CNYACE CE Event: Topics in Emergency and Critical Care

Topics in Emergency and Critical Care

CPR Basic and Advanced Life Support Update (The New Algorithm)
Newborn Resuscitation Guidelines
Diabetic Ketoacidosisa

Presented by: Daniel Fletcher, PhD, DVM, DACVECC

CPR: Basic and Advanced Life Support

When patients experience cardiopulmonary arrest (CPA), seconds count. A well-trained and prepared veterinary health care team can mean the difference between life and death when a patient experiences CPA. This lecture will explain key concepts from the newly updated RECOVER 2.0 evidence evaluation process in the domains of Basic and Advanced Life Support, including the evidence-based approach to providing optimal chest compressions and ventilation in dogs and cats, as well as monitoring, drug, and defibrillation therapy.

Learning Objectives:

1. Describe why rapid diagnosis and initiation of basic life support in a dog or cat with cardiopulmonary arrest (CPA) is crucial.
2. Demonstrate correct chest compression technique for a dog or cat given a description of the patient’s chest conformation and size.
3. Demonstrate correct mouth-to-snout ventilation technique for a dog or cat in CPA and explain how your approach would differ if the animal were endotracheally intubated.
4. Describe how to use the CPR ECG algorithm to diagnose the arrest rhythm during an inter-cycle pause in BLS.
5. Explain the rationale behind the ALS interventions you would use to treat a patient in asystole or pulseless electrical activity (PEA), and contrast them to the ALS interventions you would use to treat a patient with ventricular fibrillation (VF) or pulseless ventricular tachycardia (PVT).

Newborn Resuscitation Guidelines

The RECOVER 2.0 evidence evaluation was recently expanded to investigate the unique aspects of resuscitating newborn dogs and cats that are at risk of or have experienced cardiopulmonary arrest (CPA). The new RECOVER 2.0 evidence-based newborn resuscitation algorithm will be described in this lecture, addressing management of distressed puppies and kittens in the immediate post-partum period.

Learning Objectives:

1. Develop an approach to resuscitation in the newborn puppy or kitten given it’s post-natal heart rate.
2. Explain why ventilation is prioritized over circulation in newborn resuscitation efforts.
3. Describe the indications for the use of epinephrine during CPR in newborn puppies and kittens.

Diabetic Ketoacidosis

Diabetic ketoacidosis (DKA) is a potentially life-threatening complication of diabetes mellitus. Rapid diagnosis and aggressive treatment are essential in managing these cases. This lecture will cover the pathophysiology of DKA and criteria for diagnosis. The approach to initial stabilization and best practices for timing of insulin therapy will also be discussed.

Learning Objectives:

1. Describe the pathophysiology behind the development of DKA.
2. Identify the abnormalities on a blood gas, urinalysis and other point of care tests that are consistent with a diagnosis of Diabetic Ketoacidosis (DKA).
3. Describe the criteria for definitive diagnosis of DKA.
4. Develop an initial fluid therapy and insulin plan for a patient with DKA, and explain the pros and cons of early vs. late insulin administration.