Technical advice: Emergency services and competence
20 July 2021
Technical advice is our interpretation of how professional standards apply in a particular situation. It is designed to help veterinarians deal with common issues in practice, using their professional judgement to apply the advice to their own situation. It represents our best efforts at the time of publication but standards and expectations change over time and particular care should be used when reading old advice.
What are my obligations in relation to attending an animal in an emergency when the particular clinical skills required are outside my competence?
The Code of Professional Conduct (The Code) says that Veterinarians in clinical practice must make an emergency service available at all times so that their clients’ animals can receive essential veterinary treatment in order to relieve unreasonable or unnecessary pain or distress. The service must be sufficiently resourced so that, except in extraordinary circumstances, all veterinary emergencies involving clients' animals are attended in reasonable time to ensure the welfare of the animals.
Therefore, clinics must have sufficient and suitable resources for their clients’ animals (i.e. species appropriate veterinary skills).
The Code also requires that, if a caller is not a client, but their usual veterinary emergency service is not available, and, if the veterinarian receiving the call has the necessary skills and resources required for the particular emergency, the veterinarian must attend the emergency and provide essential treatment.
The Code outlines the veterinarian’s professional duty to take steps to relieve unreasonable or unnecessary pain or distress in animals under their care and this includes the need to administer first aid and adequate pain relief (and even euthanasia).
The Code also indicates that veterinarians should, when attending veterinary emergencies, consider carefully the potential personal risks involved and take steps to manage those risks. There is no expectation that veterinarians should place their personal safety at risk.
There is therefore complexity in cases where the particular clinical skills required to manage the emergency are outside the veterinarian’s competence. The expectations of the veterinarian are context specific.
Factors that a veterinarian should turn their mind to when considering a decision about whether to attend such an emergency would include:
- the nature and severity of the emergency (veterinarians are empowered by the Code to decide that a situation is not a veterinary emergency)
- their relative competency – considering recency of practice, species related differences, etc
- the health and safety risks to the veterinarian, bearing in mind the species of animal and the availability of suitable facilities, etc
- the availability of an alternative, more competent emergency service, bearing in mind factors like the remoteness of the location, etc
- the consent of the owner to attend the animal given the veterinarian’s skills and resource limitations (if any)
- access to support from a veterinarian skilled in that type of emergency, for example, sending videos to experienced veterinarians for advice etc
- the individual ethics of the veterinarian involved.
We acknowledge that the primary responsibility for the health and welfare of an animal lies with the owner or person in charge. Ideally, they should have a plan for emergency care of their animal in place before an emergency arises and veterinarians may wish to encourage this.
It is important to consider that a client is unlikely to have any skills or training to deal with an animal emergency so even a veterinarian working outside their usual area of competence is likely to be better equipped to manage it than they are.
A situation where a client is faced with an emergency with their animal, where they are unable to contact their usual veterinarian or haven’t registered with a veterinarian is likely to be a highly charged and emotional time.
In these situations, veterinarians should assist a client to determine the best course of action, which may include the veterinarian attending the animal. It would be prudent to recognise that these situations do occur in practice and, where they are expected to be quite frequent to plan for them in advance.
A plan might include:
- A system where nurses or techs triage calls and they then refer them promptly to a suitably skilled and resourced veterinarian
- An agreement with veterinarians that are reasonably close to accept referrals outside your skills and resources
- Advice on the businesses website, answer phone, etc, outlining what services/species the clinic does and doesn’t provide veterinary care for
- A grab bag with some appropriate drugs and dose rates
- A plan on how to navigate complex situations such as these including consent forms preprepared in advance with a clause regarding skills, competence and resources, etc
- Continuing education on common emergency conditions that a veterinarian may see in species they are not currently familiar with.
We recognise that these are complex and often emotional situations that place a great deal of pressure on the veterinarian who receives the call. We expect veterinarians to act reasonably and acknowledge that vets in this situation must be given latitude to exercise their professional judgment. Ultimately, we expect that veterinarians will do their best to help the caller find veterinary assistance, bearing in mind that the veterinarian’s own health and safety must come first.