Emergency Medicine & Critical Care: General Principles:
Emergency Equipment Checklist
Author:Christal Pollock, DVM, Dipl. ABVP-Avian.
Date: May 27, 2007 updated February 15, 2011
Keywords: emergency, supply list, checklist, training, equipment, medication, pharmacy, compounding
Prepare yourself and your staff
- Spend some time with an experienced exotic animal veterinarian. Become accustomed to recognizing signs of illness, handling and restraint, performing a good physical examination, and providing supportive care.
- Attend continuing education meetings such as the annual conference of the Association of Avian Veterinarians , Association of Exotic Mammal Veterinarians, Association of Reptile and Amphibian Veterinarians, the North American Veterinary Conference, or Western Veterinary Conference.
- If possible, also set up a "backup" system. Find a clinician that you may contact with questions and advice, potentially for a fee.
- Begin a collection of reference materials to have on hand, and if possible join a local area interest group. Review anatomy and physiology, and develop protocols for anesthesia and cerebral-cardiopulmonary resuscitation for your practice.
- While training support staff, do not forget to include your receptionists since they will be involved with telephone triage and owner instructions.
Prepare your practice
First consider caging and feeding requirements:
- Quiet: House non-traditional patients away from cats and dogs. More than one room should be available so that infectious patients may be isolated.
- Dark: Lighting should be easily dimmed. Doors and windows with glass should have blinds. Blinds protect the bird from flying into glass, while allowing people to see a bird flying around before entering the room.
- Supplemental heat: Provide an incubator, baby warmer, or intensive care unit cage for various sized patients (i.e. Lyon Electric Co.).
- Perches: Provide easily cleaned acrylic perches (i.e. Lyon Electric Co.) and/or PVC perches of variable diameter. Wrap perches with tape or vetrap for traction.
- Tube feeding formulas: The Emeraid Nutritional Care System can be fed to a variety of exotic animal patients.
- Exotic animal foods: Have a variety of commercial diets available for feeding inpatients as well as hay and seed mixes. Although seed diets are not recommended, hospitalization is not the time for diet change. Millet seed may be particularly attractive to small species like cockatiels, and hulled sunflower seeds may be an easily eaten, high calorie food source.
- Designate an examination room for exotic species.
Equipment checklist
New equipment will need to be purchased, and existing equipment may need to be modified in order to treat non-traditional pets. See the checklist below or download the PDF file.
In addition to the standard equipment of most practices, the radiographic unit should be capable of high mA settings and short exposure time (i.e. 1/60 second). Practice patient positioning and develop a radiographic technique chart before clinical patients are seen. High-detail radiographic film. Mammography film may be used as an alternative in very small patients. High-detail and fast-speed film cassette + high-detail, rare earth intensifying screens
Machine capable of horizontal beam radiography
Also how will exotic animal clinical pathology be managed? Will you use an outside lab or in-house analyzers (i.e. Abaxis, Inc.)?
