The CARES VetMed Podcast

CARES VetMed, LLC
  • 5.0 (8)
  • Education
  • Updated Semiweekly

Level up your veterinary anesthesia nursing skills with CARES VetMed! Each episode features tips, tricks, and expert advice to help you become a confident and compassionate professional. Plus, at the end of each episode, we'll challenge you with a #CARESaction to perform an act of kindness at work, and more! Grab your stethoscope, put on your headset, and join us. Let's learn, grow, and elevate the standard of veterinary patient care, together! Take care, friends!

  1. Sep 8

    Sedation vs. Anesthesia — Navigating the Gray Zone

    Sedation and anesthesia aren't two separate things — they're points on a spectrum. And the tricky part? You don't always know where your patient is going to land. In this episode, Tracey, Travis and Maryann dig into the gray zone where sedation ends and general anesthesia begins. We share real cases that didn't go according to plan. We break down the pharmacology behind these outcomes and challenge the assumption that sedation is inherently safer. Key Topics Discussed: ACVAA Definitions: Sedation is a dynamic continuum of CNS depression — and the ACVAA notes it can overlap with general anesthesia at deeper levels. Where your patient lands on that spectrum determines your monitoring plan.Unpredictable Patients: From midazolam euphoria to extended alfaxalone effects, real cases show why no protocol guarantees a predictable depth every time.Alfaxalone Is an Induction Agent: Alfaxalone causes dose-dependent cardiorespiratory depression and inhibits protective reflexes. Using it as a sedative without full monitoring and intubation readiness carries real mortality risk.The Monitoring Gap: Sedated patients deserve the same minimum monitoring standards as anesthetized ones — pulse ox, blood pressure, and ECG. Sedation is not benign.Reversibility Matters: Dexmedetomidine can be reversed with atipamezole. Alfaxalone, acepromazine, and ketamine cannot. Know your exit strategy before you draw up the drug.Team Dynamics: Techs are the patient's real-time safety net — but the veterinarian leads the plan. Your role is to communicate what you observe, support the decision, and debrief after to grow. Questions to Think About While You Listen: When was the last time you monitored a sedated patient with the same rigor as one under general anesthesia — and if that's not your standard, what assumption is driving that gap?If you pulled the last five sedation records from your clinic right now, how many would show documented continuous monitoring from drug administration through full recovery?If alfaxalone is your go-to for fractious or high-risk patients, what is your specific, prepared plan if that patient loses protective reflexes before you expect? Team Challenge: The Sedation Audit For your next five sedated patients, document whether pulse ox, blood pressure, and ECG were in place from start to finish. Let the records tell you where the gaps are. The views shared are for educational purposes only and do not replace veterinarian approval or institutional oversight. As always, we sincerely thank all of you who took time out of your busy schedules to listen to this, as well as our other episodes. If you have any suggestions or feedback for us, we'd love to hear from you! You can send us a message on social media (@CARESVetMed) or email us at hello@caresvetmed.com. Let us know if you'd like to join us on a future episode! Take care, friends!

