California Animal Referral & Emergency (C.A.R.E.) Hospital
ACVECC STANDARD RESIDENCY PROGRAM

RESIDENCY MISSION

C.A.R.E. Hospital currently offers a Standard Residency Program in the American College of Veterinary Emergency & Critical Care (ACVECC). This program prepares individuals for examination for ACVECC board certification and for a career as a specialist in Emergency and Critical Care.

DURATION & DIPLOMATE SUPERVISION

C.A.R.E. Hospital’s Standard Residency Program is a 3-year program under the direction of Deanna Purvis, VMD, DACVECC, CVA. Jennifer Devey, DVM, DACVECC will provide additional training through on-site training seminars and telephone consultation.

TRAINING WITH ACVECC DIPLOMATE

The ECC resident will acquire a minimum of 60 weeks of direct supervision by an ACVECC diplomate; a minimum of 25 weeks of indirect supervision; and a minimum of 25 weeks of independent study or practice.

TRAINING WITH DIPLOMATES FROM ADDITIONAL SPECIALTIES

The ECC resident will rotate through Internal Medicine, Surgery, Anesthesia, Cardiology, Diagnostic Imaging, and Clinical Pathology under the supervision of board certified specialists in the respective disciplines.

EMERGENCY & CRITICAL CARE SEMINARS

The ECC resident will actively participate for 3 years (2 required) of “in hospital” medical seminars, clinical case conferences, Morbidity & Mortality Rounds, board review sessions, and journal club. A minimum of 200 hours of seminars are to be accrued over not less than 2 years.

EMERGENCY & CRITICAL CARE CONTINUING EDUCATION

50 hours of continuing education courses specific to Emergency/Critical Care – Human or Veterinary Medicine to be accrued over not less than 2 years.

California Animal Referral & Emergency (C.A.R.E.) Hospital
EMERGENCY & CRITICAL CARE DEPARTMENT

THE FACILITY

C.A.R.E. Hospital has an Emergency & Critical Care Department among the specialties provided within the Hospital. The facility is specifically designed to be operated, staffed and equipped 24 hours a day to provide a broad range of veterinary emergency and critical care services.

STAFFING:

The professional staff includes: a board certified emergency/critical care specialist (Deanna Purvis, VMD, DACVECC, CVA); board certified internal medicine specialist (Andrea Wells, DVM, DACVIM); board eligible internist (Shannon Carley, DVM – taking boards June 2008); board certified oncologist (Susan Downing, DVM, DACVIM (ONC); board certified dermatologist (Jean S. Greek, DVM, DACVD) and board certified surgeon (to be announced). An additional board certified emergency & critical care specialist available to provide on-site continuing education (Jennifer Devey, DVM, DACVECC). Technical staff includes licensed veterinary technicians and non-licensed veterinary technicians & aides. A licensed veterinarian (with minimum of one year rotating small animal internship) is on location 24 hours a day. Sufficient staffing is present to assist the DVM with processing multiple patients; performing CPR; providing emergency surgeries; myelograms; CRRT; ventilator management; etc. Consultation with an ACVECC diplomate is available 24 hours per day. A licensed clinical psychologist provides free pet loss support groups and is available for consultation, as appropriate.

At least one licensed veterinarian is on premises at all times (24 hours/day, 7 days/week). There is staff sufficient to allow for processing and treating multiple patients. A minimum of three support staff employees are on site at any given time within the facility. A surgeon or a critical care specialist and one surgical technician is “on call” every night for surgical emergencies. Also, a board certified and/or board eligible internist is “on call” every night for emergencies.

Consultation with an ACVECC Diplomate (Deanna Purvis, VMD, DACVECC, CVA) is available 24 hours/day and 7 days/week. When Dr. Purvis is unavailable, our board certified internist (Andrea Wells, DVM, DACVIM) covers any needs of “in person” assistance. Phone consultation is available with either Dr. Purvis or Dr. Devey.

COMMUNICATION WITH RDVMS:

C.A.R.E. Hospital strives to ensure that excellent communication is maintained between referring veterinarians (rdvm’s) and the emergency facility. A report is faxed every 24 hours updating the referring veterinarian on patients treated and released from C.A.R.E. Hospital and patients who are hospitalized by C.A.R.E.’s Emergency and Critical Care Department.

