Tampa Bay Regional Disaster Symposium

Tampa Bay Regional Disaster Symposium 2008

Small Animal Disaster Medicine:Common Emergencies

Dr. Jo Ann DanielsCentral Pasco Veterinary CareDirector of Disaster Medicine Suncoast Veterinary Association, PARTCentralpascovetcare@hotmail.comCommon emergencies and how to prepare for these at your practiceChanges to plan ahead for. Tips to practice within these limitations.Common injuries and conditions.Supplies to pre-stock.Client and staff education to prevent these emergencies.Re-open your practice as soon as possible.

Changes: Power FailureRadiographsAutoclaveSurgical MonitorsLaboratory MachinesAir ConditioningHot water/well pumpsRefrigeratorsRechargeable EquipmentGeneratorsChanges: Power FailurePhone SystemCall your phone service provider and Call Forward your practice phone number to a cell phone.Purchase a hand crank rechargeable lantern that has an outlet to plug in your cell phone car charger. ($19.99 at Home Depot)

Changes: Limited SuppliesReordering of productsLimited access by delivery driversLimited storage of perishable supplies when power failsEmergency care to patients may deplete supplies quicklyBe familiar with sampling programs from your preventative care product representatives. Many have programs for disaster aid.

OcularTraumatic injuriesUlcers/erosionForeign bodiesFight woundsSearch and Rescue HerpesAllergies

OcularWelch Allyn Ophthalmoscope/otoscope setsC-Cell converter for 3.5v power handles- Part # 710168-501 - Remove the rechargeable module and rechargeable battery; replace with two c-cell batteries and the converter. - $16.98 - $19.99 Welch Allyn also makes a pocket ophthalmoscope

Ocular SuppliesEye WashEye StainMedicated OintmentsSterile LubeEye Surgical PackOphtho suture materialE-collars

Gastro-intestinalForeign body ingestionToxicitiesGI indiscretionStressDiet ChangeParasitismViral and Bacterial

Your clients houses

and patients environments

Gastro-intestinalClient Education.Pre-stock of appropriate diet esp. prescription diets.Ingestion of debris during clean up process.Collapsable crates.Supportive and symptomatic care.Use precautions for contamination Glove up !Drinking and eating sources.Deceased wildlife, contaminated drinking sources from sewage, uncollected garbage piles, spoiled foodGI SuppliesDewormersSucralfatePepcidMetronizadoleAlbonPanacur PacketsCaution with motility meds without radiographsReplacement Fluids Normosol RBland Diets - i/d, low residue

IntegumentTraumatic injuryLacerationsBurnsImpalementsFight woundsInfected woundsNecrotic lesionsAllergiesParasitism

Integument SuppliesBandage materialsBattery operated clippersTelfa padsWound irrigation salinePenrose DrainsSkin staplersSutureLac-packsAntibiotics, analgesics, anti-inflammatoriesMusculoskeletalFracturesEmaciation/dehydrationWeaknessInjuries from other animalsTendon/ligament tearsImpalementsCrushing InjuriesHBC of roaming animals

Musculoskeletal suppliesSplintsBandage suppliesSurgery packs and sutureAntibioticsAnalgesicsAnti-inflammatories

Other conditionsDehydrationHypoglycemiaNon-regulated diabetesAddisonian crisisHeat stress and heat strokeLost pets/found petsPets with no identificationEstablish a plan for intake of pets

DiagnosticsBattery powered glucometersRefractometerUrine Dipsticks Azo-Bun Sticks Jorgensen $27.00 for 25 pack

DiagnosticsHeartworm TestsIdexx snaps can be removed from the refrigerator and have a 90 day shelf life

Felv/FIV Tests

ACT TubesVet-Lab Supply 1-800-330-1522 100 pack for $65.00DiagnosticsReference Laboratories driver may have difficulty reaching your practice.Air card and lap-top computer may allow access to on line results if fax machine is out of order.Disaster relief sites may have federal response VMAT that have in house diagnostic machines.If you have a generator, you may have enough power to use a microscope for fecal and blood film examination.Most centrifuges will work from generators for manual HCT/TP, UA sedimentation and sample preparation.DiagnosticsMost X-ray machines draw too much power load to work with a portable generator.Establish relationships with other practices in the surrounding areas that may have power for in-house diagnostic machines - Hematology and Chemistry or they may have a working radiology suite.Surgical Injuries/ MonitoringBattery Powered DopplerOne 9v batteryNew JorgensenRefurbished MedfurbishF air canisters to attach to your anesthetic machine, if your powered scavenger systems is not operational.Battery SPO2/HR Monitor.

SurgeryGloves, Disposable Gowns, Masks Battery Powered ClippersIndividual Scrub Brushes (BD E-Z Scrub 205 Iodine) Merritt Vet Supplies 1-800-477-5167

SurgeryPenrose Drains60 cc syringes and red rubber catheters for suctionChest tube set-upLighting Source Battery powered loopsSurgeryLac-PacksIndividually wrapped mini packs of instruments to save major packs for abdominal surgeries.Olsen Hegar, Brown Adson, Towel clamps, Metzenbaums, curved forceps, blade handle, 4 x 4sConsider Hemoclips for efficient ligation and skin staplers for efficient closureRica Instruments via Merritt Veterinary SuppliesRep. Fred VanNorman 813-477-0955Fluid TherapyWithout IV Pumps.Replacement fluids.Dextrose fluids.Dial-up drip sets (5 ml/hr 250 ml/hr Abbott $5.97)Create a chart for macro and micro drip sets in your treatment area to indicate ml/hours rate conversions to drops per ml.Irrigation saline.