    Sedation vs. Anesthesia — Navigating the Gray Zone

  2. Aug 25

    Capnograph Waveform: It's Not Just About the Number

    Your end-tidal CO2 number might look perfectly fine — and your patient could still be in serious trouble. In this episode, Tracey, Travis, and Maryann go beyond the numbers and break down what your capnograph waveform is actually telling you: what each segment means, what changes signal a problem, and how to respond before things escalate. If you've been glancing at the number and ignoring the wave, this one's for you. We share real clinical cases — a cat whose bronchial wash suddenly blocked a mainstem bronchus mid-procedure, a Pomeranian with a tumor fragment that migrated into the endotracheal tube during a lobectomy, and a Rottweiler whose neck position created a shark fin during an ophthalmology case — and walk through exactly what the waveform told us and how we acted on it. Plus: a simple bedside manual breath test, why cardiogenic oscillations fool your monitor's respiratory rate counter, and why a sloped inspiratory downstroke mid-dentistry is a warning you should never ignore. Key Topics Discussed: Normal Waveform Basics — Travis walks through the "top hat" shape: sharp expiratory upstroke, flat plateau, steep inspiratory downstroke — and why every team member should actively describe the wave, not just note the number.The Shark Fin — A sloped expiratory upstroke signals impaired exhalation. Culprits include mucus plugs, kinked tubes, challenging patient positioning, PEEP valves, and lower airway disease such as feline asthma.Lost ET Tube Cuff Seal — A sloped inspiratory downstroke mid-procedure often means the cuff has failed — raising aspiration risk and team inhalant exposure, especially during wet procedures like dentistry.Rolling Waves Without a Plateau — Travis's simple manual breath test reveals whether a rapid, shallow breather truly needs ventilatory support or is compensating adequately.Cardiogenic Oscillations — That sawtooth end-plateau pattern is cardiac turbulence, not the patient waking up. Your monitor's automated respiratory rate is unreliable when you're seeing it.Confirming Tracheal Placement — No capnograph wave after intubation means no CO2 — and in a non-ruminant, that's not a monitor problem. It's a placement problem. Questions to Think About While You Listen: When was the last time you actively described your patient's capnograph waveform — not just the number — in the anesthesia record or out loud to a colleague?If a shark fin appeared mid-procedure while the end-tidal CO2 was still within normal range, what would your immediate next three steps be?Could you confidently distinguish cardiogenic oscillations from a patient beginning to breathe against a ventilator — and does your team share a common language for that moment? Team Challenge: Describe the WaveOn your next three cases, describe the capnograph waveform out loud or in the record — even when it looks completely normal. That habit is what lets you catch changes when it counts. Links: Capnography Waveform Interpretation — LITFL: https://litfl.com/capnography-waveform-interpretation/Capnography.com: http://www.capnography.comAnimal Castration by A. Liautard (1884) — Project Gutenberg: https://www.gutenberg.org/ebooks/59560ACVAA Monitoring Guidelines: https://acvaa.org/ The views shared are for educational purposes only and do not replace veterinarian approval or institutional oversight. @CARESVetMed | hello@caresvetmed.com | caresvetmed.com Take care, friends!

    Capnograph Waveform: It's Not Just About the Number

  3. Aug 11

    Medication Errors in Veterinary Medicine

    Ever grabbed the wrong syringe mid-case, caught yourself, and thought — what if I hadn't? In this episode, Maryann, Travis, and Tracey dig into a real-world Canadian study on voluntary pre-anesthetic medication error reporting and have an honest conversation about the habits and system failures that put our patients at risk. The data is humbling: technicians were involved in 72% of reported errors — but also caught 66% of them. That's a call to build better systems and smarter habits. Tune in for the stats, the personal near-misses, and the practical protocols that can protect your patients and your team. Key Topics Discussed The Calgary Study: Out of 2,728 procedures, 48 errors were analyzed — 47% during the premedication/sedation stage, 63% wrong dose, and opioids as the most error-prone drug class.The Decimal Point Problem: 23% of wrong-dose errors were tenfold overdoses from a single misplaced decimal. Knowing your expected dose ranges is one of your strongest safety tools.The Human Element: Techs were involved in 72% of errors and caught 66% of them — most often through independent double checks. We discuss how to make self-checking standard, not optional.Gold-Standard Prevention Protocols: The Five Rights, never letting an unlabeled syringe leave your hand, Vetwrap checkpoints for local blocks, no-interruption zones during drug prep, and always verifying syringe pump rates against a hand-calculated reference.Why Cats Are Not Small Dogs: Feline enzyme deficiencies (UGT class) lead to prolonged drug half-lives, opioid hyperactivity, and serious NSAID toxicity when dog doses are applied without adjustment.Breed, Genetics & Exotic Variations: MDR1 mutations in herding breeds, Von Willebrand's in Dobermans, and dramatically different exotic dosing — like dobutamine CRI ranges of 10–80 mcg/kg/min in rabbits vs. 2–10 in dogs and cats.Building a Judgment-Free Safety Culture: Why newer techs hesitate to speak up — and how mentors can normalize uncertainty and give trainees permission to pause before administering anything they're unsure about. Questions to Think About While You Listen: When did you last catch a medication error? What habit made that possible?Is your prep area set up to support focus, or does it invite interruption at the worst moment?Are your newer team members truly empowered to say "can you check this with me?" Team Challenge: The Five-Second Label RuleNothing leaves your hand without a label — drug name, concentration, and patient name, minimum. No exceptions. Start this week and make it contagious on your team. Links: Voluntarily reported preanesthetic medication errors — AVMAWSU MDR1 (ABCB1) Genetic Testing ProgramThe RECOVER InitiativeACVAA Monitoring Guidelines A Note on Our Content: The views, opinions, and personal experiences shared by the hosts are for educational and entertainment purposes only. While our hosts are VTS in Anesthesia & Analgesia, nothing discussed should replace direct veterinarian approval or institutional oversight. Every patient is unique. Always consult the attending veterinarian before implementing new protocols. As always, thank you for listening! Send feedback or suggestions to hello@caresvetmed.com or find us at @CARESVetMed. Let us know if you'd like to join us on a future episode! Take care, friends!

