Some veterinarians love the chaos of emergency medicine. They relish the challenge of not knowing what’s coming through the door and—like bungee jumpers and skydivers—revel in the adrenaline rush.
But for many of us, emergencies elicit a flurry of butterflies. We could do without the burst of adrenaline that sometimes makes our mind go suddenly and alarmingly blank.
Thankfully, managing emergencies calmly and systematically is a skill that can be learned and practiced, and adopting a few simple strategies can help you remain calm and confident.
Let’s look at 4 steps you can take the next time an emergency is rushed into your veterinary practice.
Step 1: Master Breathing Techniques for Quick Stress Relief
You know what it feels like when your sympathetic nervous system prepares you for fight or flight: your heart and respiratory rates increase, your palms sweat, you start trembling, and you may have difficulty concentrating.
While this response is helpful when you’re actually facing a threat, it’s not so beneficial when you need to focus your thoughts and systematically perform life-saving measures.
How Breathing Slows Your Heart Rate and Calms Your Mind
A few simple breathing techniques can help you settle your sympathetic response and prompt your parasympathetic nervous system to help you calm down.
Slowing down your breathing rhythm can cause immediate physiological and psychological calming effects by increasing vagal tone.1 For instance, “sighing”—characterized by deep breaths followed by extended, relatively longer exhales—is associated with psychological relief and shifting to a parasympathetic state.1
Breathing Techniques for High-Stress Situations
Members of the military and other high-stress occupations are trained to perform “box breathing” or “tactical breathing” to decrease stress and improve performance during stressful situations.1
This simple breathing technique is easy to perform in emergencies and can be highly effective. Just follow these 4 steps:
- Inhale for 4 seconds.
- Hold your breath for 4 seconds (start with 3 seconds if 4 is uncomfortable).
- Exhale for 4 seconds.
- Hold your breath for 4 seconds.
Repeat until you feel your body calming.
Step 2: Follow the XABCDs for Rapid Patient Assessment
Once you’ve acknowledged and addressed your fight or flight response, it’s time to turn to the initial assessment of your patient. Start by assessing the complications that are most likely to be life-threatening in order of body systems, which can be remembered with the help of the mnemonic XABCD.2
| Letter | Element | Assess for & Address | Additional Points |
| X | Exposure | External bleeding | Life-threatening external bleeding should be addressed immediately. |
| AB | Respiratory (airway and breathing) | Decreased or increased lung sounds, dyspnea, tachypnea, stridor, upper airway sounds, cyanosis, or apnea | Abnormal breathing patterns should be assumed to have primary respiratory causes (eg, pleural space or pulmonary parenchymal disease) unless proven otherwise. |
| C | Cardiovascular | Perfusion abnormalities resulting in pale pink mucous membranes, prolonged capillary refill time, weak pulses, hypothermia, altered mentation, tachycardia, or bradycardia | Poor perfusion should be an assumed result of hemorrhage (vs other types of shock) unless proven otherwise. |
| D | CNS (disability) | Level of consciousness, pupil size and reactivity, paresis/paralysis, seizure activity, or cranial nerve deficits |
Step 3: Turn to Trusted Support to Develop a Diagnostic and Treatment Plan
Addressing any abnormalities you find on initial assessment often means starting with basic stabilization procedures such as administering oxygen, placing an IV catheter, and administering analgesia.
Beyond that, it’s crucial to have trustworthy resources on hand to help you rapidly decide on your next steps.
Using Clinical Decision Support Tools
A clinical decision support tool like Plumb’s Pro™ can be a game-changer. It’s like having your textbooks and go-to experts in one place, so you can find everything you need to quickly make confident decisions. To save even more time, you can add any of the resources in Plumb’s Pro™ to your “favorites” list for easy access in emergencies.
Choose Next Steps with Algorithms
Whether you’re starting with clinical signs or a specific diagnosis, algorithms can provide step-by-step support that helps you swiftly narrow down your differentials and decide on your next steps.
For instance, when you find abnormal respiratory sounds or pulse alterations on initial assessment, you can review an algorithm to figure out what’s next while your technician administers oxygen and starts IV fluids.
Dive Deeper With Diagnostic and Treatment Guides
When you’re ready for a deeper dive into diagnosis and treatment, you can skip the time-consuming search for reliable information online—or on your hospital bookshelf—with Dx & Tx. These diagnostic and treatment guides are accessible from any device and have all the peer-reviewed, continually updated diagnostic and treatment information you need.
Prescribe Confidently With Current Drug Information
With Plumb’s Pro™, you can easily double-check drug information and use tools like the drug interaction checker—an animal-specific tool that helps you identify potential drug-to-drug interactions—to quickly and confidently choose medications.
Step 4: Provide Effective and Efficient Pet Owner Education
While you’re focused on caring for your patient, you know their very worried owner is waiting in the exam room, wondering how their pet is doing.
This can add to your stress, especially when you need to quickly relay your recommendations and answer their questions so you can get back to caring for your patient.
Pet owner handouts in Plumb’s Pro™ can help. Clinical handouts cover essential information about clinical conditions, common procedures, laboratory findings, and preventive care topics, and drug handouts provide pet owners with everything they need to know about the drugs we prescribe.
Using Handouts to Keep Clients Informed
Consider having a team member update the client on their pet’s condition and provide clinical handouts with information about the procedures you’re performing, like administering oxygen therapy and starting IV fluids.
When it’s time to discuss your recommendations with the client, handouts can also help you frame the conversation and prioritize critical points.
Whether you read through the handout in the exam room with the client or give them time to review it on their own, these handouts can help you highlight the essential details without overwhelming an already worried pet owner.
All the handouts in Plumb’s™ are written in simple language with clear definitions of medical terms, so you can be sure that clients understand their pet’s care.
Although managing veterinary emergencies will always be challenging, following these 4 simple steps can help you tackle your next emergency and provide confident, potentially life-saving care.
Want to see Plumb's in action? Watch a free demo.
References
- Balban MY, Neri E, Kogon MM, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023;4(1):100895. doi:10.1016/j.xcrm.2022.100895
- Blutinger A. Stabilization following vehicular trauma prior to tertiary referral. Clinician’s Brief. Updated May 2024. Accessed July 18, 2024. https://www.cliniciansbrief.com/article/blunt-force-trauma-brain-injury