How can veterinary teams navigate emergency situations with confidence?

23 May 2025

Understanding Human Factors and how the whole team can support each other in critical moments and when under stress is key to mastering emergencies successfully, was the message during a session at BSAVA Congress and Expo 2025.

In the session ‘999 tips in the trenches’, Sophie Gilbert, Veterinary Surgeon and Stevie-Leigh Egerton, Clinical Nursing Manager, shared practical tips and strategies that can be implemented with the whole veterinary team when navigating emergency situations.

Kicking off the session, Stevie-Leigh Egerton emphasised the importance of preparation to reduce stress, help decision making, save time, and improve patient outcomes. This includes having designated crash areas or kits with stock check lists, cognitive or visual aids like drug dosing charts, running team training on protocols, and simulations and de-briefs.

During triage, use flowcharts and prompt questions to assist phone triage and prepare the clinic for the emergency coming in. Actively listen to the client for clinical signs that may indicate an emergency (such as dyspnoea, continuous bleeding, dysuria, trauma).

Once the patient arrives at the clinic, conduct a rapid primary survey and record vitals before stabilisation. If there are any abnormalities in breathing (rate/effort/noise/pattern), provide oxygen therapy. Assess pulse rate, quality and synchronicity, Capillary Refill Time, and mucous membrane colour, as well as ambulatory status, gait, and mentation. You can take blood when putting in an IV.

Once triaged, Sophie Gilbert’s top tip for stabilisation was to “fly your own plane”: keep it simple, act on the information at hand, and share boundaries for intervention with the nursing team, so they are clear on when to flag issues to the veterinary surgeon.

Sophie emphasised not forgetting simple things like stress reduction (through minimal handling and anxiolytics), pain management, oxygen therapy, and patient warming or cooling, which all make a significant difference to holistic care. Serial monitoring is vital, enabling you to assess, act, reassess, and react. What we try to achieve in the first 10 minutes is different to what we will want to achieve in the next hour.

Discussing the importance of communication in delivering high-quality emergency care, Stevie-Leigh then shared advice on critical client conversations, which should comprise:

  1. Finding a quiet consult room where you won’t be interrupted.
  2. Finding out what the client already knows about the situation.
  3. Asking them “Can I speak to you about (your pet’s) condition?”
  4. Starting the explanation with “I’m going to give you some news that might be difficult…” Only give the facts, and don’t give all the information at once.
  5. Being empathic.
  6. Giving the client a summary of what has been discussed. Find out if the client wants to resuscitate or DNR, then inform the team of the decision and/or put it on the hospital notes, so that everyone is aware of the action to take if required.

Sophie addressed the emotional challenges commonly encountered in emergencies, which are often characterised by rapid decision-making and unpredictable timescales. In such situations, difficult team dynamics can lead to medical errors, delayed treatments and incivility, which all significantly affect the outcome for the patient. Sophie emphasised that one person cannot manage alone, and the aim is to achieve a shared mental model – a common understanding of what the problem is, what needs to be done, and how things are progressing.

Sophie’s tips for how to manage this are:

  • Situation awareness – Use pre-shift or pre-emergency briefings (this is especially important if you have locums), huddles, and debriefings.
  • Communication – Civility, closed loop communication/check backs (this ensures that the other person has received the information you’re trying to give), and using the CUSS framework (concern – unsure – safety – stop) as a way to raise safety concerns.
  • Cooperative behaviour and mutual support.

Highlighting that burnout is common in emergency settings, Sophie recommended using the “CALMDOON” acronym to support your emergency self-care:

  • Controlled breathing – Activates the parasympathetic nervous system
  • Articulate – When you are feeling stressed and/or need to take a break
  • List and prioritise – Have prep lists, kits and cognitive aids
  • Mental model – Use past experiences and knowledge to help make decisions
  • Delegate – You can’t do everything yourself!
  • Outside – Use all of the information you have available
  • Outsource – Using others’ skills and resources
  • Nutrition and hydration – To look after yourself.

Wrapping up the session, Sophie recommended asking yourself – before you act, are you: HALT – Hungry? Angry? Lonely? Tired?

The lecture recording for this session is available in the BSAVA Library. If you attended Congress and Expo you can access this for free, or alternatively purchase the session for £25+ VAT.

Further Resources

BSAVA Library collection on Mental Health and Wellbeing

BSAVA Manual of Emergency and Critical Care

Human Factors: Improving Safety and Patient Outcomes in Practice (Congress 2025 lecture)