    Medication Errors in Veterinary Medicine

  4. Jul 14

    Fluid Responsiveness and Perfusion Monitoring - Out with the Old, In with the New?

    Are you ready to ride the modern wave of dynamic monitoring? In this episode of The CARES VetMed Podcast, Maryann, Travis, and Tracey break down why static numbers might be lying to you and how tools you already have in your clinic—like your trusty pulse ox—can revolutionize how you predict fluid responsiveness. Traditional Central Venous Pressure (CVP): A look at the classic static measurement of right ventricular preload (normal range: 2–6 mmHg). We discuss its historical popularity in critical care and liver lobectomies, and why it is no longer the gold standard due to its invasive nature and poor ability to predict fluid responsiveness. The Rise of Dynamic Predictors (PPV, SVV, PVI): Learn how modern monitoring uses heart-lung interactions to evaluate beat-by-beat blood flow. We define Pulse Pressure Variation (PPV), Stroke Volume Variation (SVV), and the non-invasive Pleth Variability Index (PVI), highlighting how a variation threshold of >12–13% indicates a patient will actively benefit from a volume bolus. The Ventilator Prerequisite: Why getting an accurate PPV or PVI reading requires a patient to be on a mechanical ventilator with consistent tidal volumes (10 to 15 mL/kg), and the challenges of trying to replicate this consistency via manual hand-bagging. Troubleshooting and Artifact Pitfalls: Practical advice on identifying errors. We cover how drug-induced vasoconstriction (like Dexmedetomidine) can make SPO2 waveforms disappear, and how line issues (air bubbles, kinked catheters, compliant tubing) dampen arterial line PPV readings. Perfusion as a Multimodal Picture: Why we must look beyond a single monitor number. We emphasize combining automated indices with physical tissue perfusion assessments (CRT, mucous membranes, peripheral temperature), especially when managing septic patients or utilizing vasopressors like norepinephrine. #CARESaction: Too often, we find ourselves slumped over a gurney, monitor, or dental table. This week, we challenge you to keep an eye on your teammates' posture. If you see a coworker hunching over, step in and actively help them adjust the height of their table, gurney, or chair. Keep that blood flowing—for both you and your friends! Veterinary History: We dive into historical texts with an excerpt from Animal Castration (1884) by Alexander Francois Augustine Liautard. Travis shares a graphic look at how 19th-century practitioners achieved "compliance" during large animal procedures. Liautard suggests that to distract an animal, one could try "pricking him with a pin on the lips or about the anus." As a brief afterthought, he notes similar results can be obtained by the "inhalation of a little ether or chloroform"—a wild testament to how far veterinary anesthesia has advanced! We welcome your feedback, topic suggestions, or screenshots/videos showing before-and-after changes in your pulse oximeter's pleth index during a fluid bolus! Email: hello@caresvetmed.com Social Media: @caresvetmed Links: Diagnostic accuracy of pulse pressure variation, stroke volume variation and plethysmography variability index for prediction of fluid responsiveness in anesthetized and mechanically ventilated dogs (Donati et al., 2026) Animal Castration (1884) by Alexander Liautard RECOVER ACVAA

    Fluid Responsiveness and Perfusion Monitoring - Out with the Old, In with the New?

