VTS (ECC) cheat sheet

Hemorrhage classification (ATT): stage I up to 15% blood loss; stage II 15-30% (tachycardia, narrow pulse pressure); stage III 30-40% (hypotension, obtundation); stage IV >40% (moribund, often requires transfusion).

Transfusion threshold in dogs is typically PCV <20% with clinical signs or <15% without; cats generally transfuse at PCV <15-18% with signs of hypoxia; 1 unit of pRBC raises PCV ~1% per kg in dogs.

A transfusion reaction within minutes to hours suggests acute hemolytic (mismatch) reaction; signs include fever, hemoglobinuria, hypotension, and vomiting; stop the transfusion immediately and maintain IV access with crystalloids.

Fluid resuscitation bolus in dogs is 20 mL/kg (10 mL/kg in cats) of isotonic crystalloid, reassessed after each bolus; shock doses of synthetic colloid are 5-10 mL/kg with a maximum of 20 mL/kg/day.

Maintenance crystalloid rate is approximately 2-4 mL/kg/hr in dogs and cats; use 1-2 mL/kg/hr in patients at risk of volume overload (cardiac, oliguric renal, or head trauma).

Modified Glasgow Coma Scale scores motor activity, brainstem reflexes, and level of consciousness; a score of 8 or less carries a poor prognosis and warrants aggressive support.

CPR: compression rate 100-120/min, compression-to-ventilation ratio 30:2 without an advanced airway, and 2-minute cycles before rhythm reassessment; use 0.01-0.02 mg/kg IV epinephrine for asystole.

Hyperkalemia with bradycardia or widened QRS is treated with 10% calcium gluconate 0.5-1 mL/kg IV over 10-15 minutes for cardioprotection, then regular insulin with dextrose and fluid diuresis.

Pain scoring tools (e.g., Colorado State or Glasgow Composite Measure Pain Scale) guide multimodal analgesia; avoid pure mu-agonists as sole agents in cats with urethral obstruction until patency is confirmed.

Normal canine values: temperature 100.5-102.5 F (38-39.2 C), heart rate 60-160 bpm, respiratory rate 10-30/min; feline temperature 100.5-102.5 F, heart rate 140-220 bpm, respiratory rate 20-30/min.

Drug dose calculation: dose (mg/kg) x body weight (kg) = total mg; volume to administer = total mg / concentration (mg/mL); always confirm units before drawing up.

Veterinary technician specialist (VTS) certification requires graduation from an AVMA-accredited program, credentialing, a minimum of 3 years (usually 4,000-6,000 hours) of experience in the specialty, a case log, and a passing examination.

Controlled substances require a DEA registration and must be logged in a perpetual inventory with date, patient, amount, and personnel; discrepancies must be reported and reconciled per federal and state law.

Radiographic technique follows the inverse square law and 15% rule: a 15% increase in kVp approximately doubles exposure; mAs controls quantity and kVp controls penetration and contrast.

Occupational safety: use PPE per OSHA bloodborne pathogen standards; anesthetic waste gas exposure limits are 2 ppm for halogenated agents and 25 ppm for nitrous oxide over an 8-hour period.

Anesthetic monitoring standards include HR, RR, mucous membrane color, CRT, blood pressure, temperature, and SpO2 every 5-10 minutes; MAP should be maintained at 60 mmHg or greater.

Client communication and informed consent require documenting risks, benefits, and alternatives; medical records are legal documents and must be retained per state statute (commonly 3-5 years).

Isotonic crystalloid bag labeling: calculate the drug dose added, the total volume, and concentration (mg/mL); label with drug, dose, volume, date, and initials per USP <797> handling principles.

Hypoglycemia in the emergency patient is treated with 0.5-1 mL/kg of 50% dextrose diluted 1:1 to 1:4 in saline, given slowly IV, then a CRI of 2-5% dextrose in maintenance fluids.

Gastric dilatation-volvulus requires immediate decompression (trocarization or orogastric tube), fluid resuscitation, and surgery; do not delay stabilization for radiographs in an unstable patient.

Urethral obstruction in cats: relieve obstruction, monitor for post-obstructive diuresis, and recheck potassium and renal values; ECG changes (bradycardia, tall T waves, wide QRS) indicate emergent hyperkalemia.

