首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 15 毫秒
1.
Objective: To document the clinical practice of cardiopulmonary–cerebral resuscitation (CPCR) among academic veterinarians. Design: Survey. Setting: Eight colleges of veterinary medicine in the United States. Subjects: Two hundred and one academic veterinarians. Interventions: The survey was distributed by hand by the authors into the mailboxes of small animal faculty, residents, and interns. Demographic variables, questions regarding number of cardiopulmonary arrests (CPA) supervised and number successful, do not attempt resuscitation discussions, and Likert‐style questions about client presence during CPCR, appropriateness of CPCR, and CPCR decision‐making were included. Multiple linear regression models were constructed to determine the effect of multiple questions on different target variables of interest. Measurements and main results: Numerous differences were noted based on institution, gender, specialty, and position. Most institutions did not have a standard resuscitation consent form. Most respondents believed the client, house officer, and senior clinician should determine whether to perform resuscitation or not. Quality of life was the most significant determinant of whether to resuscitate or not, followed by long‐term prognosis, then short‐term prognosis. Conclusions: Veterinarians differ in many aspects of their approach to CPA and resuscitation. Creating consensus within the veterinary profession would benefit client service and patient care.  相似文献   

2.
3.
Objective – To review the use of impedance threshold devices (ITD) during CPCR, their proposed mechanism of action, and their application in veterinary medicine. Data Sources – Data sources include scientific reviews and original research publications using the PubMed search engine with the following keywords: ‘impedance threshold device’ and ‘resuscitation’ and the Veterinary Information Network search function using the keywords ‘impedance threshold device.’ Human Data Synthesis – Studies in human medicine have demonstrated that the use of an ITD during CPCR in patients during out‐of‐hospital cardiac arrest improves coronary perfusion pressure and cerebral perfusion pressure. This improvement in vital organ blood flow results in increased cardiac output and faster return of spontaneous circulation. The use of an ITD has been studied in people and currently holds a class IIb level of recommendation according to the 2010 American Heart Association Guidelines for CPR and Emergency Cardiovascular Care. This device is recommended as a way to improve hemodynamics during CPCR by enhancing venous return and avoiding hyperventilation, thereby increasing the likelihood of a successful resuscitation. Veterinary Data Synthesis – Multiple controlled studies using pigs with ventricular fibrillation induced cardiopulmonary arrest have demonstrated increased myocardial and cerebral perfusion with the use of an ITD. These studies have emphasized the importance of decreasing intrathoracic pressures during the decompression phase of CPCR and avoiding hyperventilation in order to maximize vital organ blood flow. Conclusions – Use of an ITD during CPCR in human and animal studies has demonstrated improved vital organ perfusion and faster return of spontaneous circulation. However, the majority of these studies have been carried out in people during out‐of‐hospital cardiac arrest and ventricular fibrillation cardiopulmonary arrest pig models. Further studies evaluating the use of an ITD during CPCR in the veterinary hospital setting are warranted.  相似文献   

4.
OBJECTIVES: To report the results of 3 surveys evaluating the extent that the Food Animal Residue Avoidance Databank (FARAD) is used by veterinarians, the profession's perception of the need for the program, barriers that prevent veterinarians from fully using the service, and the perceptions that animal production industry groups have regarding FARAD. DESIGN: Telephone and mail surveys were used to collect information using cross-sectional, case-control, and directed sample studies. SAMPLE POPULATION: Food animal veterinarians and veterinarians and nonveterinarians in allied animal industries or with special interest in production animal medicine. RESULTS: The use of FARAD was high among dairy and general practitioners, but low among beef practitioners and veterinarians with minor commitment to food animal medicine. Solo practitioners and veterinarians with less than 13 years in practice were less likely to use FARAD. Dairy practitioners who had not used FARAD were most likely to prescribe extralabel products. CLINICAL IMPLICATIONS: Results imply that dairy and general food animal practitioners have either greater need or access through educational networks and are more aware of FARAD than practitioners who work with beef and those with a minor component of their practice involving food animals. The difference in familiarity and use of FARAD between practice type is an important finding, but the root of the difference is not clear; it may be attributable to a difference in the effectiveness of knowledge transfer for the groups, or the message is ignored because the issue of drug residues is less compelling for veterinarians and their clients in the beef sector.  相似文献   