  5. Jun 30

    Pediatric Anesthesia Monitoring Challenges and Tips

    Welcome to another episode of The CARES VetMed Podcast! This week, Maryann, Travis, and our host tackle the unique challenges of pediatric anesthesia monitoring. From neonates to young adults, these little patients present distinct physiological differences that require tailored approaches. Join us as we explore essential tips, tricks, and common pitfalls to ensure the safest possible anesthetic experience for our smallest patients. This episode covers: Monitoring Equipment Adaptations: Practical advice for pulse oximetry in tiny patients, including using reflectance probes (rectal or shaved skin), relieving clamp pressure with needle caps or rubber bands, and the truth about "wetting the tongue." Discussion also covers adjusting the settings of an oscillometric blood pressure machine for small patients and the difficulties in obtaining accurate readings. Pediatric Physiological Parameters: Insights into managing temperature in rapidly cooling/warming pediatric patients, and the surprising lack of direct correlation between hypotension and acute kidney injury in human pediatrics. We discuss how very young patients rely heavily on heart rate to estimate blood pressure, and how to prioritize physical assessments such as mucous membrane color, CRT, and fluid status. Pharmacology & Protocols (Mini-Deep Dive): Brief discussion on using anticholinergics and ketamine in pediatric patients, especially for painful procedures, and the caution needed with propofol's cardiovascular effects.  Lung Compliance and Ventilation: The critical importance of monitoring peak inspiratory pressure in pediatric patients due to their compliant chest walls but less compliant pulmonary tissue, and the risk of pulmonary edema from over-inflation. Hypotension Intervention Strategies: A candid conversation about how to approach hypotension in pediatric patients, including when to intervene with multiple treatments simultaneously versus a stepwise approach, and the common use of pressors like dopamine. Glucose Monitoring: Guidelines for checking blood glucose in pediatric patients, particularly those under six months, and techniques for obtaining blood samples. We welcome your feedback, suggestions for future topics, or any wild experiences you'd like to share from your careers. Please reach out to us at hello@caresvetmed.com or connect with us on social media at @caresvetmed. Links: Veterinary Anesthetic and Monitoring Equipment Martins ARC, Ambrósio AM, Fantoni DT, Pinto ACBCF, Villamizar-Martinez LA, Soares JHN, Otsuki DA and Malbouisson LMS (2022) Computed Tomography Assessment of Tidal Lung Overinflation in Domestic Cats Undergoing Pressure-Controlled Mechanical Ventilation During General Anesthesia. Front. Vet. Sci. 9:842528. doi: 10.3389/fvets.2022.842528 Moll X, Aguilar A, García F, Ferrer R, Andaluz A. Validity and reliability of Doppler ultrasonography and direct arterial blood pressure measurements in anaesthetized dogs weighing less than 5 kg. Vet Anaesth Analg. 2018 Mar;45(2):135-144. doi: 10.1016/j.vaa.2017.08.006. Epub 2017 Sep 15. PMID: 29246711.

    Pediatric Anesthesia Monitoring Challenges and Tips

  6. Jun 16

    Cognitive Aids

    Ever feel like the busier your shift gets, the easier it is for your brain to go on autopilot right when it matters most? In this episode of The Cares VetMed Podcast, Maryann, Travis, and Tracey look at the hard science and surprising data behind why even the most seasoned veterinary experts rely on a simple piece of paper to save lives. The math speaks for itself: a humble, one-page checklist can drop machine setup errors by 88% and cut airway complications by a staggering 97%. Getting human egos to step aside for the data isn't always easy, but from halving surgical complications to preventing catastrophic equipment mistakes, we explore how clinical checklists act as your team’s ultimate safety net against distraction. Tune in to find out why keeping it simple is your patient's best line of defense! Key Topics Discussed The 2025 Equipment Setup Study: We break down a study by Love et al. that shows introducing a simple anesthesia machine checklist reduced student errors from 6.6% to 0.8%—an incredible 88% drop. The APL Valve & Airway Wins: How the same 2025 study proved that checklists reduced airway supply errors by 97.2% and cut the dangerous mistake of leaving the APL valve closed by 75%. The 2018 Surgical Safety Study: A look at data from Cray et al. showing that implementing a surgical safety checklist dropped overall perioperative and postoperative complication rates from 40.9% down to 29.3%. The Anatomy of Distraction: Why human error, lapses in judgment, and phone calls/questions in the middle of a setup are the biggest threats to patient safety—and how checklists catch you when you get pulled away. "Read-Do" vs. "Do-Confirm" Checklists: Breaking down the two distinct styles of checklists from Atul Gawande’s The Checklist Manifesto. Learn when to use a comprehensive instruction-style list (Read-Do) versus a quick, expert safety net (Do-Confirm). Fighting "Checklist Fatigue": How to get genuine buy-in from your team by keeping lists practical, concise (5 to 9 items max), and allowing room for local modifications. The Future of Tech: A discussion on how modern anesthetic monitors are beginning to integrate digital checklists and software that syncs directly into electronic medical records. Questions to Think About While You Listen: Are you letting ego get in the way of safety? Why admitting we are human and prone to distraction takes humility, but actively saves lives. Does the layout of your paperwork cause mistakes? Why stacking multiple checklists on a single page might cause your team to accidentally skip vital blocks of information. Is your team only as strong as your weakest player? How checklists level the playing field for new grads, novice assistants, and solo on-call staff. Team Challenge: The Surgical Timeout Challenge We are challenging every single listener to implement one practical, 3-point checklist in their clinic this week: The Surgical Timeout. Before the first incision is made, pause your team and confirm just three things: Correct Patient Correct Surgical Site Verified Surgical Drugs & CPR Code Links mentioned in the episode for reference: The use of a checklist reduces errors in equipment set-up by veterinary student anesthetists Effect of implementation of a surgical safety checklist on perioperative and postoperative complications at an academic institution in North America A Must Read!: The Checklist Manifesto by Atul Gawande. Clinical Templates: The World Health Organization (WHO) Surgical Safety Checklist.

