Emergency and Critical Care
What the exam tests
Emergency and Critical Care tests triage, primary survey, shock management, CPR, transfusion, and continuous monitoring.
Core rules
- Triage by airway, breathing, circulation, disability, and exposure; treat the most life-threatening problem first.
- Shock boluses are given in aliquots and reassessed: commonly 20 mL/kg for dogs and 10-15 mL/kg for cats, adjusted for cardiac or renal disease.
- CPR follows RECOVER-style compression and ventilation ratios; high-quality compressions are the priority.
- Emergency drugs include epinephrine, atropine, naloxone, diazepam, and dextrose; know concentration and route.
- Monitor perfusion, mentation, urine output, lactate when available, and temperature.
Worked example
A 20 kg dog in hypovolemic shock receives a 20 mL/kg bolus: 20 × 20 = 400 mL over about 15-20 minutes. Reassess heart rate, pulse quality, mucous membrane color, and blood pressure. If still shocked, repeat a smaller bolus rather than giving the entire calculated daily volume at once.
Traps
- Giving a full shock bolus rapidly to a patient with cardiac disease or pulmonary contusion.
- Delaying compressions to place a catheter or intubate.
- Using the wrong epinephrine concentration; read the label aloud.
- Forgetting to warm the patient; hypothermia worsens coagulopathy and bradycardia.
- Failing to document times, doses, and response during a code.