WRITTEN BY: Lara Cooke
AssDip (AppSc), DipMan, VN, TAA.
No two patients ever ingest the same amount of toxin or are the same breed, weight or age as one another. For this reason, preparing for a patient with a suspected toxicity always starts with triage. Telephone triage is an art form, especially if the client on the other end of the line is in panic mode.
If I can make a recommendation, when dealing with a potential toxicity case a short form with the following information kept at reception is a handy way to ensure you gather the correct information from your client. This ensures you provide your veterinary team with sufficient information to correctly set up for the patient’s arrival.
| Owners Name: |
| Contact Number: |
| Species: |
| Breed: |
| Weight of the pet: |
| Suspected toxin: |
| Amount of toxin ingested: |
| Time of ingestion: |
| Presence / absence of any abnormal behaviour:
|
| Estimated time of arrival: |
On arrival at the clinic, the patient should be triaged, along with the standard TPR/MM and CRT check you should also make sure to assess your patients level of consciousness, including a pupillary light reflex test – both pupils are equal in size and reactive to light.
If you are not overly familiar with this technique practice on your fit healthy patients so that you have a base line to judge any anomalies with.
Without delving too deeply into how toxins can inhibit the normal function of the CNS, it is not uncommon for pets who are suffering from toxicities such as theobromine (chocolate) or metaldehyde (snail bait) to show signs such as:
- Anxiousness, restlessness (owner describes this as their pet being unable to settle)
- Salivation, mydriasis, tremors and ataxia
- Seizures, tachycardia and hyperthermia.
Inducing Emesis
If the toxin or poison was ingested less that one to two hours prior to your patient arriving at the clinic and the substance is a NON CORROSIVE of nature then it is likely that your vet will then proceed with inducing emesis (vomiting). Your clinic protocol will dictate what you need to prepare and may include soda crystals, apomorphine, or in the case of cats, Xylazine is often used. Of course, you will also prepare gloves as a minimum for yourself and a plastic bag lined litter tray or incontinence pad to catch the offensive toxin, as your Veterinarian will likely want to examine the contents.
On a side note to this: Never leave a patient alone once emesis has been induced as it is not uncommon for them to re-eat what they have brought up!!
Other things to prepare for a toxicity emergency case
Although each patient that presents to you may be showing differing clinical signs dependant on what the cheeky monster has ingested here are some further guidelines as to what you can prepare prior to the arrival;
- Admission sheet and/or treatment sheet
- IVC set up – size of catheter will be dependent on the initial information provided over the phone on the size of the pet
- Primed extension set
- IV fluids and administrations set – primed. Fluid pump
- Oxygen (mask or fly by set up )
- Equipment for blood collection – syringe, needle, EDTA, lithium Hep and sodium citrate for coagulation profile
- Charcoal (powder or liquid form)
- Stomach tube – buckets and lubrication as well as warm water for lavage
- Anaesthetic machine set up – ET tubes and ties of various sizes
- Laryngoscope
So there you have it, responding to toxins in a nut shell.
I could go on all day and cover off tick, snake toad toxins but this blog would turn into a novel and you are likely reading this on the fly as we all do! If you do want to learn more about being prepared for many different types of emergencies, then our Emergency Nursing short course is for you. If Emergency is a passion of yours, you may want to consider a Diploma of Veterinary Nursing (ECC) or our Advanced Certificate in Professional Veterinary Nursing.
want to learn more?
Emergency nursing
SHORT COURSE
Emergency nursing can be exciting and very daunting. This subject will teach students about how to effectively triage cases over the phone, and in clinic; first aid advice to provide to owner, how to prepare for the arrival of the emergency patient and how to assist the Veterinarian in the management of these cases. Setting up and maintaining crash carts is also covered along with cardiopulmonary resuscitation.
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