Heat Stroke

Heat StrokeClient EducationEncourage clients to purchase a rectal digital thermometer and demonstrate its proper useBoard pets until their houses are powered againCollapsable crates with fan if clients have their own generator at homeDiscourage use of walled kennels that offer minimal air circulationAsk clients to evacuate early so they are not stuck in long traffic jams with their pets in a hot car.

Blood productsAnimal Emergency of Pasco Blood Bank8740 US 19, Port Richey 727-841-6575Packed rbcs, fresh frozen plasma, frozen plasmaIf you generator supports a mini-fridge/freezer, stock plasma for heat stroke and snake bite victimsWhole blood products for traumatic injury, Packed Rbcs also available for canine and feline patients. Have blood collection sets on hand. Blood typing cards from Rapid Vet do not need to be refrigerated

Other SuppliesWater, water and more waterCardboard Carriers inexpensive and easy to storeJorgensen productJ-133 $95.00 for 20 pack($4.75 each)

Other SuppliesKeep the shipping coolers and ice packs that your vaccines arrive in. They make great temporary housing for vaccines and perishable medications and products during brown outs.Spare scrubs for a quick change after examining a contagious patient.Staff care items non perishable snacks and drinks, hand sanitizers, baby wipes for hygiene Extra biohazard boxes in case your pick up service is unavailable.

Other SuppliesDisposable sanitation suppliesKennel PadsDisposable paper food bowls/traysLess dishes to wash if your dont have running waterJorgensen J-974Manual Can OpenerDisposable water bowlsJ-975Extra leashes

Other SuppliesDisposable litter boxes.Contractor Bags for debris collection.Shed suppliesPlywoodChainsaw Tarp and nails to cover roof damageDuct tape

Record KeepingPaperless practice need pink and blue hand written medical records. All practices need pre-printed prescription labels so directions can be hand written below hospital information. Patterson Office Supplies 1-800-637-1140 Item 073-2594 Treatment Flow SheetsStray and clients pets identification bands Digital Camera Record KeepingOff site information back up monthly servicePortable external hard drive.Set on timerAutomatic DailyBest Buy or Dell$100- $150

FinancesCredit Card MachinesCall merchant services company and order a manual imprinter. ($22.00-$24.00)Utilize cell phones to call in authorizations.

FinancesCare Credit Pre-print out care credit applications to phone in authorization requests you may not have access to the web applications.Keep records of any products used and services performed during disaster aid for your end of year accounting.InsurancesMeet with your insurance agent Building damageReview your lease for your responsibilitiesDo you have wind insuranceContents InsuranceProfessional OverheadShort-term/ Long term disabilityGeneral LiabilityProfessional Liability and Animal Bailee www.avmaplit.comHospital PoliciesCreate a Severe Weather Guidelines chapter to your employee manual. Have each member of your staff read and sign these policies.Create a flexible schedule so staff can rotate duties to allow time for them to get home for their own pets.Discuss job responsibilities with staff for before, during and after disaster events.Do not offer boarding to clients if you are in an evacuation or flood zone.Choose one media representative from your practice. Use caution with interviews.

Staff EducationSchedule a staff meeting to go over disaster guidelines and client education.Provide staff with resourcesbrochuresphone listswebsite addresses www.hsus.org $20.00 for 100 pack

Staff EducationEducate staff of universal precautions and for isolation protocols.Prevent contamination of your hospital by limiting one staff member to interact with isolated patients during a shift.

Client EducationPost disaster preparedness guidelines on your website.For an example, visit www.CentralPascoVetCare.com please cut and paste any portion of this guide.

Client EducationAsk clients if they live in an evacuation zoneFamiliarize your clients with your boarding policies.Brochures and practice handouts.List of pet-friendly hotels in the area.www.petfriendlytravel.comGet involved in your community.Write an article for your local paper.Offer first aid classes at your practice.

Client EducationDiscuss proper identification for all petsScan all patients on very visit to assess microchip function, inquire if registration is current and demonstrate to clients what we would look for if their pet was micro-chipped and lost. Res Q Universal Scanner Bayer 1-800-633-3796 $200.00

Client EducationCollars on all petsID tags on all petsInclude name, Addressphone numbers alternate contact number

Reopen as soon as it is safe toFollow local emergency service coordinators directions for safe return to the practice.GPS Coordinates of your practice forwarded to the FVMA and AVMA street signs are goneGo to http://maps.google.com/Type in your practice address, city, state and zipRight click over your exact location and scroll down to center map here. Coordinates will appear in location box.

ResourcesAttend your local VMA and regional FVMA meetings to introduce yourself to fellow veterinarians and establish a network of resources.Discuss disaster plans with other hospital owners and managers to see if resources can be consolidated.Know the emergency hospital policies in your area so you can educate your clients accordingly.The American Veterinary Medical Foundation accepts applications for disaster relief funding.

Disaster Relief Sites

Questions ? Dr. Jo Ann DanielsCentral Pasco Veterinary Care17945 State Road 54Lutz, FL 33558813-926-1126www.CentralPascoVetCare@hotmail.com