CONTINUING EDUCATION

All veterinarians obtain a minimum of 40 hours of accredited continuing education every 2 years in the field of emergency and critical care medicine.
Technicians receive at least 24 hours of continuing education in emergency and critical care medicine every 2 years. Technician continuing education is conducted on-site monthly.
The ECC Resident and interested Veterinarians attend on-site weekly meetings including: Morbidity & Mortality Meetings, Board Review Rounds, Case Presentation, Journal Club, Grand Round Presentations and In-Hospital Training. Meetings are open to technicians as well as veterinarians.

LIBRARY

C.A.R.E. Hospital provides a full library containing current textbooks, periodicals, peer reviewed journals, and electronic data sources/Internet access.

MEDICAL RECORDS

A complete medical record (following AVMA guidelines) is kept for each patient. Each medical record includes:

Client Identification
Patient Signalment
Presenting Complaint(s)
History
Physical Examination
Clinical Pathology Tests performed and Results
Diagnostic Imaging Procedures and Interpretation
Tentative Diagnosis or Rule Outs
All Treatments (including anesthesia records and surgical procedures)
Progress Notes
Medications Administered and Time Administered
Client instructions and Communications (including estimates and release forms)
Client and Referring Veterinarian Communications
All Entries in the Medical Record Clearly Identify the Individual Responsible for Administering Care and Entering Data

LABORATORY (ON SITE)

CBC, Chemistry analyzer, Electrolyte analyzer
Full Chemistry Panel
Refractometer
Glucometer
Urinalysis
Activated Clotting Time
Electrolytes
PT
PTT
FIV
FeLV
Parvo
Direct hemoglobin measurement (Hemo-cue)
Cytology – stat in house and within 24 hours by boarded clinical pathologist.
Heartworm testing
Fecal examination (cytology, flotation)
In house blood gas analysis
In house lactate measurement
In house magnesium measurement

LABORATORY (OFF SITE)

Histopathology - Routinely taken and submitted daily for analysis.
Microbiological cultures - Routinely taken and submitted daily for analysis.
Cytology – Routinely taken daily and submitted for analysis.

IMAGING

C.A.R.E. Hospital utilizes Digital Radiography (RapidView E-Film System by Eklin). Radiographs of very good to excellent quality are routinely produced while ensuring the safety of the patient and staff. On-site ultrasonography is routinely performed by ACVIM and ACVECC. MRI is projected to be available by Fall 2008.

ENDOSCOPY is routinely performed for diagnostic and therapeutic indications by ACVIM and ACVECC diplomates at CARE Hospital.

California Animal Referral & Emergency (C.A.R.E.) Hospital
EMERGENCY & CRITICAL CARE SERVICES

DIAGNOSIS & MANAGEMENT OF LIFE-THREATENING EMERGENCIES:

Cardiovascular, Respiratory, Neurologic, Metabolic, Traumatic causes.
CPR - routinely performed, with electrical defibrillation available.
Placement and management of thoracostomy tubes.
Emergency placement and management of tracheostomy tubes.
Oxygen supplementation (cage-side, intranasal, hood)
Assisted ventilation (short or long term)

MONITORING CAPABILITIES:

ECG – 1-6 lead
ABP – Direct and Indirect
CVP
Pulse Oximetry
End Tidal CO2
Esophageal stethoscope

EMERGENCY SURGERY:

Surgical hemostasis, wound debridement, application of wound dressings
Stabilization of musculo-skeletal injuries
Aseptic thoracic, abdominal and neurologic surgery on–site

TREATMENT OF CIRCULATORY SHOCK is performed using crystalloids, synthetic colloids (Hetastarch, Oxyglobin), oxygen, and blood products (whole blood, pRBC’s, FFP). Equipment includes infusion pumps, syringe pumps and burettes to allow fluid delivery. Sufficient pumps are available to treat multiple patients. On-site blood typing and cross matching is available on site.

ANESTHETIC & ANALGESIC THERAPY

Opiates
NSAIDS
CRI’s:
KLM
Fentanyl
Epidural Analgesia
Inhalational Anesthesia
Isoflurane
Sevoflurane
In-line anesthesia scavenging

INTRA-OPERATIVE MONITORING:

ECG
BP – Direct or indirect
Pulse Oximetry
End Tidal CO2
Core Temperature
Esophageal stethoscope (if needed)

PERITONEAL DIALYSIS & CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) C.A.R.E. Hospital utilizes the Prisma System. Both forms of therapies are available on site.

CONTINUOUS PLEURAL DRAINAGE is available on site and utilized by the intensive care unit.

ENTERAL & PARENTERAL NUTRITION is provided at C.A.R.E. Hospital.