Heatstroke management includes active cooling (cool water, fans, IV fluids) to a target of 103 F (39.4 C), avoiding overcooling, and monitoring for DIC, renal failure, and hypoglycemia.

CPR post-resuscitation care includes oxygen, blood pressure support (MAP 65-90 mmHg), glucose and electrolyte correction, and targeted temperature management; ROSC does not equal survival.

Emergency drug doses: atropine 0.04 mg/kg IV for bradycardia; lidocaine 2 mg/kg IV bolus for ventricular arrhythmias (avoid in cats >1 mg/kg); furosemide 2-4 mg/kg IV for pulmonary edema.

Pain assessment in the emergency patient uses physiologic (HR, RR, BP) and behavioral cues; cats often show pain as hiding, reluctance to move, or facial expression changes rather than vocalization.

Emergency thoracic trauma: triage for tension pneumothorax and open chest wounds; perform thoracocentesis or chest tube placement for pneumothorax, and monitor for pulmonary contusions over 24-48 hours.

Common emergency drug concentrations: epinephrine 1:1,000 (1 mg/mL); atropine 0.54 mg/mL; lidocaine 2% (20 mg/mL); calcium gluconate 10% (100 mg/mL); dextrose 50% (500 mg/mL).

Anesthetic monitoring equipment: pulse oximetry measures SpO2 (target 95-100%); capnography end-tidal CO2 target 35-45 mmHg; Doppler blood pressure target systolic 80-120 mmHg.

Veterinary practice acts define scope of practice for technicians; tasks such as diagnosis, prognosis, and surgery are reserved for veterinarians, while technicians may perform delegated tasks under supervision.

Continuing education requirements for credential maintenance vary by state but commonly require 10-20 hours per year, with a portion in the specialty area; document CE certificates for audit.

Medical math: convert pounds to kilograms by dividing by 2.2; convert Celsius to Fahrenheit by (C x 1.8) + 32; convert Fahrenheit to Celsius by (F - 32) / 1.8.

Radiographic safety: ALARA principles (as low as reasonably achievable) include collimation, lead PPE, dosimetry badges, and distance (inverse square law) to minimize exposure.

Controlled substance recordkeeping: biennial inventory, records of receipt and dispensing, and secure storage; federal law requires records be kept for at least 2 years and available for inspection.

Emergency triage uses the ABCs (airway, breathing, circulation) and a color-coded system; red (immediate), yellow (urgent), green (stable), and black (moribund or deceased) guide treatment order.

Cardiopulmonary arrest in cats: compressions at 100-120/min with chest compression at the widest part of the thorax; use a 30:2 ratio without an advanced airway and 2 breaths per 10 compressions with one.

Fluid therapy in head trauma: avoid hypotonic fluids and target normovolemia and normotension; hypertonic saline (3-7%) at 3-5 mL/kg or mannitol 0.5-1 g/kg IV for intracranial pressure.

Monitoring for sepsis: use lactate, blood pressure, mentation, and urine output; a lactate >2 mmol/L with hypotension suggests hypoperfusion and warrants aggressive fluid resuscitation.

Emergency stabilization of the trauma patient follows the primary survey (ABCs), then secondary survey; obtain baseline PCV/TP, blood glucose, and lactate, and place IV access before diagnostics.

Nutrition in the critically ill: initiate enteral feeding within 24-48 hours when the GI tract is functional; calculate resting energy requirement (RER) as 70 x (kg^0.75) and start at 1/3 to 1/2 RER.

Wound management in the emergency patient: copious lavage (0.9% saline, 5-10 psi), debride devitalized tissue, and cover with a sterile dressing; avoid cytotoxic antiseptics in open wounds.

Anesthetic emergencies: if bradycardia with hypotension occurs, reduce anesthetic depth, provide 100% oxygen, and give atropine 0.02-0.04 mg/kg IV; if cardiac arrest, begin CPR immediately.

Triage of the vomiting/diarrhea patient includes assessing hydration, electrolytes, and blood glucose; obtain PCV/TP and blood glucose in any patient with severe GI signs before treatment.

