Programme accéléré d'Urgences

Key Learning Objectives

• Identify and interpret acid base disorders
• Identify primary and secondary acid base disorders and compensatory mechanisms .
• List causes of acidosis and alkalosis
• Discuss the anion gap and its diagnostic use
• Describe the management of acidaemia and alkalaemia.
• Discuss the physiology of lactate production and its use as a perfusion marker
• Describe the pathophysiology of hyperlactataemia
• Outline oxygenation in terms of arterial blood oxygen, ventilation, perfusion and V/Q mismatch
• Recall the physiological causes of hypoxaemia and associated disease processes
• Use the P:F ratio and A-a Gradient in reference to oxygenation
• Discuss the parameters involved in assessment of ventilation

Key Learning Objectives

• Define shock and the physiological causes
• Explain circulatory shock in terms of hypovolemic, cardiogenic, distributive, obstructive shock
• Outline  the stages of shock
• Describe the principles of fluid therapy Discuss the goals of fluid therapy
• Demonstrate how to assess the degree of dehydration
• Discuss types of intravenous fluids and their indications Construct a fluid plan to correct hypovolaemia, dehydration, ongoing losses and maintenance
• Explain indications for bolus and shock fluid rates
• Describe monitoring and end points for fluid therapy.
• List the potential complications of fluid therapy
• List considerations for perioperative fluid therapy

Key Learning Objectives

• List the main serum electrolytes which need to be monitored and clinically managed
• Recall the common causes of  derangements in main electrolyte
• Describe the  clinicopathological changes seen with common electrolyte derangements e
• List the appropriate management and treatment for the common electrolyte disturbances
• Discuss hypernatremia and hyponatremia in terms of volume status
• Recall the specific calculations used in the management and treatment of sodium disorders

Key Learning Objectives

Clinical Pathology Part I

• Identify and interpret  a complete blood count.
• Outline differential diagnoses for complete blood count changes
• Discuss how to perform and evaluate a blood smear
• Interpret a serum biochemistry profile and outline differential diagnoses for abnormalities.
• Outline the interpretation of the coagulation profile
• Identify artefacts that may affect clinical pathology results in terms of animal breed, sample artefact and laboratory artefacts

Focussed Ultrasound Part II

• Describe aFAST and tFAST techniques.
• Outline the abdominal fluid scoring system
• Describe and outline VetBLUE including the acoustic windows
• Identify lung ultrasound signs - A lines, B lines, glide sign
• Describe likely disease processes using the regionally based respiratory pattern
• Describe focused echocardiography and the use of this technique

Key Learning Objectives

• Outline the pathophysiology of the pain pathways including the main neurotransmitters
• Recall the three types of pain
• Identify how to assess pain and use pain scales
• Define multimodal analgesia and pre-emptive analgesia
• Discuss basic pharmacology of commonly used analgesics, their advantages and disadvantages
• Select appropriate analgesic agents for different trauma situations
• Discuss the advantages and disadvantages of some commonly used sedative and anaesthetic agents.
• List considerations for anaesthetic drugs based on common emergency presentations and surgeries

Key Learning Objectives

• Identify the important components of a triage assessment
• Discuss life sustaining interventions in primary triage and use of point of care diagnostics
• Explain the secondary triage survey and assessments
• List the clinical signs of cardiopulmonary arrest (CPA)
• Explain basic life support (BLS) and cardiopulmonary resuscitation (CPR)
• Describe recommended techniques for chest compressions and ventilatory support
• Describe monitoring devices used in advanced life support (ALS)
• Identify shockable and non-shockable rhythms in CPR and how to treat
• Discuss medications potentially used during CPR

Key Learning Objectives

• Explain the cell-based model of coagulation
• Recall the pathophysiology of primary haemostasis
• Identify the clinical signs, diagnostic tests and treatment of primary haemostatic disorders
• Recall the pathophysiology of secondary haemostasis
• Identify the clinical signs, diagnostic tests and treatment of secondary haemostatic disorders
• Recall the main disorder of tertiary haemostasis (fibrinolysis)
• Recall the basic overview of traumatic coagulopathy
• Outline the primary mechanisms of anaemia
• Identify the clinical signs, diagnostic tests and the treatment of anaemia.

