You have 4 summaries left

VETgirl Veterinary Continuing Education Podcasts

Crash Cart Basics in Veterinary Medicine with Dr. Garret Pachtinger andamp; Dr. Justine Lee | VETgirl Veterinary Continuing Education Podcasts

Mon Aug 07 2023
veterinary medicineemergency medicinecrash cartsdosing recommendationscardiac arrest preparationCPR

Description

The episode covers the importance of crash carts in emergency medicine for veterinary professionals. It provides insights on the essential tools, drugs, and equipment needed in a crash cart, as well as dosing recommendations for various medications. The episode also discusses the role of EKGs, pulse oximeters, capnographs, and defibrillators in cardiac arrest preparation. Additionally, it emphasizes the significance of having a well-stocked crash cart, providing training for staff members, and remaining calm during veterinary emergencies.

Insights

Crash carts should be mobile with working wheels

To ensure easy accessibility during emergencies.

Important tools for future cases

Include laryngoscopes, stylets, endotracheal tubes, catheters of different sizes, needles of different sizes, and syringes of different sizes.

Recommended drugs for every crash cart

Epinephrine and atropine, with additional drugs depending on the clinic's case load.

Proper dosing is crucial

Different medications have varying dosing recommendations, and it is important to be aware of the appropriate doses for each drug.

Importance of EKGs, pulse oximeters, capnographs, and defibrillators

These devices play a vital role in cardiac arrest preparation and monitoring during CPR.

Regularly check and restock the crash cart

To ensure its effectiveness in emergency situations.

Training sessions for staff members

To ensure they are properly trained to use the crash cart and equipment during emergencies.

Remaining calm and focused

Adrenaline can hinder clear thinking and recall of knowledge during veterinary emergencies.

Implementing CPR can save lives

Both animal and human lives can be saved by performing CPR in emergency situations.

Early recognition of clinical signs

Can help address issues before they escalate into emergencies.

Chapters

  1. Introduction
  2. Crash Cart Essentials
  3. Conclusion
Summary
Transcript

Introduction

00:00 - 07:10

  • Becca is offering a free 14-day trial membership for veterinary professionals to access their full on-demand library of veterinary continuing education, webinars, and resources.
  • The podcast features Dr. Garrett Pachtinger and Vek girl discussing crash carts in emergency medicine.

Crash Cart Essentials

00:00 - 32:10

  • A crash cart should be mobile with working wheels.
  • A piece of white tape can be used to indicate if the cart has been opened.
  • Crash carts can vary depending on the type of hospital or clinic.
  • Every crash cart should have common instruments like a laryngoscope and stylette for intubation.
  • Other important tools include overhead lights, wire cutters, and endotracheal tubes.
  • Important tools to remember for future cases include laryngoscopes, stylets, endotracheal tubes, catheters of different sizes, needles of different sizes, and syringes of different sizes.
  • Recommended drugs to have in every crash cart are epinephrine and atropine. Other drugs to consider include calcium gluconate for blocked cats, furosemide or lasix for heart failure patients, reversal agents like naloxone or flumazenil, and vasopressin if the clinic sees a lot of related cases.
  • For hypoglycemic patients, it is important to have dextrose close by.
  • Big emergency clinics and specialty clinics should have large crash carts with all necessary equipment. General practitioner clinics can use smaller toolboxes but should still have everything in one place.
  • When securing the airway, it is important to have various size blades for laryngoscopes, multiple sizes of stylets and endotracheal tubes taped with a white piece of tape so they are not mistakenly taken without replacement.
  • Dosing recommendations for drugs like naloxone vary by country. In the United States, it is usually 0.4 mg per milliliter. For benzos like diazepam or midazolam used in seizure patients, the usual dose is 5 mg.
  • In emergency situations with seizure patients, there may not be time to look up doses. A general guideline is one milliliter of diazepam for a medium-sized dog and three to five milliliters for a large dog.
  • In cases of seizures in cats, check blood glucose and reach for 1 milligram of diazepam.
  • For medium-sized dogs, reach for 3 to 5 milligrams of benzodiazepine during a seizure.
  • For large dogs, reach for 5 to 7 milligrams of benzodiazepine during a seizure.
  • The typical dextrose dose for hypoglycemic patients is 0.5 grams per gig or approximately one milligram per every 10 kilograms of patient weight.
  • Insulinoma patients should not be given as much dextrose due to the risk of a reflexive spike in insulin release.
  • Calcium gluconate is commonly used for hyperkalemic patients with heart arrhythmia concerns. The typical dose range is 50 to 150 milligrams per kilogram using a standard solution.
  • A shortcut calculation for calcium gluconate dosage is using three milliliters per cat based on a solution with a concentration of ten percent. For each additional five kilograms, add three more milliliters.
  • An EKG (electrocardiograph), pulse oximeter, and capnograph are important devices to have available during cardiac arrest preparation.
  • An EKG should be neatly wrapped up and have untangled clips and leads for stress-free use.
  • A capnograph measures carbon dioxide levels and can indicate return of spontaneous circulation (ROSC) in an intubated patient during CPR.
  • A defibrillator works only on rhythms that can accept defibrillation, such as ventricular fibrillation or pulseless ventricular tachycardia.
  • Defibrillators may not work on pets with no heart rate or rhythm
  • ECG leads can be attached to tongue depressors to prevent tangling
  • Positioning of ECG leads can be remembered using mnemonics like 'white rhymes with right'
  • Pulse oximeters are not necessary for patients with cyanotic gums
  • A venous blood gas plus a pulse oximeter can provide as much information as an arterial blood gas
  • Hands-on assessment of the patient is important before relying on machine data
  • Essential equipment includes oxygen, appropriate tubing, bag valve masks, and suction units
  • Defibrillation is less common in dogs and cats compared to humans
  • Having a good suction unit is more important than a defibrillator in general practice
  • Aspiration pneumonia prognosis is fair to good, so having a suction unit is crucial
  • Other items to consider include syringes, catheters, tape, scrub, and scalpel blades for cut downs
  • Intravenous fluids and administration sets should also be available
  • Consider having essential medical supplies like scalpels, intravenous fluids, administration sets, and defibrillator conducting gel in your crash cart or nearby.
  • Ensure you have equipment for common emergency procedures such as catheters and chest tubes.
  • Regularly check and restock the crash cart to maintain its effectiveness.
  • Provide training sessions for staff members to ensure they are properly trained to use the crash cart and equipment in emergency situations.
  • Prefer using one large syringe of medication instead of multiple individual doses for efficiency and safety.
  • Place the crash cart in a central location for easy access during emergencies.

Conclusion

00:00 - 36:41

  • During a veterinary emergency, it is important to have readily available supplies such as venous access, fluids, and blood transfusion units.
  • In certain circumstances, quick administration of head of starch or blood may be necessary depending on the underlying disease.
  • Remaining calm, practicing and educating oneself, and having prepared supplies can lead to better outcomes in emergencies.
  • When faced with a patient arrest, it is crucial to stay focused and not let adrenaline hinder clear thinking and recall of knowledge.
  • A pet owner who had learned CPR from a webinar was able to save his neighbor's life when they experienced a heart-related problem.
  • Implementing CPR can save both animal and human lives.
  • Noticing early clinical signs before a crash can help address issues before they escalate into an emergency situation.
1