LONG TERM MECHANICAL VENTILATION is also available (Drager)

Dr. Erich Stumpp – 3^rd Year ACVECC Resident

Deanna Purvis, DVM, DACVECC, CVA

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		California Animal Referral & Emergency (C.A.R.E.) Hospital ACVECC STANDARD RESIDENCY PROGRAM RESIDENCY MISSION C.A.R.E. Hospital currently offers a Standard Residency Program in the American College of Veterinary Emergency & Critical Care (ACVECC). This program prepares individuals for examination for ACVECC board certification and for a career as a specialist in Emergency and Critical Care. DURATION & DIPLOMATE SUPERVISION C.A.R.E. Hospital’s Standard Residency Program is a 3-year program under the direction of Deanna Purvis, VMD, DACVECC, CVA. Jennifer Devey, DVM, DACVECC will provide additional training through on-site training seminars and telephone consultation. TRAINING WITH ACVECC DIPLOMATE The ECC resident will acquire a minimum of 60 weeks of direct supervision by an ACVECC diplomate; a minimum of 25 weeks of indirect supervision; and a minimum of 25 weeks of independent study or practice. TRAINING WITH DIPLOMATES FROM ADDITIONAL SPECIALTIES The ECC resident will rotate through Internal Medicine, Surgery, Anesthesia, Cardiology, Diagnostic Imaging, and Clinical Pathology under the supervision of board certified specialists in the respective disciplines. EMERGENCY & CRITICAL CARE SEMINARS The ECC resident will actively participate for 3 years (2 required) of “in hospital” medical seminars, clinical case conferences, Morbidity & Mortality Rounds, board review sessions, and journal club. A minimum of 200 hours of seminars are to be accrued over not less than 2 years. EMERGENCY & CRITICAL CARE CONTINUING EDUCATION 50 hours of continuing education courses specific to Emergency/Critical Care – Human or Veterinary Medicine to be accrued over not less than 2 years. California Animal Referral & Emergency (C.A.R.E.) Hospital EMERGENCY & CRITICAL CARE DEPARTMENT THE FACILITY C.A.R.E. Hospital has an Emergency & Critical Care Department among the specialties provided within the Hospital. The facility is specifically designed to be operated, staffed and equipped 24 hours a day to provide a broad range of veterinary emergency and critical care services. STAFFING: The professional staff includes: a board certified emergency/critical care specialist (Deanna Purvis, VMD, DACVECC, CVA); board certified internal medicine specialist (Andrea Wells, DVM, DACVIM); board eligible internist (Shannon Carley, DVM – taking boards June 2008); board certified oncologist (Susan Downing, DVM, DACVIM (ONC); board certified dermatologist (Jean S. Greek, DVM, DACVD) and board certified surgeon (to be announced). An additional board certified emergency & critical care specialist available to provide on-site continuing education (Jennifer Devey, DVM, DACVECC). Technical staff includes licensed veterinary technicians and non-licensed veterinary technicians & aides. A licensed veterinarian (with minimum of one year rotating small animal internship) is on location 24 hours a day. Sufficient staffing is present to assist the DVM with processing multiple patients; performing CPR; providing emergency surgeries; myelograms; CRRT; ventilator management; etc. Consultation with an ACVECC diplomate is available 24 hours per day. A licensed clinical psychologist provides free pet loss support groups and is available for consultation, as appropriate. At least one licensed veterinarian is on premises at all times (24 hours/day, 7 days/week). There is staff sufficient to allow for processing and treating multiple patients. A minimum of three support staff employees are on site at any given time within the facility. A surgeon or a critical care specialist and one surgical technician is “on call” every night for surgical emergencies. Also, a board certified and/or board eligible internist is “on call” every night for emergencies. Consultation with an ACVECC Diplomate (Deanna Purvis, VMD, DACVECC, CVA) is available 24 hours/day and 7 days/week. When Dr. Purvis is unavailable, our board certified internist (Andrea Wells, DVM, DACVIM) covers any needs of “in person” assistance. Phone consultation is available with either Dr. Purvis or Dr. Devey. COMMUNICATION WITH RDVMS: C.A.R.E. Hospital strives to ensure that excellent communication is maintained between referring veterinarians (rdvm’s) and the emergency facility. A report is faxed every 24 hours updating the referring veterinarian on patients treated and released from C.A.R.E. Hospital and patients who are hospitalized by C.A.R.E.’s Emergency and Critical Care Department. CONTINUING EDUCATION All veterinarians obtain a