Veterinary Medical Team Handbook. Andrew J. Rosenfeld

Transcription

1 Veterinary Medical Team Handbook Andrew J. Rosenfeld

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3 The Veterinary Medical Team Handbook The Team Approach to Veterinary Medicine

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5 The Veterinary Medical Team Handbook The Team Approach to Veterinary Medicine Andrew J. Rosenfeld DVM Diplomate, American Board of Veterinary Practitioners Canine and Feline

6 Andrew J. Rosenfeld, DVM, Diplomate ABVP, is the founder and president of Veterinary Team Education Course. He lectures frequently on topics in emergency medicine, small animal anatomy and physiology, and cardiology. He has practiced small animal critical care and emergency medicine for 16 years and served as hospital director of Paradise Valley Emergency Animal Clinic in Scottsdale, Arizona, for 3 years. Previously, Dr. Rosenfeld was director of technical education for the Pet s Choice family of veterinary hospitals and specialty practices and an adjunct professor at Mesa Community College and Arizona State University Blackwell Publishing All rights reserved Blackwell Publishing Professional 2121 State Avenue, Ames, Iowa 50014, USA Orders: Office: Fax: Web site: Blackwell Publishing Ltd 9600 Garsington Road, Oxford OX4 2DQ, UK Tel.: +44 (0) Blackwell Publishing Asia 550 Swanston Street, Carlton, Victoria 3053, Australia Tel.: +61 (0) Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by Blackwell Publishing, provided that the base fee is paid directly to the Copyright Clearance Center, 222 Rosewood Drive, Danvers, MA For those organizations that have been granted a photocopy license by CCC, a separate system of payments has been arranged. The fee codes for users of the Transactional Reporting Service is ISBN-13: /2007. First edition, 2007 Library of Congress Cataloging-in-Publication Data Rosenfeld, Andrew J. The veterinary medical team handbook: the team approach to veterinary medicine/andrew J. Rosenfeld. 1st ed. p. ; cm. Includes bibliographical references and index. ISBN-13: (alk. paper) ISBN-10: (alk. paper) 1. Veterinary medicine Handbooks, manuals, etc. I. Title. [DNLM: 1. Veterinary Medicine Handbooks. 2. Animal Diseases nursing Handbooks. 3. Animal Technicians Handbooks. SF 748 R813v 2007] SF748.R dc22 The last digit is the print number:

7 Dedicated to Lisa, Lauren, and Jillian, who act as my center, my practicality, my imagination, and my world

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9 Contents Preface CD-ROM Instructions and Contents Section 1 The First Two Days on the Job Chapter 1 Basic Terminology 3 Chapter 2 Vaccines, Heartworms, and Their Terminology 7 Chapter 3 Elective Procedures 15 Chapter 4 Safety and Restraint 25 Chapter 5 Obtaining an Adequate and Precise History 33 Chapter 6 The Medical Record and the 30-Second Triage Examination 39 Section 2 Anatomy and Physiology The Science behind the Diseases Chapter 7 Physical Exam 51 Chapter 8 Skeletal System 63 Chapter 9 Teeth and the Oral Cavity 87 Chapter 10 Gastrointestinal System 103 Chapter 11 Respiratory System 129 Chapter 12 Cardiovascular System 147 Chapter 13 Urogenital System 173 Chapter 14 Liver 193 Chapter 15 Exocrine and Endocrine Pancreas 207 Chapter 16 Thyroid Gland 217 Chapter 17 Adrenal Gland 223 Chapter 18 Reproduction 235 Chapter 19 Integument 249 Chapter 20 Eyes and Ears 273 ix xi Section 3 Clinical Diagnostics The Science behind the Diagnostics Chapter 21 Complete Blood Count 293 Chapter 22 Organ, Hormonal, and Drug Level Clinical Pathology 309 Chapter 23 Urinalysis and Fecal Clinical Diagnostics 337 Chapter 24 Electrocardiogram 353 Chapter 25 Radiology, Ultrasound, and Endoscopy Techniques 365 Section 4 Understanding the Concepts of Disease and Treatment Chapter 26 Pharmacology 379 Chapter 27 Toxins and Poisons 397 Chapter 28 Fluid Therapy 409 Chapter 29 Anesthesia 419 Chapter 30 Shock 435 Chapter 31 Cardiopulmonary Cerebral Resuscitation (CPCR) 453 Appendix 461 Glossary 487 Index 505 vii

