Impending Doom Recognizing the Patient in Trouble

Knowing when patients are getting into trouble is part science and part art. It
requires constant contact with the patient, repeat physical examinations and very
close monitoring. It also requires a thorough understanding of physiology and pathophysiology. The goal of monitoring and assessing patients is to ensure minor changes in patient status are noted – and corrected – prior to these minor changes becoming major events whose progression can no longer be affected. Because the doctor is rarely capable of spending the amount of time with patients this requires due to other responsibilities, he or she must learn to rely on nurses. Teamwork is essential. Nurses must be well trained in physical examination skills as well as monitoring skills and must feel comfortable relaying information to the doctor. The doctor, in turn, must know what to do with that information and be able to respond quickly and efficiently in order to ensure patient morbidity and mortality are minimized. For instance, alterations in certain parameters such as elevations in respiratory rate, heart rate and blood pressure can be associated with organ dysfunction, pain or anxiety. When treating the ill or injured patient the assumption should be that the more serious problem exists and this should be ruled out first. Mistakenly assuming tachycardia for anxiety when, in fact, it was in indicator of hypotension, can have life-threatening consequences for the animal. […]