EQUINE ICU
SHADOWING CHECKLIST
To apply for a position in the Equine ICU as a student worker, you must complete at least 3
shadow shifts (each shift is 4 hours long) prior to the application deadline (week before Spring
Break). You will not be paid for these shadow hours and you can shadow as often as you would
like, provided you have signed up on the sheet and there are no more than 3 students per shift.
This list covers the minimum that you will be expected to know while working. Please put your
name below and have the technician/student write down the hours you shadow and sign it.
Return this completed checklist to the ICU coordinator along with your application.
Equine ICU Coordinator:
Ashley Misner (.5) and Vera Kazaniwskyj (.1)
VME III
VMEIII
CHECKLIST
Have technician on duty initial when each item is completed.
____1. Enter stall safely, catch horse, put on halter, attach lead, walk horse properly and pick up
feet.
____2. Colic Parameters
Temperature, Pulse, Respiration, Mucus Membrane Color, Capillary Refill Time, Digital
Pulse, And Gut Sounds
____3. Learn to recognize a painful (colicky) horse:
Restlessness, pacing, pawing, rolling, biting/kicking at sides, grinding teeth, bloating, etc.
_____4. Make up hep saline
_____5. Flush a catheter
_____6. Hang and connect a fluid system and CRI
_____7. Stop and disconnect a fluid system and CRI
_____8. Check jugular catheter for swelling and/or heat
_____9. Dilute and give penicillin (K-Pen/Amicillin)
_____10. Give IV medications with and without fluids including preparing drugs
______11. Give oral medications
_____12. Isolation protocol
_____13. Run and read a packed cell volume/total protein and blood glucose, IRMA, Lactate
_____14. Add drugs (calcium, dextrose, KCI) to fluids
_____15. Differentiate between grass hay, alfalfa hay, and straw
_____16. Recognize respiratory distress
Your name ____________________ Tel Number: ____________ E-Mail: _______________
Date
Time
Name of Student Shadowed
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Equine ICU Organization and Responsibly
Organization
1. ICU student technicians are scheduled in the evenings Monday through Friday when there is only
a single technician scheduled and 10-10 on Saturdays, Sundays, and holidays. Each shift is 4
hours long, and each worker will be scheduled according to availability of both the worker and
shifts.
2. A schedule of ICU coverage will be maintained through out the major portion of the academic
year. ICU student technicians will not be scheduled to work during midterms. final exams, or the
evening before and exam. If they wish, student technicians will be scheduled during school
breaks as shift availability permits.
3. Schedules are posted in equine ICU
4. Each student technician will be required to complete a scheduled orientation program and work
20 hours of shadowing with a student ICU worker prior to being assigned to ICU.
Responsibilities of the student technician.
1. The student technician coming on duty should clock in 10-15 minutes before their shift starts to
facilitate the shift report. The student tech should meet with the on duty tech to be able told which
horses are critical, painful, or on fluids. All treatments should be read and explained if necessary.
2. The student technician coming on duty is expected to initial the schedule in Equine ICU to inform
the senior students and residents as to who is currently on duty. This also verifies that you were
their for your shift. Multiple absences will result in removal from the schedule.
3. Patient care is outlined on the yellow ICU sheet. A half-slash should be made when treatment has
been initiated, and the second slash should be made when the treatment is completed. All
treatments and observations must also be recorded on the stall door charts. Questions or problems
should be directed to the staff technician, senior students, or residents. If there has been a
significant change with an ICU case, inform the staff technician and they will contact the resident
or clinician.
4. In the case of an emergency, contact the staff technician or senior student, and they will inform
the resident.
5. The primary responsibility or the ICU technician is to provide nursing care to the patients,
monitor vital signs, fluid lines maintain catheters, administer ICU treatments, and check feeding
and watering requirements. Ask the staff technician or senior student what these instructions
should be if they are not written on the yellow ICU sheets.
6. ICU student techs share treatment responsibilities with the senior students. A yellow ICU sheet
for each case is posted under either “intensive care cases” or “treatment only”. Student technician
primary treatment responsibly include:
a. A. Days (8am-6pm, over breaks): intensive care cases
b. Evenings/weekends: intensive care cases and treatments only
ICU student technicians should alert senior students when not enough fluids or drugs have been ordered
to last the night. This is the senior student’s responsibility, but they may not be aware of the problem.
Problems
1. ICU student technicians should never hesitate to bring problems to the attention of the Equine
ICU staff technician and the ICU coordinator. Unless we know of problems, corrections cannot
occur.
2. Clinical problems should be brought to the attention of staff technicians.
3. Administrative problems (pay checks, time cards, etc.) should be brought to the attention of
Darlene.
