Emergency and Critical Care
An Emergency and Critical Care (ECC) specialist is a veterinarian who has completed advanced training in ECC (including an internship and residency) following their veterinary degree.
What does an ECC specialist do?
An ECC specialist is trained to provide life-saving treatment and intensive care for unstable or critically ill dogs and cats. An ECC specialist, also known as a Criticalist, works alongside a group of highly trained emergency veterinarians and nurses in a facility that is open 24/7.
The emergency team handles a wide range of urgent cases, including emergencies that occur outside of regular veterinary clinic hours. Emergency veterinarians and nurses are skilled at triaging and stabilising patients, as well as providing initial treatment before determining if further specialised care is required.
Criticalists primarily work in an Intensive Care Unit (ICU) within referral hospitals. They accept direct referrals from general practitioners, transfers from other speciality services like internal medicine, surgery, cardiology, and neurology, as well as transfers from the emergency team.
Which patients are typically under the care of an ECC specialist?
Any patient that requires immediate life-saving interventions or admission to the ICU.
Conditions include:
Respiratory distress e.g. breathing difficulties caused by heart failure, lung or chest cavity disease, upper airway obstruction
Shock i.e. patients with a very high or slow heart rate, low blood pressure, pale gums, collapse etc.
Trauma e.g. hit by car, animal attack, penetrative or burn injuries
Sepsis i.e. infection triggering the immune system to go into overdrive, resulting in widespread inflammation and organ dysfunction
Uncontrollable seizures or coma
Urinary tract dysfunction i.e. not producing urine or difficulty urinating
Life-threatening complications e.g. pneumonia, organ failure (heart, kidney, liver), clotting issues, cardiac arrhythmias, blood pressure abnormalities
Severe poisonings
Complicated post-anaesthetic and surgical patients
Cardiopulmonary resuscitation (CPR) and post-CPR intensive care
After patient stabilisation, an ECC specialist will collaborate with other specialists and perform further diagnostic tests to identify the underlying cause of the patient’s
condition. Based on test results, an ECC specialist will discuss options and treatment plans with the pet owner, keeping them updated and informed. Treatment may involve surgery, intensive medical therapy, oxygen support, and/or other interventions to address the underlying problem.
ECC specialists and the ICU team, play a vital role in managing critical patients whilst providing compassionate care during times of crisis.
What happens in a veterinary ICU?
ICU facilities can provide:
Multiparameter monitoring - ECG, blood pressure measurement
Serial blood testing - acid/base, electrolytes, glucose, lactate, haemoglobin, clotting times, and arterial blood gas analysis
Point of care ultrasound
Medication administration – e.g. pain relief, antibiotics, anti-nausea, infusions to stabilise blood pressure, sedatives, anti-seizure medications and antiarrhythmics
Nutritional support – feeding tube placement and management
Oxygen supplementation - dedicated oxygen kennels with climate control and humidification
Advanced oxygen therapy and life support - high flow nasal oxygen therapy and mechanical ventilation
Blood and plasma transfusion administration
Equipment for cardiopulmonary resuscitation including a defibrillator
Overall, the goal of a veterinary ICU is to provide intensive care and support to patients with complex or life-threatening conditions, with the aim of stabilising their condition, managing complications, and promoting recovery.
