Emergency and Critical Care
Emergency and critical care tests triage speed, CPR technique, shock recognition, and safe drug use. The exam favors priorities: airway, breathing, circulation, then everything else.
Triage and CPR
- Triage ABC: airway patency, effective breathing, and circulation (pulse quality, mucous membranes, mentation). Treat life threats before obtaining a full history.
- CPR: compressions at 100-120/min, about one-third to one-half of chest depth, with a 30:2 compression-to-ventilation ratio; switch compressors every 2 minutes.
- Useful arrest drugs: epinephrine 0.01 mg/kg IV (low dose) or 0.1 mg/kg (high dose), atropine 0.04 mg/kg, and vasopressin 0.8 U/kg.
- Shock boluses are typically 10-20 mL/kg of crystalloid in dogs and 5-10 mL/kg in cats, reassessing after each bolus.
Worked example
A hit-by-car dog arrives with pale gums, heart rate 180 beats/min, and weak femoral pulses. That is hypovolemic shock. Place two large-bore IV catheters, give a 20 mL/kg bolus, reassess perfusion, and repeat as needed while controlling hemorrhage. Do not reach for an NSAID; pain control must not compromise perfusion.
Traps that cost marks
Delaying compressions to intubate; giving oral medication to a vomiting patient; using steroids or NSAIDs in a shocky animal; forgetting to check glucose; and declaring death before confirming absent heart sounds and a flat ECG.