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A Technician’s Night in the Veterinary ER

By: Renae Hamrick, RVT

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At 6:15, the staff members are sharing a laugh and having some dinner when the night's first client comes to our door. She is crying. Her St. Bernard, Mozart, has been hit by a car. He's not doing well. We quickly grab a gurney and run to her car. Mozart is breathing heavily, his gums are pale (a sign that the patient is not in stable condition), and there is blood coming from his nose. We carefully lift this 115 pound giant onto the gurney and whisk him into the treatment area.

This is obviously a difficult time for pet owners, and they often want to be by their pet's side to provide comfort. While wheeling Mozart into the clinic, gathering a history, and assessing the patient, I explain to Mozart's mom that she needs to stay in the lobby while we work on her dog. She is understandably upset about this, but it is important that we are not distracted while trying to save Mozart. It is also important to protect Mozart's mom from potential dangers, such as a bite from the painful dog.

At request from the doctor, I run out to the lobby to inform our client that Mozart is in critical condition, as he is bleeding into and around his lungs and probably has abdominal injuries as well. I also must tell her that stabilization alone will cost at least $500. This news is very difficult to deliver. She wants us to continue and do all we can.

An IV catheter is placed, IV fluids are started, pain medications are administered, and a chest tap is performed. Everyone is swarming around Mozart performing their piece of the treatment puzzle. One tech is able to sneak away to check on hospitalized patients and do 7:00 treatments. Mozart deteriorates and goes into respiratory failure. At the owner's request, CPR is initiated. Again, everyone pitches in to help.

Mozart is not recovering. His mom comes to the treatment area to say good-bye. CPR is stopped. Tears fall onto Mozart's thick hair coat as his mom hugs his body. It is obvious that Mozart was a beloved family member. The staff fight tears at the sight of this painful parting of friends.

We take Mozart's body into an exam room so his mom can have private time with him. Then we talk to her about aftercare options. She wishes to take him home for burial. Mozart's remains are cleaned up, his eyes are closed, a memorial paw print is made, and he is arranged in a nice position in a cardboard casket. It's been a sad hour, but we can't let it get us down; because there are other patients who need us.

We get cleaned up in time for two more patients. We receive a cat named Harold who is vomiting and having diarrhea and a Greyhound named Speedy with a laceration. I take vital signs on both patients and go over the doctor's estimates with their families. After approval, another technician and I get x-rays and bloodwork on Harold. We also help the doctor sedate and suture Speedy.

Based on Harold's diagnostics, he is going to stay in the hospital on IV fluids. We place an IV catheter and make him a soft bed in a cage. Speedy recovers from his sedation and goes home with antibiotics, pain medications, an e-collar, and written care instructions for his parents.

Most of the in-house patients are doing very well. Brutus' vital signs are great; he's tolerating his surgery well. Charlie's blood transfusions are replenishing his blood loss, Buddy has not had more seizures, and Spike is content with his repaired led. Lucy, however, is vomiting profusely and now has a fever. She will need to go to surgery tonight to remove her foreign body. Our surgeon is called.
Meanwhile, a family shows up with a 6 month old unvaccinated mixed breed puppy named Bob. Bob has bloody diarrhea and is not eating. I don a protective gown and exam gloves. Vital signs show an elevated heart rate and temperature. I get permission from the client to run a Parvo test, which is positive.

The doctor evaluates the patient and writes an estimate for the very costly recommended Parvo treatment. I nervously present the estimate to the client. This estimate is often a shock. Unfortunately, the very frustrated client is unable to afford this treatment. Because outpatient treatment is not recommended for this critically ill puppy, the owner elects euthanasia. Another death, this time very avoidable if they had only vaccinated. More tears are shed. Again, we must carry on.

The surgeon arrives to bring relief to our dog with a major belly ache. Another technician and I induce Lucy with anesthesia, intubate her, maintain her on oxygen and gas anesthesia, and clip and clean her abdomen. The surgeon is scrubbing for the procedure. The technicians take Lucy into the surgery suite where she is hooked to monitoring devices and given a sterile preparation for surgery.
During this process, we hear a commotion coming from Buddy's cage. He is having a seizure. A technician runs to his side to administer seizure-stopping Valium.

Surgery is performed without complications, and a pair of underwear are removed from Lucy's small intestine. I sit with Lucy after surgery and closely monitor her until she's awake, her tube is out of her throat, and her temperature is normal. She will be in the hospital for a couple more days for post-operative care.
It's been a long night. It's finally midnight, and I am tired. I say goodnight to my co-workers and the patients. The drive home will hopefully clear my mind of the evening's stresses, for I must be refreshed for whatever tomorrow night holds.

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