What Is Critical Care?

Critical care is a recent specialty within veterinary medicine, recognized in 1989 as the American College of Veterinary Emergency & Critical Care. Critical care evolved as an adjunct specialty to aid the needs of very ill or potentially ill surgical, medical, or emergent veterinary patients. The critical care specialist is trained to monitor for, recognize, prevent, and treat disease, disease complications, or potential complications in patients with potentially life-threatening problems. Education of the critical care specialist involves training in the specialty areas of critical care, internal medicine and its various subspecialties, surgery, anesthesia, ophthalmology, nutrition, clinical pathology, toxicology, and diagnostic imaging.

What does a Critical Care Hospital do?

Critical care involves the frequent monitoring of patient’s whose clinical condition can change from minute to minute. The use of serial physical examination, diagnostic testing, and physiologic monitoring devices allow the critical care specialist to tailor a therapeutic plan that provides optimum support and treatment for the patient’s clinical condition.
The goal of critical care is to diagnose any primary or secondary disease conditions, anticipate complications and prevent or treat them, initiate and continue treatment of these problems, and support and monitor these patients until the patient is well enough for follow-up by a general practitioner, internist, or surgeon.
Technology is important for the critical care specialist to perform optimally. Many patient abnormalities are not readily detectable on physical examination or changes in the status of vital parameters may not be perceptible by examination alone. Monitoring of electrolyte and blood glucose status, acid-base status, coagulation ability, cardiac function, ventilation and pulmonary function, vascular volume, hydration, renal function, immune status, as well as other vital parameters are improved through the use of monitoring devices.
A critical care specialist has training in the use of blood gas analysis, capnography, pulse oximetry, electrocardiography, abdominal ultrasound, echocardiography, use and interpretation of laboratory analysis among their many skills. Technology can also play a vital role in the therapy of the critical patient. For example, the use of external ventilatory support may provide a patient with compromised ventilatory or pulmonary capacity sufficient time until normal ability is regained.
Specialists in other areas of veterinary medicine are vital for a critical care specialist to perform optimally. Using a team-oriented approach, critical care specialists consult with other specialists to plan and implement diagnostic and treatment plans. These other specialists may or may not be involved in the continuing care of the critical care patient once the patient’s condition improves.

How can a Critical Care Hospital be of assistance to other Veterinarians?

Many patients present to the general practicing veterinarian or emergency veterinarian with disease processes or traumatic injuries that may benefit from continuous monitoring, ongoing diagnostic procedures, and ongoing therapy.
These patients may require 24-hour care and monitoring, blood and blood component transfusions, enteral and/or parenteral nutritional support, surgical intervention, post-surgical care, specialized anesthetic protocols for high-risk patients, or advanced diagnostic testing and therapies that may not be available in the general practice setting.
Not all critical care patients are ill at the time of presentation to the general or emergency veterinarian. Exposure to certain toxic substances may not produce clinical signs for several hours to days after the exposure; the critical care specialist can treat the patient to prevent clinical consequences and/or monitor the patient for the earliest signs of toxicity and initiate therapy prior to the development of catastrophic consequences.
Anesthesia for high-risk surgical patients can be tailored to minimize detrimental effects of anesthesia and can be extensively monitored during and after the anesthetic event for potential complications of the anesthesia and surgical procedure.
The doctors and staff at Veterinary Care Specialists have the experience and training to provide for these critically ill patients. Please contact us if you have any questions about critical care or if you may require assistance for one of your valued patients.