Episode 16: Triage by Dr. Wheeler

Episode 22: Post-Cardiac Arrest Care in Dogs and Cats

The VetEmCrit Academy built for ER and ICU vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join [https://academy.vetemcrit.com/join] In this episode, Dr. Lance Wheeler, DVM, DACVECC tackles what happens after the pulse comes back - post-cardiac arrest care, one of the most complex and high-stakes phases of critical illness. Drawing from Chapter 5 of Small Animal Critical Care Medicine (3rd edition) by Manuel Boller and Daniel Fletcher, and weaving in the key updates from the 2024 RECOVER guidelines, Lance walks through a practical, structured framework for managing patients in the first minutes, hours, and days after ROSC: preventing early rearrest, recognizing the four components of post-cardiac arrest syndrome (systemic ischemia-reperfusion injury, brain injury, myocardial dysfunction, and the persistent precipitating disease), and building a physiologic environment that lets the brain and heart recover. He then moves through the practical bedside management such as controlled reoxygenation to normoxemia rather than hyperoxemia, normocapnic ventilation targets, hemodynamic goals and the fluid/norepinephrine/dobutamine approach to hypotension, glucose and adrenal considerations, targeted temperature management and slow rewarming, seizure and cerebral edema management, and the reversible nature of myocardial stunning. Along the way, he integrates the latest veterinary evidence, including 2021-2025 studies on functional outcomes after discharge, ROSC and survival predictors, post-ROSC blood-gas and electrolyte variables, global hypoxic-ischemic brain injury, neuroprognostication windows, and reversible myocardial dysfunction, and closes with a high-yield rapid-fire board review covering every key number worth memorizing. If you enjoy this episode and want the full experience, weekly deep-dives, interactive simulators, and clinical algorithms you can use on shift, come join us inside the VetEmCrit Academy.

Episode 21: Cardiopulmonary resuscitation in dogs and cats

The VetEmCrit Academy built for ER and ICU vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join [https://academy.vetemcrit.com/join] In this episode, Dr. Lance Wheeler, DVM, DACVECC tackles one of the highest-stakes situations in emergency and critical care - cardiopulmonary arrest and resuscitation. Drawing from Chapter 4 of Small Animal Critical Care Medicine (3rd edition) by Daniel Fletcher and Manuel Boller, and weaving in the key updates from the 2024 RECOVER CPR guidelines, Lance walks through a practical, structured framework for managing arrest in real time: rapid recognition (the "shake and shout"), the CAB sequence, high-quality BLS, the physiology of coronary perfusion pressure, and how chest conformation changes compression strategy. He then moves into advanced life support such as ECG and capnography monitoring, epinephrine and vasopressin dosing, atropine, defibrillation energy, the lidocaine/amiodarone/esmolol ladder for refractory shockable rhythms, reversal agents, fluids, sodium bicarbonate, and when to consider open-chest CPR. Along the way, he integrates the latest veterinary evidence, including 2023–2025 studies on ROSC predictors, blood-gas variables, conformation-based outcomes, shockable rhythm prevalence, and CPR skill retention, and closes with a high-yield rapid-fire board review covering every key number worth memorizing. If you enjoy this episode and want the full experience, weekly deep-dives, interactive simulators, and clinical algorithms you can use on shift, come join us inside the VetEmCrit Academy.

Episode 20: Journal Club (NG tubes, pericardiocentesis, platelet transfusion)

The VetEmCrit Academy built for ER vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join [https://academy.vetemcrit.com/join] This episode reviews three papers: radiographic guidelines for confirming NG/NE tube placement in dogs and cats, the effect of operator experience on pericardiocentesis adverse events, and a retrospective evaluation of lyophilized platelet use in dogs — with practical clinical takeaways for each.

Episode 19: Hemostasis

The VetEmCrit Academy built for ER vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join [https://academy.vetemcrit.com/join] In this episode, Dr. Lance Wheeler, DVM, DACVECC continues building on the previous episodes' triage and serial-assessment foundations and shifts the focus to one of the most consequential physiologic systems in emergency and critical care — hemostasis. Drawing from Chapter 3 of Small Animal Critical Care Medicine (3rd edition) by Ronald Lee, Lance walks through hemostasis in a practical, stepwise way: the three stages of platelet activation (initiation, extension, stabilization), the cell-based model of coagulation (initiation, amplification, propagation, termination), the vitamin K–dependent factors, the tenase and prothrombinase complexes, fibrinolysis and its endogenous inhibitors, and the increasingly important concept of immunothrombosis and neutrophil extracellular traps in sepsis. Along the way, he weaves in the most current veterinary evidence — including 2024–2025 studies on trauma-associated coagulopathy, hyperfibrinolysis in cats, the TXA hemorrhagic shock trial in dogs, and the link between sepsis, fibrinolysis inhibitors, and NETs — and closes with a high-yield rapid-fire board review covering every key number worth memorizing. If you enjoy this episode and want the full experience — weekly deep-dives, interactive simulators, and clinical algorithms you can use on shift — come join us inside the VetEmCrit Academy.

Episode 18: The Daily Physical Exam in the ICU

The VetEmCrit Academy built for ER vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join [https://academy.vetemcrit.com/join] In this episode, Dr. Lance Wheeler, DVM, DACVECC builds on the previous episode's triage discussion and shifts the focus to one of the most underappreciated skills in modern emergency and critical care — the daily physical examination of the critically ill patient. Drawing from Chapter 2 of Small Animal Critical Care Medicine (3rd edition) by Timothy Hackett, Lance makes the case that no monitor, point-of-care ultrasound, or laboratory analyzer can replace a structured, intentional bedside exam — especially when it comes to assessing perfusion, hydration, and overall trajectory in real time. If you enjoy this episode and want the full experience - weekly deep-dives, interactive simulators, and clinical algorithms you can use on shift - come join us inside the VetEmCrit Academy.