minimum of 40 hours of accredited continuing education every 2 years in the field of emergency and critical care medicine. Technicians receive at least 24 hours of continuing education in emergency and critical care medicine every 2 years. Technician continuing education is conducted on-site monthly. The ECC Resident and interested Veterinarians attend on-site weekly meetings including: Morbidity & Mortality Meetings, Board Review Rounds, Case Presentation, Journal Club, Grand Round Presentations and In-Hospital Training. Meetings are open to technicians as well as veterinarians. LIBRARY C.A.R.E. Hospital provides a full library containing current textbooks, periodicals, peer reviewed journals, and electronic data sources/Internet access. MEDICAL RECORDS A complete medical record (following AVMA guidelines) is kept for each patient. Each medical record includes: Client Identification Patient Signalment Presenting Complaint(s) History Physical Examination Clinical Pathology Tests performed and Results Diagnostic Imaging Procedures and Interpretation Tentative Diagnosis or Rule Outs All Treatments (including anesthesia records and surgical procedures) Progress Notes Medications Administered and Time Administered Client instructions and Communications (including estimates and release forms) Client and Referring Veterinarian Communications All Entries in the Medical Record Clearly Identify the Individual Responsible for Administering Care and Entering Data LABORATORY (ON SITE) CBC, Chemistry analyzer, Electrolyte analyzer Full Chemistry Panel Refractometer Glucometer Urinalysis Activated Clotting Time Electrolytes PT PTT FIV FeLV Parvo Direct hemoglobin measurement (Hemo-cue) Cytology – stat in house and within 24 hours by boarded clinical pathologist. Heartworm testing Fecal examination (cytology, flotation) In house blood gas analysis In house lactate measurement In house magnesium measurement LABORATORY (OFF SITE) Histopathology - Routinely taken and submitted daily for analysis. Microbiological cultures - Routinely taken and submitted daily for analysis. Cytology – Routinely taken daily and submitted for analysis. IMAGING C.A.R.E. Hospital utilizes Digital Radiography (RapidView E-Film System by Eklin). Radiographs of very good to excellent quality are routinely produced while ensuring the safety of the patient and staff. On-site ultrasonography is routinely performed by ACVIM and ACVECC. MRI is projected to be available by Fall 2008. ENDOSCOPY is routinely performed for diagnostic and therapeutic indications by ACVIM and ACVECC diplomates at CARE Hospital. California Animal Referral & Emergency (C.A.R.E.) Hospital EMERGENCY & CRITICAL CARE SERVICES DIAGNOSIS & MANAGEMENT OF LIFE-THREATENING EMERGENCIES: Cardiovascular, Respiratory, Neurologic, Metabolic, Traumatic causes. CPR - routinely performed, with electrical defibrillation available. Placement and management of thoracostomy tubes. Emergency placement and management of tracheostomy tubes. Oxygen supplementation (cage-side, intranasal, hood) Assisted ventilation (short or long term) MONITORING CAPABILITIES: ECG – 1-6 lead ABP – Direct and Indirect CVP Pulse Oximetry End Tidal CO2 Esophageal stethoscope EMERGENCY SURGERY: Surgical hemostasis, wound debridement, application of wound dressings Stabilization of musculo-skeletal injuries Aseptic thoracic, abdominal and neurologic surgery on–site TREATMENT OF CIRCULATORY SHOCK is performed using crystalloids, synthetic colloids (Hetastarch, Oxyglobin), oxygen, and blood products (whole blood, pRBC’s, FFP). Equipment includes infusion pumps, syringe pumps and burettes to allow fluid delivery. Sufficient pumps are available to treat multiple patients. On-site blood typing and cross matching is available on site. ANESTHETIC & ANALGESIC THERAPY Opiates NSAIDS CRI’s: KLM Fentanyl Epidural Analgesia Inhalational Anesthesia Isoflurane Sevoflurane In-line anesthesia scavenging INTRA-OPERATIVE MONITORING: ECG BP – Direct or indirect Pulse Oximetry End Tidal CO2 Core Temperature Esophageal stethoscope (if needed) PERITONEAL DIALYSIS & CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) C.A.R.E. Hospital utilizes the Prisma System. Both forms of therapies are available on site. CONTINUOUS PLEURAL DRAINAGE is available on site and utilized by the intensive care unit. ENTERAL & PARENTERAL NUTRITION is provided at C.A.R.E. Hospital. LONG TERM MECHANICAL VENTILATION is also available (Drager) Dr. Erich Stumpp – 3^rd Year ACVECC Resident Deanna Purvis, DVM, DACVECC, CVA Print this page


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California Animal Referral & Emergency (C.A.R.E.) Hospital ACVECC STANDARD RESIDENCY PROGRAM