UT-VMC emergency room tails: the chicken and the egg

UTVMC COLUMN HEADER  2By Dr. Amanda Rainey

We have all experienced times when situations become humorous even if in theory we should not be laughing. Once such experience happened to my students and I during an emergency shift last March. It had been a busy weekend and the cases continued to arrive long into Sunday afternoon.

I had been working with a rowdy puppy with an ear infection—as well as an elderly miniature schnauzer suffering from a suspected urinary tract infection—when I received a call from the intern sharing ER duty with me that day. “Dr. Rainey, could you come to radiology? We have a situation with a chicken,” the intern said with an unusually urgent tone, as he is often quite relaxed. I knew vaguely of the chicken in question, as it was presented as being attacked, most likely by a dog or coyote.

The owners were extremely fond of this particular chicken and wanted to do everything possible to save her. Our exotics personnel had been contacted and our plan was to anesthetize the chicken to fully examine its wounds and perform radiographs to determine if there had been internal injury. I made my way to radiology and was surprised to find the room a flurry of activity.

“The chicken is arresting! We need to begin CPR now,” the exotics clinician’s voice rang out as I entered the room. I have participated in many resuscitation efforts for small animal patients, but this was my first foray into avian CPR. The exotics clinician expertly placed an endotracheal tube to provide the bird with oxygen while the intern began compressions on her pointy keel, which is equivalent to the sternal area of a dog or cat. The student working with the chicken had been instructed on the dosages of emergency drugs, such as epinephrine and atropine, and quickly drew them up in syringes and began giving the medications down the endotracheal tube. Keeping my wits about me, I took over compressions as the intern attempted to contact the owners about the detrimental condition of the chicken.

I was compressing the keel in rhythmic fashion when the most unexpected event occurred. Something white suddenly erupted from the chicken’s hind end and rocketed into the wall near the radiology table, making contact with a splattering crack. When we looked at the sight of impact, the contents of a large egg dripped down the wall and gathered on the ground around the shattered shell. It was at that moment that a giggle escaped from someone in the room, which then spread like a wave until we were all chuckling while trying hard to suppress full-blown laughter.

Humor in no way means one does not care. We certainly cared for our patient. But as humans, sometimes one just can’t help having an emotion, despite its inappropriateness.

Moments later the intern returned and told us the owners had elected to stop resuscitative efforts. His face held a look of shock as he saw us stifling our laughter, but after an explanation, a small grin also flitted across his face. I was sorry for the loss of the chicken, but knew I would never forget this day.

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