Physical Exam
Adult horse
Temperature (T):
Pulse Rate (P):
Respiratory Rate (R)
Capillary Refill Time (CRT)
Mucous Membranes (MM):
Gut Sounds:
100-101 F
30-40 beats/min
8-16 breaths/min
less than 2s
pink, moist; check gums and around eyes
normally present in all 4 abdominal quadrants
Foal
Temperature (T):
Pulse Rate (P):
Respiration Rate (R):
Capillary Refill Time (CRT):
Mucous Membranes (MM):
99-101.9 F
1-5 min. of life:
70 beats/min (mean)
6-60 min of life:
130 beats/min (mean)
9-43 hours of life:
96 beats/min (mean)
1-15 min of life:
60-80 Breaths/min
>15 min of life:
20-40 breaths/min
less than 2s
pink, moist; check gums and around eyes
It is important to evaluate changes in these parameters. Look at the record and not trends. Also observe
the patient for changes in behavior. Monitor for signs of pain such as swelling, pawing, rolling, etc. any
horse showing such signs should be reported to the staff technician, senior student, and resident. If you
notice a change in behavior, recheck the TPR, CRT, MM, and gut sounds, and notify the above
individuals.
Packed Cell Volume & Total Protein
Packed Cell Volume (PCV) is a function of erythrocyte size and number of cells per volume of
blood.
Foals: 29-42%
Adults: 30-45%
Procedure:
After Collection of Blood:
1. Fill 2 capillary tubes 2/3 full with blood.
2. Place tubes opposite from each other in the centrifuge and spin.
3. Remove tubes and place against card reader for evaluation.
Total Protein
1. Once PCV is determined, break the capillary tube at the plasma-red cell interface
2. Place plasma on refractometer
3. Read total protein.
4. Normal is 6-8 g/dl.
Medications
1. When giving IV medications, carefully follow ICU orders. When drawing up
medications, check label for:
a. Correct drug
b. Correct dose
c. Expiration date
2. If you have any doubts about an ICU order do not hesitate to ask the staff technician or
senior student.
3. If you have more than one IV medication to give at a certain time, flush the IV line with
5-6cc hep saline between medications. Some medications will cause a precipitate to form
inside the IV line if they come into contact with each other.
4. If a precipitate starts to form, DO NOT try to flush it into the vein. Use a syringe to
aspirate the precipitate out slowly until blood is aspirated into the syringe. Use hep saline
to flush blood back and clear the line, or if on IV fluids, turn fluids on to clear the line.
5. DO NOT USE ANY UNLABLED SYRINGES. For example, a syringe left in a patients
medicine tray contains fluids the same color as the medication to be given. DO NOT
ASSUME!!!!!
6. Sterile water is often used to prepare medications. These bottles do not contain any anti
bacterial additives. Once opened they are good for 48 hours. They should always be
labeled for discard time and date. If you have any questions as to how long a bottle has
been opened, it should be discarded and replaced.
7. The following are a few frequently used medications:
a. Flunixin Meglumine: used for pain management; causes a precipitate to form
easily when it comes in contact with many other IV medications. Always flush
well after giving this drug. (Banamine)
b. Penicillin G Potassium (K-Pen): contains a significant amount of potassium, thus
should be given slowly over 2 minutes to prevent cardiac problems. Make sure KPen is well mixed in the bottle before drawing it up.
c. Heparin: anticoagulant: comes in different concentrations but the bottles are
almost identical. For therapeutic use, concentration is 10,000 units/cc and drug is
given subcutaneously; for making hep saline, concentration is 1,000 units/cc.
d. Calcium Gluconate: IV calcium; may be added to fluid bags. When this is done,
IV bags should be labeled using orange “additive” labels. The label should
specify amount and type of drug given. When giving IV medications into a fluid
line which has calcium added, flush the line with hep saline before and after
medication has been injected. The calcium may cause a precipitate to form.
8. To make hep saline (1% heparin) use IV bags of normal saline (0.9% NACL).
a. For a 250 cc bag add 2. 5 cc heparin (1000units/cc)
b. For a 500cc bag add 5.0 cc heparin (1000units/cc)
9. When a patient just has a catheter (not hooked up to IV fluids) hep saline is used to flush
the catheter ever7y 2-4 hours to prevent clotting.
10. You may receive an order to discontinue IV fluids after a certain number of IV bags have
infused. When the fluids have infused, you will need to separate the IV line from the
extension set, cover the extension set with a sterile injection cap, and protect the IV line
with a sterile cap. Flush the catheter with hep saline, slide the lock closed on the
extension set.
LARGE ANIMAL ISOLATION AREA:
Barn Aisle
1
X
A
B
X
W
A anteroom
B treatment room
C stall
X wastebasket
F feed bucket
W water bucket
C
Out Side
F
Plastic boot covers, gloves, and suits should be placed in A when the case enters
isolation. A supply of materials is kept in the cabinet in the storage room past ISO 9. If materials
are not there, contact large animal groom.
Lab specimens from isolation stalls need to be bagged to avoid contamination of
yourself or other hospital personnel. After you have collected a lab specimen, leave it on the
floor just inside the door of the treatment area. Exit from B to A as normal. Use a clear plastic
bag or a boot cover if no bags are available to transport the specimen. Place the bag over your
hand, reach into B and pick up the specimen, pull the bag over your hand, and tie off the bag.