5.
OBJECTIVE-To assess the knowledge and use of infection control practices (ICPs) among US veterinarians. DESIGN-Anonymous mail-out population survey. PROCEDURES-In 2005 a questionnaire was mailed to US small animal, large animal, and equine veterinarians who were randomly selected from the AVMA membership to assess precaution awareness (PA) and veterinarians' perceptions of zoonotic disease risks. Respondents were assigned a PA score (0 to 4) on the basis of their responses (higher scores representing higher stringency of ICPs); within a practice type, respondents' scores were categorized as being within the upper 25% or lower 75% of scores (high and low PA ranking, respectively). Characteristics associated with low PA rankings were assessed. RESULTS-Generally, respondents did not engage in protective behaviors or use personal protective equipment considered appropriate to protect against zoonotic disease transmission. Small animal and equine veterinarians employed in practices that had no written infection control policy were significantly more likely to have low PA ranking. Male gender was associated with low PA ranking among small animal and large animal veterinarians; equine practitioners not working in a teaching or referral hospital were more likely to have low PA ranking than equine practitioners working in such institutions. CONCLUSIONS AND CLINICAL RELEVANCE-Results indicated that most US veterinarians are not aware of appropriate personal protective equipment use and do not engage in practices that may help reduce zoonotic disease transmission. Gender differences may influence personal choices for ICPs. Provision of information and training on ICPs and establishment of written infection control policies could be effective means of improving ICPs in veterinary practices.  相似文献   

6.
7.
8.
9.
Objective— To evaluate the prevalence of, and risk factors for, methicillin‐resistant Staphylococcus aureus (MRSA) colonization in veterinary personnel. Study Design— Cross‐sectional study. Sample Population— Conference attendees (n=341) at the 2008 American College of Veterinary Surgeons Symposium in San Diego California. Methods— Nasal swabs were collected and tested using selective culture for MRSA. Isolates were typed and risk factors were evaluated using questionnaire data. Results— 17.3% of subjects (17% veterinarians and 18% technicians) were MRSA positive. Colonized individuals originated from 5 different countries, predominantly the United States and Canada. Contact with small ruminants in the preceding 30 days (odds ratio [OR] 2.2), living with a person diagnosed with MRSA in the preceding year (OR 19.8) and working in a clinic where there is a specific person in charge of the infection control program (OR 2.2) were associated with colonization using multivariable analysis. Conclusion— The high rate of colonization identified here provides more evidence that MRSA exposure is likely an occupational risk for veterinary personnel. The equal rates in small animal and large animal personnel were surprising and contradict earlier studies indicating greater rates among equine personnel. The association of MRSA and small ruminant contact has not been reported previously. Clinical Relevance— MRSA is an important emerging pathogen in veterinary medicine and is a concern for both patients and veterinary personnel. The high colonization rate indicates the need to understand and control the spread of MRSA in veterinary clinics.  相似文献   

