Emergency and Critical Care
Emergency and critical care items test triage, CPCR, shock management, and monitoring. Prioritize life-threatening problems and know the doses and sequence cold.
Core rules
- Triage ABC: airway, breathing, circulation. Treat the most unstable patient first, not the loudest.
- CPCR: compressions 100–120/min at about one-third to one-half chest depth, allow full recoil, minimize interruptions; switch compressors every 2 minutes.
- Shock: place IV/IO access, give isotonic crystalloid bolus (commonly 20 mL/kg in dogs, lower volumes in cats or cardiac patients per veterinarian), reassess perfusion.
- Emergency drugs include epinephrine, atropine, and reversal agents; know route and concentration.
- Monitor glucose, temperature, blood pressure, and urine output in critical patients.
Worked example
A 15 kg dog in shock is ordered 20 mL/kg crystalloid bolus. 15 × 20 = 300 mL. Give over 15–20 minutes and reassess heart rate, mucous membranes, CRT, and blood pressure. Reasoning: the bolus is a starting dose, not a fixed total; repeated boluses require reassessment to avoid overload.
Traps
- Delaying compressions to place an IV or intubate.
- Giving a full bolus to a patient with known heart disease without veterinary direction.
- Forgetting to warm a hypothermic trauma patient.
- Using a low-dose epinephrine calculation without checking the concentration.