Emergency and Critical Care
This domain tests triage, primary survey, shock management, cardiopulmonary resuscitation, oxygen therapy, and continuous monitoring.
Triage and primary survey
Assess airway, breathing, and circulation first, then disability and exposure. Treat the most life-threatening problem first. Obtain IV access, provide oxygen, control hemorrhage, and keep the patient warm. Reassess after every intervention.
Shock and CPR
Shock boluses are given by protocol and reassessed; a common cat starting bolus is 10 to 15 mL/kg, but the veterinarian sets the plan. For CPR, compress at 100 to 120 per minute at one-third to one-half chest depth, use a 30:2 compression-to-ventilation ratio for one rescuer, and rotate the compressor every 2 minutes. Give epinephrine per protocol and record times.
Worked example
A 5 kg cat in shock is ordered 10 mL/kg. Reasoning: 5 kg × 10 mL/kg = 50 mL. Give over the ordered period, reassess perfusion, and repeat only on veterinarian direction. The calculation does not authorize repeated boluses.
Monitoring
Track mentation, heart rate, respiratory rate, blood pressure, mucous membrane color, capillary refill time, temperature, urine output, and lactate when available. Keep an emergency drug chart and calculate doses in advance.
Traps
Delaying CPR to obtain a definitive diagnosis; using one shock protocol for every species; failing to record arrest times and drugs; forgetting hypothermia and hypoglycemia; giving oral medication to a vomiting patient.