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Instilling confidence in emergency medicine
  1. Stef Phillips

Abstract

Stef Phillips has known that her future lies in emergency medicine since starting at vet school. As president of the Royal Veterinary College's Student Veterinary Emergency and Critical Care Society (SVECCS), she aims to ensure that students are comfortable working in an emergency setting

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THE high-adrenalin aspects of emergency care and the importance of working in a tight knit team make this field of veterinary medicine a fascinating and exciting one to work in. With increasing availability of in-house diagnostics, general practices are commonly well equipped to deal with emergency patients, but specialist veterinary critical care departments continue to multiply for when referral is necessary.

Naturally, a thorough understanding of the best approach to the care of emergency/critical patients is crucial for all new graduates, yet despite five years' preparation, it is still a daunting prospect to be faced with such patients on that dreaded first night on call. The mission of the SVECCS is to enhance student education in emergency medicine. Whether our members' goals are to specialise or simply to feel more confident when dealing with the wide range of emergency presentations that arise in first-opinion practice, we are committed to providing relevant lectures and practicals alongside curriculum learning.

Group discussions with emergency and critical care interns and residents are highly valued

The SVECCS committee is made up of veterinary students in their clinical and pre-clinical years, and it is our responsibility to recruit speakers, organise venue bookings, gain sponsorship and advertise and run events. Essential to the success of the society is the support provided by RVC staff, especially those based at the Queen Mother Hospital for Animals (QMHA). We are privileged to have Lindsay Kellet-Gregory and Dan Chan, who share their experience and expertise, and advise on choices of event. Shailen Jasani has also been a familiar face this year, facilitating SVECCS ‘rounds’ every three weeks, in which students discuss the approach to various cases, focusing on a different theme at each session.

Events

Society events occur in many different formats. We run lectures and practicals throughout the year and hold an annual symposium in February, where members enjoy a range of high calibre speakers and practicals. This year, for example, speakers have included Amanda Boag (clinical director of Vets Now, and president of the European Veterinary Emergency and Critical Care Society), Rachael Kilroy (senior veterinarian at PDSA Bow Hospital) and Holger Volk (clinical director and head of neurology and neurosurgery at the QMHA). We aim to provide a variety of topics from speakers of varying backgrounds for a well-rounded experience. Many participants take this opportunity as a forum to inform delegates of graduate training schemes that their businesses may offer, and members benefit from making connections that may result in EMS placements or future employment.

As a society run by students we recognise that it is important to provide a ‘safe’ environment in which to practice essential Day 1 clinical skills and our practicals are particularly popular. The Clinical Skills Centre in the RVC's LIVE centre provides a perfect environment for enhancing these skills. Past events have included a catheter placement lab, where students from all years were able to practice peripheral, intraosseous and central line catheter placements and discuss the indications for and possible complications associated with such procedures.

We have also held cardiopulmonary cerebral resuscitation (CPCR) labs using CPD level models, and hope to improve this practical this year by coordinating with RVC veterinary nursing students to reinforce the importance of good working relationships. We are eternally grateful to QMHA interns and emergency critical care residents who give up their (rare) free time to help.

Recently, with support from the RVC's CPD department and BCF Technology, which kindly provided portable ultrasound machines, we ran an A-FAST/T-FAST lab. Members were introduced to the importance and method of free fluid abdomen and thorax scans by Pete Mantis and were then able to practice these techniques on live animals guided by Dr Mantis and Annie Makin from BCF. Ultrasound can seem particularly formidable to veterinary students, with real-time imaging often first encountered on EMS and opportunities to actually practice ultrasound on live animals scarce. Members found the experience hugely valuable in improving their practical skills and understanding of the use of this imaging modality, and we are going to run the lab again at the next available opportunity.

Although many of our topics are primarily centred on small animal practice, many emergency skills are transferable across species, and we also hold equine and farm animal events. For example, Vikki Wyse from XL Vets has presented an interactive lecture on the ‘Approach to the downer cow’ and her colleague Sotirios Karvountzis has spoken on displaced abomasums. The RVC's farm animal clinicians John Fishwick and Steven Van Winden also provided an emergency bovine caesarean practical, where delegates practiced the interlocking suture pattern on cadaver specimens and discussed the approach to anaesthesia and surgery.

We believe that we provide our members with access to experiences that better prepare them to calmly and logically respond to emergency scenarios, and boost confidence and competence in essential practical skills used in routine work. The dramatic increase in membership over the past couple of years and the enthusiasm and commitment of our members has confirmed our belief that the material we cover is of great benefit and enjoyable too.

Third-year student Ella Townsend performs an A-FAST scan on labrador Alfie

We hope that as the society continues to develop we will be able to offer our members a wider variety of events and that our growing presence will attract yet more speakers and sponsorship to run practicals that require specific equipment. With Liverpool vet school now running its own chapter, the prospect of further universities following suit and national events occurring is an exciting possibility.

For more information about SVECCS or on speaking to our society, e-mail: sveccs{at}rvc.ac.uk

What running SVECCS involves

Stef is a graduate student (with an English literature degree) and has been keen to pursue a career in emergency medicine since starting vet school. She writes: ‘I have been a member of the RVC's Student Veterinary Emergency and Critical Care Society (SVECCS) committee since it was founded in 2011. As a first year, I was the Camden rep in charge of filtering information to members, coordinating events and organising travel to Hawkshead events. I am now serving as the society's president.

‘The president and vice-president work together to recruit speakers for talks and facilitators for practicals, etc. We were voted in during a meeting at which we had to make a short speech about our motivation for the position, our plans and so on.

‘Since my election, I seem to spend most of my time thinking up lectures and practicals that I think students would enjoy, or polling members for their opinion and then tracking down suitable people to speak or demonstrate. As our secretary has been unwell, I have also taken on the role of secretary this year, which means handling membership subscriptions, booking rooms for meetings, producing invoices for events and keeping members up to date on what's going on, advertising future events and setting up online sign-up for our practical events. The society handles its own finances (overseen by the RVC Students’ Union) through which we pay speakers fees/travel expenses as well as for equipment for practicals, and I collaborate with our treasurer to decide where best to spend our money. This might be on promotional material to recruit more members, or to establish a bursary system where members who attend all/most SVECCS events receive discounted international membership.

‘It's really important to me that we provide our members with material that will make them feel more comfortable in an emergency setting, and also to make ourselves more employable.

‘We encourage members to present their own case studies – facilitated by staff at the Queen Mother Hospital for Animals – of cases they have seen on rotations/EMS. Such opportunities offer the chance to practice basic communication skills, and introduce students to the idea of presenting their material, hopefully making the future prospect of speaking at larger events less daunting.

‘I am keen to provide information on internships/graduate training schemes/residencies early on in the course, so that people can start thinking critically about their future and what connections/placements they might want to make to facilitate their goals.

‘This year, we're working with Vets Now and Village Vet, Hampstead, to offer EMS placements in out-of-hours work to SVECCS members. This has been offered to us as a result of people being impressed with our organisation and our enthusiasm.’

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