Key Learning Objectives

• Discuss the pathophysiology and clinical signs of cardiac failure
• Outline the diagnostic evaluation of cardiac system
• Outline the medical treatments and procedures used in management of cardiac emergencies
• Discuss the Renin-Angiotensin-Aldosterone System (RAAS) and blood pressure maintenance
• Describe the clinical signs of  hypertension and hypotension
• List the diagnostic tests used in the evaluation of blood pressure
• Outline the medical treatment for hypotension and hypertension
• Outline the aetiology, diagnosis and management of FATE (Feline Aortic Thromboembolism)
• Describe the commonly seen cardiac arrhythmias
• Outline emergency treatment of common cardiac arrhythmias

Key Learning Objectives

• Discuss respiratory physiology in terms of hypoxaemia and hypoxia and causes
• Describe the difference between ventilation and oxygenation measures and V/Q mismatch
• List relevant measures for assessment of ventilation and oxygenation
• Explain the oxyhaemoglobin dissociation curve
• Explain lung function assessment in terms of the PF ratio
• Detail a diagnostic plan for patients with respiratory distress
• Detail a treatment plan for patients in respiratory distress
• List common disease states that present as respiratory emergencies.

Key Learning Objectives

• Describe the physiology of potassium homeostasis
• Discuss the aetiology, clinical consequences and management of hyperkalemia
• Discuss the aetiology, diagnosis and management of uroabdomen
• Discuss the aetiology, diagnosis and management of Feline Lower Urinary Tract Disease (FLUTD)
• Describe pathophysiology of acute kidney injury and the differential diagnoses for pre-renal, renal and post-renal causes
• List the veterinary staging systems for acute kidney injury
• Discuss the treatment, management and monitoring of acute renal injury
• Discuss the diagnosis and treatment of pyometra
• Discuss the diagnosis and treatment of eclampsia
• Discuss the recognition and management of dystocia
• Discuss the criteria of caesarean for managing dystocia

Key Learning Objectives

• Describe how to perform a complete ophthalmic assessment
• Discuss the ophthalmic assessment in terms of gross and specialised examination techniques
• List the required equipment and drugs required for a complete ophthalmic assessment
• Describe the aetiology and clinical signs of common ophthalmic emergencies
• Discuss the diagnostic workup of common ophthalmic emergencies
• List the treatment and management of the following ophthalmic conditions
  • Corneal ulcer/laceration
  • Descemetocele
  • Uveitis
  • Glaucoma
  • Horner’s Syndrome
  • Proptosis

Key Learning Objectives

• Describe assessments that are used in neurological lesion localisation in brain and spinal cord injury
• Describe how to perform a neurological examination
• Discuss primary and secondary traumatic brain injury
• List the clinical assessments and treatment for traumatic brain injury
• List the diagnostic workup and treatment of  seizures and status epilepticus
• List the diagnostic workup of patients with suspected intracranial disease
• Discuss specific treatments for meningitis and meningoencephalitis

Key Learning Objectives

• Discuss the clinical findings in acute abdomen presentations
• Describe the diagnostic workup for an acute abdomen presentation
• Describe treatment for an acute abdomen presentation
• Discuss Acute Pancreatitis, including clinical signs, diagnostic plan and management
• Discuss Acute Gastroenteritis, including clinical signs, diagnostic plan and management
• Discuss Gastric Dilation and Volvulus (GDV), including clinical signs and diagnostic plan and management
• List the post-operative management and monitoring of GDV patients
• Discuss Acute Non-Traumatic Haemoabdomen - including clinical signs and diagnostic plan and management

Key Learning Objectives:

• Discuss the pathophysiology, clinical signs and diagnostic investigation of diabetic ketoacidosis (DKA)
• Describe the clinicopathological abnormalities and management regimes for DKA patients
• Discuss hyperglycaemic hyperosmolar syndrome (HHS)
• Outline the pathophysiology of glucose regulation and the clinical signs, diagnostic investigation and management of patients with hypoglycemia
• Discuss the pathophysiology of primary and secondary hypoadrenocorticism
• Describe the common clinicopathological abnormalities and diagnostic investigations for hypoadrenocorticism
• Discuss the emergency treatment and management of patients in ‘Addisonian Crisis’.
• Discuss Critical Illness Related Corticosteroid Insufficiency Syndrome (CIRCS)

Key Learning Objectives

• Describe the phone triage of suspected intoxication cases
• Discuss the decontamination methods for intoxicants and associated complications and contraindications
• Discuss the common intoxications, including clinical signs, diagnosis, stabilisation, and management of patients affected :
  • Metaldehyde intoxication
  • Synthetic pyrethrin intoxication
  • Anticoagulant rodenticide intoxication
  • Lily plant intoxication
  • Non-steroidal anti-inflammatory drug (NSAID) intoxication
  • Chocolate/Caffeine intoxication
  • Ethylene glycol intoxication
  • Grape & Raisin intoxication
• Discuss 'serotonin syndrome’, including clinical signs, diagnosis, stabilisation, and management of affected patients