10.
In the present market, veterinarians with a strong background in career development, practice management, and business skills have a clear advantage in achieving financial success. Although there is ample evidence that the scientific and clinical skills of veterinary college graduates are high, there are also data that suggest that additional capabilities in the business realm may promote greater economic success. As noted in the KPMG executive summary, the field of veterinary medicine must make changes in its "current business practices and attitudes" to be successful in the future. Furthermore, the KPMG study found that 36% of industry employers reported that some jobs within their companies had specific job requirements that were not met by a veterinarian with only a veterinary medical degree. The areas of additional training most often cited included business, administration, personnel management, sales and marketing, and financial skills. Yet, Lewis and Klausner found that veterinarians reported challenges in the business realm, such as "how business works and how business goals are translated into action. This challenge held true for veterinarians in industry, academia, government, and private practice." The present gender trends in the field of veterinary medicine provide additional impetus to make career development and business skills training more prevalent. Presently, women comprise >65% of the veterinary student population and approximately 45% of all practicing veterinarians. In some areas of practice, the rate is much higher. For example, in 2002, women comprised 48.2% of all small animal exclusive private practitioners. Unfortunately, the KPMG study found that female veterinarians in private practice report lower self-evaluation of business management and financial skills, compared with their male cohorts. Female veterinarians in nonprivate practice report lower self-evaluation in communication, personnel management, business management, and marketing skills than that reported by males. As a result of these pressing needs, CSU CVMBS has undertaken a major initiative to improve the veterinary practice management and business skills training of veterinary students by offering a variety of options to gain this knowledge: a combined MBA/DVM degree program, a Business Certificate Program for Health Professions, and core curriculum courses. In this way, students can select the amount of focus they want to place on career development and business skills as they earn their DVM degree, to best ensure that they become successful veterinarians.  相似文献   

11.
In March 1996, a questionnaire was sent to 2000 veterinary surgeons, primarily involved in small animal practice, to assess their attitudes to perioperative analgesic therapy in dogs, cats and other small mammals. This paper is concerned only with the data relating to dogs. The veterinary surgeons considered that pain was a consequence of all the surgical procedures specified, but there were differences in their treatment of pain. Some veterinarians considered that a degree of pain was necessary postoperatively to prevent excessive activity. In general, women and more recent graduates assigned higher pain scores to the procedures and were more likely to treat the pain with analgesics. A significant number of veterinarians consider the use of opiates or non-steroidal anti-inflammatory drugs before surgical procedures, but relatively few appear to use combinations of different classes of analgesics either before or after operations.  相似文献   

12.
In previous studies, it has been demonstrated that, similar to general practitioners, veterinarians find it difficult to discuss overweight in dogs. This study aimed to provide insight in the barriers and motivators for veterinarians to discuss overweight in dogs and to compare the results with findings from human medicine. Sub-hypotheses were postulated based on existing literature to investigate if lack of time, fear of offending clients, or lack of skills were potential barriers, and if feeling responsible and feeling compassion were potential motivators for veterinarians to discuss overweight in dogs. To this end, an online survey (n = 59) was conducted. Furthermore, 15 small animal clinicians working in general practice were interviewed by semi-structured face-to-face interviews. Results from the online survey indicated that veterinarians find it sometimes difficult to discuss overweight in dogs. Veterinarians who responded to the online survey did not experience strong barriers but did make use of motivators (e.g. feeling responsible and feeling compassion) when discussing overweight in dogs. Interestingly, results from the semi-structured face-to-face interviews showed that the responding veterinarians did experience strong barriers, as well as motivators, when discussing overweight in dogs with their clients. The most prominent barrier was customer dissatisfaction, whereas lack of time and lack of skills were also experienced. The most prominent motivator was feeling responsible for animal health and preventive veterinary medicine. These findings were strikingly similar to previous research on discussing childhood overweight by general practitioners. To improve treatment and prevention of overweight in dogs, veterinarians need more communication skills and should be more aware of the motivators that drive their self-motivation. Improving awareness on overweight and its comorbidities should be a One Health issue.  相似文献   

