VSPN TECH313-0320: Critical Care Nursing: Following Kirby’s Rule of 20

The lectures for this course will be presented in an audio format using a webinar platform.

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Presenter: Courtney Waxman, CVT, VTS (ECC)
Course Open: March 31, 2019-May 22, 2020
Real Time Sessions (RTS): Tuesdays April 7, 14, 21, 28, and May 5, and 12, 2020:9:00-10:00pm ET (USA)
Course RTS Times in Your Area: World Clock Converter

Level and Prerequisites: This intermediate course will be open to veterinary technicians/technologists and support staff actively interested in improving patient care by using the tenets of the Kirby Rule of 20 as a therapeutic and nursing strategy to meet the animal's ongoing needs.
VSPN CE Course: “This program has been approved for 6 hours of continuing education credit in jurisdictions which recognize RACE approval."(22-39672)

Course Description:
This course is designed to review critical care patient parameters based on Kirby’s Rule of 20. This course will focus on veterinary technician patient assessments, pathophysiology of disease processes related to each parameter, nursing care, and critical thinking skills. The final session will use a case-based approach (real patient cases) to practice implementing critical thinking based on the knowledge learned in the previous sessions.

Week 1 (Real Time Session April 7): Fluid Balance, Electrolytes/Acid-Base, & Albumin/Oncotic Pull
Required reading:
  • AAHA Fluid Therapy handout
  • Clinician’s Brief Fluid Therapy article
  • Acid-Base proceedings
  • Electrolytes proceedings
Objectives: Upon completion of this session, the participant should be able to:
  • Understand the pathophysiology of body fluid composition and fluid needs of critically ill patients.
  • Understand Starling’s Forces and the role of albumin in fluid composition.
  • Understand patient fluid therapy needs (i.e. maintenance versus replacement fluid requirements).
  • Understand the aspects of the fluid therapy plan.
  • Understand how to monitor fluid therapy, including fluid overload.
  • Understand the body’s essential electrolytes (Na, K, Cl, Mg, Ca, Phos).
  • Understand how electrolyte disturbances manifest clinically.
  • Understand normal acid-base pathophysiology.
  • Identify the four most common acid-base derangements.
  • Discuss basic blood gas interpretation.
Week 2 (Real Time Session April 14): Mentation, Heart Rate/Rhythm/Contractility, Blood Pressure, & Body Temperature
Required reading:
  • MGCS Chart
  • Multi-Parameter Monitoring Part 1
  • Temperature Extremes handout
Objectives: Upon completion of this session, the participant should be able to:
  • Understand the five main levels of consciousness.
  • Utilize the Modified-Glasgow-Coma-Scale to evaluate mentation.
  • Understand the cardiovascular parameters to be evaluated in a critical patient.
  • Understand mechanical versus electrical activity of the heart.
  • Discuss basic ECG interpretation.
  • Identify common tachyarrhythmias and bradyarrhythmias.
  • Understand the methodologies of obtaining a blood pressure.
  • Understand normal thermoregulation.
  • Understand consequences of hypo/hyper-thermia.
Week 3 (Real Time Session April 21): Oxygen & Ventilation, RBCs & Hemoglobin, & Coagulation Cascade
Required reading:
  • Multi-Parameter Monitoring Part 2
  • Anemia handout
  • Hemostasis handout
Objectives: Upon completion of this session, the participant should be able to:
  • Understand normal pulmonary pathophysiology.
  • Define oxygenation and ventilation.
  • Understand the parameters used to evaluate oxygenation.
  • Understand the parameters used to evaluate ventilation.
  • Understand disease process that can affect oxygenation and ventilation.
  • Understand the essential functions of RBCs and hemoglobin.
  • Understand the disease processes that can affect RBCs and hemoglobin.
  • Understand hemostasis and the component of the clotting cascade.
  • Understand disease process that can affect the coagulation cascade.
Week 4 (Real Time Session April 28): Renal Function, GI Motility & Integrity, Nutrition, & Glucose
Required reading:
  • AKI article
  • GI handout
  • Clinical Nutrition proceedings
Objectives: Upon completion of this session, the participant should be able to:
  • Understand renal anatomy and physiology.
  • Monitor appropriate urine output.
  • Understand the disease processes that can affect the renal system.
  • Understand gastrointestinal concerns in critically ill.
  • Identify pharmacologic agents that can be used for the GI system.
  • Understand the disease processes that can affect the GI system.
  • Understand nutritional requirements of patients.
  • Calculate the nutritional needs of a patient.
  • Understand what refeeding syndrome is.
  • Understand the role of glucose.
  • Understand consequences of hypo/hyper-glycemia.
Week 5 (Real Time Session May 5): Immune Status/Antibiotics, Would Healing & Bandages, Drug Dosage & Metabolism, & Pain Control
Required reading:
  • Immunology handout
  • Practical Wound Management handout
  • AAHA/AAFP Pain Management Guidelines PDF
  • Canine Pain Score chart
  • Feline Pain Score chart
Objectives: Upon completion of this session, the participant should be able to:
  • Understand wound care in the ECC setting.
  • Understand the types of bandage care in the ECC setting.
  • Identify the 5 rights of drug administration.
  • Understand the physiology of pain.
  • Utilize pain scoring systems in practice.
Week 6 (Real Time Session May 12): Case-Based Approach, Nursing Care, & TLC
Required reading:
  • Art of Nursing handout
  • Critical Thinking Skills handout
Objectives: Upon completion of this session, the participant should be able to:
  • Utilize critical thinking skills.
  • Understand methods of providing nursing care and TLC.
  • Understand how to implement Kirby’s Rule of 20 in practice.
Successful completion (scoring 80% or better) on the end-of-course test is required to earn a certificate of completion for the course.
To learn more about the requirements for earning a CE certificate, please refer to Receiving Your CE Credit and Course Completion Certificate.