Veterinary technician duties include venipuncture, catheter placement, anesthesia monitoring, dental prophylaxis, radiography, and client education, all under veterinarian supervision per state practice act.

Recordkeeping: SOAP format (subjective, objective, assessment, plan) standardizes documentation; record all treatments, drugs, and client communications in the medical record.

Emergency practice equipment: crash cart should include endotracheal tubes, laryngoscope, ambu bag, IV catheters, emergency drugs, and defibrillator; check expiration dates monthly.

Veterinary ethics and professional conduct: maintain confidentiality, avoid conflicts of interest, and follow the AVMA Principles of Veterinary Medical Ethics; report suspected animal cruelty per state law.

Infection control: hand hygiene is the most effective measure; use appropriate disinfectants (e.g., quaternary ammonium, accelerated hydrogen peroxide) with correct contact time per label.

Anesthetic machine check: verify oxygen supply, vaporizer function, breathing circuit integrity (leak test), and scavenging system before each use; document the check.

Common emergency blood products: packed RBCs (1 unit raises PCV ~1% per kg), fresh frozen plasma (10-15 mL/kg for coagulopathy), and whole blood (20 mL/kg); crossmatch before administration.

Veterinary continuing education in ECC: advanced skills include CPR certification (e.g., RECOVER guidelines), advanced life support, and critical care monitoring; document CE hours for credential renewal.

RECOVER CPR guidelines: high-quality compressions (100-120/min, 1/3 to 1/2 chest depth), minimize interruptions, and use vasopressors early; capnography and direct arterial pressure guide compression quality.

Post-cardiac arrest syndrome includes myocardial dysfunction, systemic ischemia-reperfusion injury, and brain injury; provide oxygen, vasopressors, and targeted temperature management (avoid hyperthermia).

Emergency management of anaphylaxis: epinephrine 0.01 mg/kg IM (1:1,000) or 0.01 mg/kg IV (1:10,000), IV fluids, and antihistamines; epinephrine is first-line for hypotension and bronchospasm.

Diabetic ketoacidosis: correct dehydration with 0.9% saline, then add dextrose when glucose falls below 250 mg/dL; monitor potassium and give insulin only after potassium is >3.5 mEq/L.

Emergency seizure management: benzodiazepines first-line (diazepam 0.5 mg/kg IV or midazolam 0.2 mg/kg IV/IM); if refractory, use levetiracetam or phenobarbital and monitor for hyperthermia.

Acute kidney injury: fluid therapy to restore volume, monitor urine output (target 1-2 mL/kg/hr), and manage hyperkalemia; avoid nephrotoxic drugs and adjust doses for renal function.

Emergency oxygen therapy: provide supplemental oxygen via mask, nasal cannula, or oxygen cage; target SpO2 >94%; monitor for oxygen toxicity with prolonged high FiO2.

Pain management in critical patients: use multimodal analgesia (opioids, NSAIDs when renal function is adequate, local blocks) and reassess pain scores every 4-6 hours.

Veterinary practice management: understand inventory control, controlled substance logs, and billing; accurate charging for supplies and drugs supports practice sustainability and legal compliance.

Client education: explain diagnoses and treatment plans in plain language, provide written discharge instructions, and confirm understanding; document client consent for procedures.

Emergency triage color coding: red (immediate life-threatening), yellow (urgent, stable but needs treatment), green (non-urgent), black (moribund or deceased); reassess every 15-30 minutes.

Common emergency diagnostic tests: PCV/TP, blood glucose, blood gas, lactate, coagulation panel, and urinalysis; interpret results in context of the patient's clinical status.

Veterinary technician continuing education in ECC: advanced skills include CPR certification (e.g., RECOVER guidelines), advanced life support, and critical care monitoring; document CE hours for credential renewal.

Legal and ethical considerations: informed consent, confidentiality, and accurate medical records; technicians may not diagnose or prescribe but may perform delegated tasks under supervision.

Anesthetic monitoring: use a combination of subjective (mucous membrane color, CRT, jaw tone) and objective (HR, BP, SpO2, ETCO2, temperature) parameters; document every 5-10 minutes.

Emergency preparedness: maintain a crash cart, emergency drug doses, and a call-back list; conduct regular drills and review protocols for common emergencies (GDV, urethral obstruction, trauma).