This course will cover the basic and advanced aspects of hemorrhagic shock with emphasis on traumatic etiology. In addition, it will provide an in-depth overview of an up-to-date approach to management of severe hemorrhagic shock that is refractory to standard therapy and resuscitation. All recommendations are based on current human and veterinary research as well as the author’s experience working in emergency and critical care field for 10 years. This course will consist of non-interactive lessons in the form of videos, journal articles, and texts highlighting the most important take-away messages. Lessons will include handouts and questions that will re-enforce the most important concepts of each lesson. Completion of all lessons (videos, reading materials, quizzes, and end-of-course test) will take a minimum of 3-4 hours.
These materials have been successfully used by interns, residents and students of American Colleges of Veterinary Medicine.
Objectives: Upon completion of this course, the participant will learn
· Main pathophysiologic aspects of hemorrhagic shock including acute traumatic coagulopathy, vasodilatory phenotype and stages of hemorrhagic shock
· The concept of damage control resuscitation and lethal triad
· Implementation of hypotensive resuscitation
· Controversies of arterial blood pressure measurement in patients with hemorrhagic shock
· The most recent recommendations on the use of crystalloids in patients with traumatic hemorrhagic shock
· The concept of viscosity targets in hemorrhagic shock
· Principles of the vasopressors and autotransfusion in patients with severe hemorrhagic shock
Level: Intermediate to Advanced
Audience: This course is focused towards veterinarians working in emergency rooms and ICUs (including emergency veterinarians, interns, ECC and anesthesia residents, emergency technicians and ACVECC diplomates).
Course outline:
Lesson 1: Introduction and pathophysiology
Video: 15 minutes
Journal articles and reading: available
Quiz: 5 questions
Lesson 2: Diagnosis and Damage Control
Video: 12 minutes
Journal articles and reading: available
Quiz: 5 questions
Lesson 3: Hypotensive resuscitation
Video: 9 minutes
Journal articles and reading: available
Quiz: 2 questions
Lesson 4: The use of crystalloids and viscosity targets
Video: 4.5 minutes
Journal articles and reading: available
Quiz: 2 questions
Lesson 5: Autotransfusion and pelvic hemorrhage
Video: 5.5 minutes
Journal articles and reading: available
Quiz: 1 question
Lesson 6: The use of vasopressors
Video: 4 minutes
Journal articles and reading: available
Quiz: 1 question
Final examination: 10 questions