13.
OBJECTIVE: To identify the prevalence of exposure to potentially harmful occupational hazards in Australian female veterinarians and to report factors associated with prevalence of occupational hazards in this profession. DESIGN: National cross-sectional survey of a cohort population. PROCEDURE: A self-administered questionnaire was mailed to 5748 veterinarians (males and females) graduating from Australian veterinary schools from 1960 to 2000. This paper reports the prevalence of occupational exposures in 1197 female veterinarians in their current job including radiation, anaesthetic gases, pesticides and long working hours. Comparisons were undertaken between respondents by practice type and decades of graduation. Multivariate logistic regression was undertaken to predict the risk for exposure to occupational hazards in female veterinarians by age, type of practice, graduation year and number of hours worked. RESULTS: The response rate for females was 59%. We found that age under 30 years, small and mixed animal practice, graduation year after 1990, and working more than 45 hours per week were all associated with greater exposure to putative risk factors. Mixed animal practitioners worked more than 45 hours per week (53%) and reported the highest exposure to anaesthetic gases (94%) and pesticides (54%). Twenty two percent of those who were exposed to anaesthetic gases did not have waste anaesthetic gas scavenging systems. Small animal practitioners reported they took more X-rays (90%). While taking X-rays, 56% of respondents reported physically restraining animals, and only one in five of respondents used film holders and lead screens. CONCLUSIONS: The high prevalence of potentially harmful exposures among female veterinarians and lack of use of protective equipment at work needs to be considered in developing and planning the safety of veterinary work.  相似文献   

14.
The objective of this study was to generate demographic data on veterinarians working in western Canada. A sample of 551 veterinarians was randomly selected from a population of 2474 veterinarians employed in western Canada, 425 (77.1%) of whom responded to the survey. The respondents were evenly split between males (53.1%) and females (46.9%). More than half (58.0%) of the private practitioners practised exclusively on companion animals (small animals and horses), while 2.9% devoted 100% of their time to food animals. There were 351 respondents who had had ≥ 2 employers since graduation; 80% of those who had begun their careers in companion animal (CA) practice had remained in this type of practice, while 54.3% of those who had begun their careers in mixed animal practice had switched to CA practice. Analyses of wage and workload data from 85 full-time veterinary employees showed that CA practitioners worked the fewest hours/week (47.0), had the least number of evenings on-call/month (3.7), and earned the highest hourly wage ($35.79) as compared with non-CA practitioners.  相似文献   

15.
We used an exploratory study in two districts of West Bengal State, India to find out the constraints of private veterinary practice. Privatization of veterinary services is being seen as an alternative to government-sponsored veterinary services to livestock. In December 2000 to February 2001, 50 private veterinary practitioners were interviewed from the districts. Their opinion was that weak regulations about competition from illegal practitioners and the use of veterinary drugs, competition by animal-health technicians (who are likely to charge less than veterinarians), absence of efficient diagnostic-laboratory support, and lack of commercial livestock farming were the main constraints faced.  相似文献   

16.
There are clear differences in the normal radiographic appearance of the abdominal organs between a left lateral vs. a right lateral view. While a few veterinary academic institutions have transitioned to a three‐view abdominal radiographic study protocol, obtaining only two views of the canine abdomen remains the current standard in veterinary medicine. In this combined retrospective and prospective, case‐controlled study, 48 canine patients presenting with signs of acute abdomen were recruited. Four board‐certified veterinary radiologists and four general practice veterinarians with greater than 3 years of experience in small animal practice were asked to determine if 10 predetermined findings were present within the set of images and if surgery was recommended based on those findings. Image readers were unaware of the clinical history. Three‐view studies did not yield statistically significantly greater accuracy than two‐view studies when evaluating all readers together. No statistically significant associations between the availability of the third view and increased accuracy or confidence were found in evaluations of general practitioners specifically. Evaluation of three‐view radiographic examination, as compared to two‐view examination, did not have perceived or statistically significantly increased diagnostic utility. Based on our findings, there is no statistically increased utility to justify a standard three‐view abdominal radiographic examination over a two‐view study for canines presenting with signs of acute abdomen.  相似文献   

