Emergency and Critical Care
Emergency and critical care tests triage, cardiopulmonary resuscitation, shock recognition, fluid resuscitation, oxygen therapy, emergency drug calculations, and continuous reassessment. The exam rewards systematic ABC assessment and prompt intervention.
Core rules and concepts
- Triage by airway, breathing, circulation, and neurologic status. Life-threatening problems are treated before a full history or definitive diagnosis.
- RECOVER-aligned CPR emphasizes high-quality compressions at 100–120 per minute, depth of about one-third to one-half of chest width, minimal interruptions, and a compression-to-ventilation ratio of 30:2 without an advanced airway. Defibrillate shockable rhythms as early as possible.
- Shock boluses are commonly about 20 mL/kg in dogs and 10 mL/kg in cats, given rapidly and reassessed. Over-resuscitation can worsen pulmonary edema or hemorrhage.
- Know emergency drugs: epinephrine 0.01 mg/kg IV for CPR, atropine 0.04 mg/kg for bradycardia, and diazepam or midazolam for seizures. Verify concentration and route.
- Provide oxygen by mask, flow-by, nasal cannula, or cage, and monitor for stress and hyperthermia.
Worked example
A 20 kg dog in cardiac arrest needs epinephrine at 0.01 mg/kg. Dose = 20 × 0.01 = 0.2 mg. The 1:1000 concentration is 1 mg/mL, so the volume is 0.2 mL. A 1:10,000 concentration is 0.1 mg/mL, which would require 2 mL. State the concentration aloud during a code to prevent a tenfold error.
Traps that cost marks
- Confusing 1:1000 and 1:10,000 epinephrine concentrations.
- Interrupting chest compressions for prolonged intubation attempts or rhythm checks.
- Giving a full shock bolus without reassessing perfusion.
- Forgetting that cats often need smaller boluses and careful fluid titration.