Course Materials: Course materials will be available in the course library prior to each Real Time Session.
Required Textbook: There is no required textbook for this course.

About the Presenter:
Courtney Waxman, CVT, RVT, VTS (ECC) has spent almost 15 years working in in veterinary field. She holds licensure as a Certified Veterinary Technician (CVT) in Arizona and as a Registered Veterinary Technician (RVT) in Indiana. In 2017, she became a Veterinary Technician Specialist (VTS) in Emergency and Critical Care (ECC). Courtney currently works as an instructor for Purdue University's Veterinary Nursing Program and in the Veterinary Teaching Hospital's ICU department. Her areas of special interest include CPR, mechanical ventilation, environmental hazards, one-on-one case management, critical care nursing, critical thinking, and technician training. In addition to working in critical care, Courtney is actively involved within the veterinary community. She is the NAVTA Executive Board Member-at-Large, the President of the Indiana Veterinary Technician Association (IVTA), on the advisory team for the Veterinary Nurse Initiative, is a RECOVER Certified BLS and ALS Instructor, is a speaker for the veterinary technician community at the national and international levels, and has been published in several veterinary technician and nursing journals. In 2018, she started her own business, Veterinary Nurse Consulting, LLC to share her love of emergency and critical care to fellow technicians. Courtney has been nominated for the NAVTA Vet Tech of the Year in 2018 and 2020. In 2019, she was named New Educator of the Year by the Association of Veterinary Technician Educators (AVTE). Off duty, she enjoys world travel with her husband, reading, fitness, and spoiling her two dogs, Biggs and Ollie.

Total CE Credit: 6

Tuition: $126 ($113early bird special if enrolled March 17, 2020)
* Students currently enrolled in and taking at least 2 classes or 5 units at an AVMA accredited or CAAHT approved Veterinary Technician Program may be eligible to receive a 50% discount off the regular rate for this course (upon verification of student status).
Prices are listed in US dollars.

*To ensure participants are ready and prepared for classes, enrollment will close on April 7, 2020 at 5 pm ET (USA) or when the maximum number of participants is reached.

*For more information on how online CE works, see the Participant Resource Center.

To Enroll:
  1. Enrollment qualifications: VIN CE courses are open to VIN member and non-member veterinarians. Veterinarians enrolling in a VSPN CE course must be a VIN member. Veterinary support staff must be a VSPN member to enroll in a VSPN CE or a VIN CE course open to VSPN member enrollment.
  2. Each enrollee must be able to receive emails from @vspn.org and @vin.com addresses. Email is our major form of communication with participants; personal emails are highly recommended rather than clinic/hospital email addresses.
  3. Each person is individually responsible for his/her own registration. To ensure that all information received is secure and correct, please do not enroll for a course on behalf of another individual.
  4. For further assistance call 800-846-0028 ext. 797 or email . Please include the course title, your full name, and contact information in your correspondence.
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“This program has been approved for 6 hours of continuing education credit in jurisdictions which recognize RACE approval."(22-39672)

Course withdrawal and refund policy: A complete refund of the paid course price will be issued when your withdrawal request is received prior to the listed start date of the course. If you wish to withdraw after the start date please contact the VIN office 800-846-0028 ext. 797 to discuss eligibility for a pro-rated refund.

*For more information on VSPN's upcoming CE courses, check the VSPN Course Catalog.

Lisa Kernaghan, LVT, RVT, CVT, VTS (ECC)
VSPN CE Coordinator

VSPN CE Services:
800-846-0028 or 530-756-4881; ext. 797
or direct line to VIN/VSPN from the United Kingdom: 01 45 222 6154
or direct line to VIN/VSPN from Australia: 02 6145 2357