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I have learnt several things this week: not all accidents are predictable, and children and dogs are very similar.
I have also learnt that emergency doctors and vets do a similar job. On Tuesday our spaniel found a way to take the coffee granule capsules from their dispenser in the kitchen. This was all the more remarkable because I haven’t yet found a way to do so, despite the benefits of ownership several thumbs and an instructional booklet (for the coffee machine, not the thumbs).
Unwisely choosing Volluto over Decaffeinato, she overdosed on caffeine by chewing and swallowing two of the capsules. Caffeine has the same effect on dogs as on small children, and can be extremely dangerous, causing tachycardia, agitation, hyperthermia and convulsions. Both species require emetics and activated charcoal and consequently we drove her to the vets instead of watching EastEnders.
I knew it was an accidental overdose because she didn’t seem particularly depressed, at least not until she saw the vet approaching with a thermometer, which she clearly remembered from her last visit. Children and small dogs can vomit at will but not when required to do so by someone else. Vets have as their secret weapon the drug apomorphine, and it would have been really nice to know in advance that it works within 20 seconds in a dog, if only to avoid the freshly brewed Nespresso, complete with the frothy bit on top, that she produced.
Getting activated charcoal into a dog is just as difficult as getting it into a child, but with much cajoling and bribery, including charcoal biscuits, which she usually devours whole, the crisis was averted. Perhaps we need charcoal biscuits in the ED (emergency department) too.
Naturally we were made to feel foolish and careless, as are parents everywhere, and when suitably admonished we left with our proverbial and real tails between our legs.
Looking around the surgery it all felt very familiar to an emergency doctor, even the mess on the floor and walls and the smell of hygienic floor cleaner was the same. In the waiting room, where puddles of urine had yet to be cleaned up, there was a queue of victims eyeing each other up and growling territorially at one another.
I couldn’t help noticing the rack of muzzles in different sizes, which I think I could use in the ED, along with choker chains and short leashes.
Such a leash was proving very effective in stopping a bullmastiff eating its neighbour whole.
Another improvement was the sign above the door used for big animals that read ‘Emergency exit: keep clear’. Exit blockage is one of our big-ticket problems, but it may take more than a door sign to sort it out. Still, it could be worth a try, as nothing else seems to work! Another difference was the cash register at reception, where each of the owners would soon deposit about £45.
This is a distinct improvement on our flow model, but one which I don’t see coming to the ED soon. Pity.
Charles Lamb is a consultant in emergency medicine. He writes under a pseudonym