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aWhite towels may be bleached and present a professional image for restraint of medium to large-sized birds. Blue surgical towels or unbleached paper towels are superior to washcloths for restraint of small birds. |
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| Bird equipment | □Stethescope (pediatric or infant) (Littman) □ Ball-tipped metal gavage or feeding tubes (Ejay International or Veterinary Specialty Products) □Gram scale, digital (changes in increments of 1 gram or less) □Pediatric scale, digital □Towels for restrainta □Small acrylic pet cage(s) □Incubator or intensive care cage □Masking tape or blue painter’s tape (3M) to secure patients during radiographs or surgery □Red rubber catheters, 3-5 Fr (Sherwood Medical) to tube feed very small patients. □Small gauge (25 to 27 ga) needles (Monoject) □Insulin syringes (0.3-0.5 ml) □Nebulizer, ultrasonic or disposable (Marquest Medical, DeVilbiss Health Care, Inc.) □Mini-tip culturettes (Marion Laboratories) |
Surgery/anesthesia |
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| □Scale perch (Veterinary Specialty Products) □Band cutter □Two pairs of small vice grip pliers are also useful for band removal. □Rotary tool (i.e. Dremel) for grooming □Mouth specula (Veterinary Specialty Products) |
□Small surgical blades, 15 and 11 □ Uncuffed endotracheal tubes ranging in size from 1 mm to 4mm (Cook Veterinary Products) □Cufffed endotracheal tubes 2.0-4.0 mm (Veterinary Specialty Products) □Doppler pediatric probe (Parks Electronic) for anesthetic monitoring □Isoflurane or sevoflurane □Atraumatic and fine tipped surgical instruments □Circulating warm water blanket (Gaymar) or heating pad □Non-rebreathing anesthesia circuits and 0.5-L rebreathing bag (SurgiVet) □Pediatric laryngoscope blade □Ambubag, neonatal |
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| Small mammal equipment | ||
| □Illuminated bivalve nasal speculum (Welch Allyn) □Dental kit starter pack (Jorgensen Laboratories) □24-gauge indwelling catheters |
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| Reptile Equipment | Clinical pathology | |
| □Baby spoons, rubber spatulas and/or nylabones as makeshift oral specula □Digital thermometers and/or infrared thermometers, digital hygrometers □Ceramic heat lamp |
□Coverslips □ Microtainers to collect small blood volumes (200 to 700 ml) (Becton Dickinson) |
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Medication
Many medications commonly used in exotic practice are also used in domestic small animals. Listed below is a short list of medications or drug classes that may prove helpful. It is also important to locate a reliable, competent compounding pharmacist in your area. The pharmacist should be a member of professional associations such as the American College of Veterinary Pharmacist, International Academy of Compounding Pharmacists, or the National Association of Compounding Pharmacies.
Antimicrobials
- Amikacin
- Cephalosporin, second generation such as ceftiofur (Naxcel, Pharmacia or Excede, Pfizer)
- Cephalosporin,third generation such as cefotaxime (Claforan, Hoechst-Roussel) or ceftazidime (Fortaz, GlaxoSmithKline)
- Clavulanic acid (Clavamox, Pfizer)b
- Clindamycin (Antirobe, Upjohn)b
- Enrofloxacin (Baytril, Miles)
- Ivermectin
- Metronidazole (compounded suspension)
- Nystatin (Mycostatin, Bristol-Myers Squibb)
- Silver sulfadiazine cream (Silvadene, Marion Labs, Inc.)
- Sulfa-trimethoprim suspension
bNot for use in rabbits and rodents
Anesthesia/analgesia/sedation
- Atipamizole (Antisedan, Pfizer)
- Buprenorphine (Buprenex, Reckitt & Colman)
- Butorphanol (Torbugesic, Fort Dodge)
- Ketamine (Ketaset, Fort Dodge)
- Medetomidine (Dormitor, Pfizer)
- Meloxicam (Metacam, Boehringer Ingelheim)
- Midazolam (Versed)
Miscellaneous agents
- Calcium EDTA (Calcium Disodium Versenate®, 3M Pharmaceuticals)
- Calcium glubionate (Calcionate syurp, Watson/Rugby )
- Calcium gluconate (Fort Dodge)
- Dextrose 50%
- Iodine (Lugol’s iodine)
- Lactulose (Cephulac, Schiapparelli Searle)
- Metoclopramide (Reglan, Robins)
- Oxytocin (Oxytocin, Butler)
- Prostaglandin E (Prepidil, Pharmacia and Upjohn)
- Vitamin A/D3
References
Brown SA, Nye RR. Essentials of the exotic pet practice. J Exotic Pet Med 15(3):225-233, 2006.
Capello V. The dental suite: equipment needed for handling small exotic mammals. J Exotic Pet Med 15(2):106-115, 2006.
Hillyer EV. Physical examination. In: RB Altman, SL Clubb, GM Dorrestein, K Quesenberry (eds). Avian Medicine and Surgery. WB Saunders. Philadelphia, PA, 1997. Pp. 125-141.
Lennox AM. Equipment for exotic mammal and reptile diagnostics and surgery. J Exotic Pet Med 15(2):98-105, 2006.
Shields A. Preparation of a special species ER. Seminars in Avian and Exotic Pet Medicine 13(3): 111-117, 2004.
