre contributes to a global registry of each traumatised patient, which currently stand approximately 34,000 patients collected around the world. Continuing education is also an essential aspect of this project – trauma centres need to ensure each clinical staff member receive ongoing training.

Given the shared visions between the RVC and VetCOT initiative, this partnership embodies the RCV’s commitment to the highest standards of care, a transdisciplinary holistic approach to patients, and a drive to innovate and improve veterinary science.

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