17.
Cardiopulmonary resuscitation in small animal medicine: an update   总被引:1,自引:0,他引:1  
In December 2005, the American Heart Association published new guidelines for cardiopulmonary cerebral resuscitation (CPCR) in humans for the 1st time in 5 years. Many of the recommendations are based on research conducted in animal species and may be applicable to small animal veterinary patients. One important change that may impact how CPCR is performed in veterinary medicine is the recommendation to avoid administration of excessive ventilatory rates because this maneuver severely decreases myocardial and cerebral perfusion, decreasing the chance of survival. The new guidelines also emphasize the importance of providing well-executed, continuous, uninterrupted chest compressions. Interruption of chest compressions should be avoided and, if necessary, should be minimized to <10 seconds. During defibrillation, immediate resumption of chest compressions for 2 minutes after a single shock, before reassessment of the rhythm by ECG, is recommended. This recommendation replaces previous recommendations for the delivery of 3 defibrillatory shocks in rapid succession. Allowing permissive hypothermia postresuscitation has been found to be beneficial and may increase success rate. Medications utilized in cardiopulmonary resuscitation, including amiodarone, atropine, epinephrine, lidocaine, and vasopressin, along with the indications, effects, routes of administration, and dosages, are discussed. The application of the new guidelines to veterinary medicine as well as a review of cardiopulmonary resuscitation in small animals is provided.  相似文献   

18.
The American Animal Hospital Association Computer Program should benefit all small animal practitioners. Through the availability of well-researched and well-developed certified software, veterinarians will have increased confidence in their purchase decisions. With the expansion of computer applications to improve practice management efficiency, veterinary computer systems will further justify their initial expense. The development of the Association's veterinary computer network will provide a variety of important services to the profession.  相似文献   

19.
Objective – To review the use of IV lipid emulsion (ILE) for the treatment of toxicities related to fat‐soluble agents; evaluate current human and veterinary literature; and to provide proposed guidelines for the use of this emerging therapy in veterinary medicine and toxicology. Data Sources – Human and veterinary medical literature. Human Data Synthesis – Human data are composed mostly of case reports describing the response to treatment with ILE as variant from mild improvement to complete resolution of clinical signs, which is suspected to be due to the variability of lipid solubility of the drugs. The use of ILE therapy has been advocated as an antidote in cases of local anesthetic and other lipophilic drug toxicoses, particularly in the face of cardiopulmonary arrest and unsuccessful cardiopulmonary cerebral resuscitation. Veterinary Data Synthesis – The use of ILE therapy in veterinary medicine has recently been advocated by animal poison control centers for toxicoses associated with fat‐soluble agents, but there are only few clinical reports documenting successful use of this therapy. Evidence for the use of ILE in both human and veterinary medicine is composed primarily from experimental animal data. Conclusions – The use of ILE appears to be a safe therapy for the poisoned animal patient, but is warranted only with certain toxicoses. Adverse events associated with ILE in veterinary medicine are rare and anecdotal. Standard resuscitation protocols should be exhausted before considering this therapy and the potential side effects should be evaluated before administration of ILE as a potential antidote in cases of lipophilic drug toxicoses. Further research is waranted.  相似文献   

20.
Nebraska veterinary practitioners were surveyed to collect data about background characteristics and other factors related to veterinarians' decision to include or not include food animals in their practices and to practice in rural versus urban communities. Background characteristics that were significantly (p < or = 0.05) associated with choosing food-animal practice included growing up on a working farm or ranch; having parents who owned livestock; growing up in a town with a population of less than 10,000; majoring in animal science at university; being male; and having a primary interest, at the time of entering veterinary college, in food animal-exclusive or mixed-animal veterinary practice. The primary factor for choosing the community in which to practice was rural/urban lifestyle for rural veterinarians, while this factor was second for urban veterinarians. For all groups of veterinarians, the primary consideration in selecting their current practice was the species orientation of the practice. The primary reason for not choosing food-animal practice was better working conditions and lifestyle in companion-animal practice, followed by greater interest elsewhere.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号