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11 Preface Veterinary medicine is a dynamic field, allowing all team members growth in every aspect of the science and profession. It is the only medical profession that allows a medical team member to be part of surgical, radiological, emergency medicine, internal medicine, and surgery teams all in one day. With increasing expectations of quality care and technology, a team member s knowledge and responsibilities are growing at an exponential rate. This book is dedicated to that veterinary team that works as one unit to focus the doctor s attention where the hospital needs him or her most, utilize the staff to their fullest potential, increase staff satisfaction and loyalty as well as decrease employee turnover, increase revenue by becoming more effective communicators and increasing their ability to sense health problems and deal with upset clients, and turn the veterinary technician field into a profession that can be financially and professionally rewarding. This book is intended to be used as a training and interactive resource to help train the medical team to be a resource for the veterinarian, the patient, and the client. How to Use This Book Each section of this book is divided into sections. The sections are broken down into the following: The First Two Days on the Job, Anatomy and Physiology The Science behind the Diseases, Clinical Diagnostics The Science behind the Diagnostics, Understanding the Concepts of Disease and Treatment, and the Appendix. The overall goal of this book is to give the paraprofessional the education and tools to discuss and understand the different disease, diagnostic, and treatment processes that may be required; serve as a quick reference source for the paraprofessional on general practice subjects; and reinforce the concepts of each section with interactive clinical cases in a PowerPoint format. Using this book either as a simple resource or as a part of a formal training program will help refine the skills of the staff and make them greater resources within the hospital team. Acknowledgments Thanks to the following professionals who reviewed the book: Dr. Curt Coffman, Fellow of the Academy of Veterinary Dentistry, Aid Animal Dental Clinic, Scottsdale, Arizona; Dr. Kimberly Coyner, DVM ACVD, Dermatology Clinic for Animals, Phoenix, Arizona; Dr. Sharon Dial, DVM ACVP (Clinical and Anatomic Pathology), associate research scientist, Department of Veterinary Science and Microbiology at University of Arizona, Tucson, Arizona; Victoria M. Lukasik, DVM, Diplomate ACVA, Southwest Veterinary Anesthesiology, and assistant research scientist, Radiology, University of Arizona College of Medicine, Phoenix, Arizona. Thanks also to Stephen Bistner, DVM DACVO, Plymouth, Minnesota, and Jeffrey Bowersox, DVM ACVO, Wilmington, Delaware, for editing support and images. Special thanks to Caron Cann, who has been my professional sounding board and a compass for me while I finished this project. ix

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13 Veterinary Medical Team Handbook Interactive CD-ROM The goal of the interactive CD-ROMs is to practice the key concepts of each section of the book. The CD-ROM is split into two programs. The first CD-ROM is meant for practice with the first two sections of the book with special focus on: Auscultation Trainer Reviews basic concepts of auscultation and allows team members to practice ausculting hearts with different murmurs in case formats. Section I Cases Helps the team member apply basic concepts of nomenclature, lesion position, and obtaining a medical history and understanding the concepts of surgery, vaccination, and heartworm prevention. Section II Cases A slightly more advanced program outlining and testing concepts of basic anatomy and physiology, diseases, clinical diagnostics, and communication with clients about the cardiac, renal, liver, and pancreatic organs. The second CD-ROM contains advanced rounds for the medical team focusing on physical examination, clinical diagnostics, and treatment concepts. Topics contained on the CD-ROM are: EKG Trainer and Case Rounds This section reviews the basic concepts of the electrical rhythm of the heart, step-by-step protocols on how to evaluate an EKG, and how recognize basic arrhythmias. Emergency Triage Trainer The program takes the medical team through two emergency cases that enter the hospital at the same time; the team has to evaluate which animal is more of an emergency at each step of the evaluation. Toxin Rounds This program takes the medical team through toxin and poison ingestion cases and focuses on common physical symptoms and clinical diagnostics associated with common poison ingestion. Complete Blood Count Rounds This program shows the medical team how to evaluate a complete blood count focusing on red blood cell morphology, white blood cell changes, and platelet estimation on the blood film. Fluid Rounds This section takes the medical team through how to evaluate the patient for dehydration, determine fluid need, and practice fluid calculation. To Load the CD Both CD-ROMs contain self-loading narrated PowerPoint based programs that work on any computer (PC or Macintosh). Both contain large files and will take 3 to 5 minutes to load. Simply place the CD-ROM into your CD- ROM drive and allow the program to load. The program will then instruct you on how to navigate through each program. To Navigate in the PowerPoint Environment Once in the PowerPoint environment, you will be able to navigate through each slide by clicking on selected tabs to move forward, answer a question, evaluate a heart rhythm, or make choices where to go in the program. To fully enjoy this process, please follow these guidelines to navigate in this environment. 1. When the program begins, you get a Macro Warning. These programs contain commands called macros that allow the participant to move throughout the environment, listen to sound files, and view image files contained on these CDs. These are not meant to affect your computer or its ability to function. In order to use the CD-ROMS you will need to select to activate the macros in this presentation. In order to view this program properly, please select Enable Macro and click Okay. The program will then load and run normally. xi

14 xii CD-ROM Instructions and Contents 2. When selecting a tab, make sure that the mouse arrow has changed to a small hand before left clicking the mouse button. This will select the proper tab, and will not move you one slide forward in the program. 3. When using the mouse, you inadvertently click or use the dial to move one slide forward. If you do inadvertently move to the next slide and are out of place, simply right click the mouse, which will bring up the following options: Correct way The mouse has gone from arrow to hand, showing you are selecting the proper tab. By right clicking the mouse, the following options become available, please highlight Previous and click with the left mouse button. This will move you back one slide space. 4. There is no narration for the slide. On occasion, PowerPoint may not initiate the narrative sequence. To restart the narration process, simply click the left mouse button once. Incorrect Way In this image the arrow has not changed into the hand, and clicking the mouse will move the program forward one slide only. Finally The programs are meant as fun exercises to reinforce the concepts of the book. At no time does the program, the book, or the author suggest that the medical team is responsible for diagnosis, prognosis, or treatment of the patient.

15 Section 1 The First Two Days on the Job This section is for the new employee who has an active interest in learning the fundamentals of being a part of the veterinary team. It is a training manual that outlines what all team members should know on the first 2 days on the job.