    Cognitive Aids

  7. Jun 2

    The Recovery Danger Zone

    Think the hard part is over once the last suture is tied? Think again. In this episode of The CARES VetMed Podcast, Travis, Maryann, and Tracey shine a light on the "Danger Zone"—that high-stakes window where even the most routine procedures can take a sudden, life-threatening turn. We’re diving into the "why" behind post-op complications, sharing clinical experiences and exploring specific strategies to keep patients safe once the monitors come off. In this episode, we explore: The Post-Op Statistic: Why do half of all anesthesia deaths happen after the surgery is finished? We talk about why "waking them up" is the most dangerous part of your day. The "Heavens to Betsy" Tray: We reveal what needs to be within arm’s reach when a recovery goes sideways—and why it isn't just about the breathing tube. The Science of "Flow-By": Why 100% oxygen isn't always the answer. We explain the "Nitrogen Skeleton" and how a simple Ambubag trick can help fix collapsed lungs. Pain vs. Panic: How can you tell if a patient is hurting or just confused? We look at the subtle physical cues that tell you exactly what your patient needs. Airway Brinkmanship: We discuss the high-wire act of recovering brachycephalic breeds and new tools that make it less stressful. Thermal Roadblocks: Why being "cold" is actually a form of sedation. We explore how temperature affects the body's ability to clear drugs, especially in exotic species. Questions to Think About While You Listen: Are you pulling the monitor off too early? We discuss the crucial "5-minute shift" that happens the moment you switch to room air. Is the "quiet" patient the most dangerous? Why the patient sleeping peacefully might actually be the one in the most trouble. Could your multitasking be a risk factor? We look at how 60% of techs who "double-task" might be missing the most important signs. Links mentioned in the episode for reference: The Post-Op Hypoxemia Data:  C Piemontese et al. Noninvasive respiratory support in dogs Veterinary Anaesthesia and Analgesia 2026, 53, 101187 High-Flow Nasal Oxygen: Jagodich TA, Bersenas AME, Bateman SW, Kerr CL. Preliminary evaluation of the use of high-flow nasal cannula oxygen therapy during recovery from general anesthesia in dogs with obstructive upper airway breathing. J Vet Emerg Crit Care. 2020;30:487–492. Mila/Cook Airway Tools:  Mila Cook The Feline Grimace Scale A Note on Our Content: The views, opinions, and personal experiences shared by the hosts on this podcast are for educational and entertainment purposes only. While our hosts are Veterinary Technician Specialists (VTS) in Anesthesia & Analgesia, the protocols, techniques, and case management styles discussed on this show should never take the place of direct veterinarian approval or institutional oversight. Every patient is unique. Always consult with the attending veterinarian and review your specific clinic protocols before implementing any new anesthesia or analgesia plans. As always, we sincerely thank all of you who took time out of your busy schedules to listen to this, as well as our other episodes. If you have any suggestions or feedback for us, we’d love to hear from you! You can send us a message on social media (@CARESVetMed) or email us at hello@caresvetmed.com. Let us know if you’d like to join us on a future episode! Take care, friends!

    The Recovery Danger Zone

  8. May 20

    2025 ACVAA Monitoring Guidelines - What's New?

    Welcome to another episode of The CARES VetMed Podcast! We're excited to be back with a deep dive into the updated 2025 American College of Veterinary Anesthesia and Analgesia (ACVAA) monitoring guidelines for small animals. Join Travis, Maryann, and Tracey as they discuss the significant changes since the 2009 version, focusing on the new minimum recommended monitoring standards and their implications for veterinary professionals. In each episode, we hope to continue spreading kindness and positive impact through our #CARESaction Challenge! NEW - Veterinary History Feature: Join us for a new recurring segment where we delve into historical veterinary texts! In this episode, we explore a quote from Leonard Conky's 1890 book, "Veterinary Medicine, Animal Castration Surgery, and Obstetrics Simplified." His intuitive observations on "natural pulse, temperature, and respirations" as keys to practice remain surprisingly relevant even in light of our modern advancements. This episode is a must-listen for anyone involved in veterinary anesthesia, offering insights into best practices, new requirements, and the enduring importance of attentive, skilled monitoring. Links mentioned in the episode for reference: ⁠⁠ACVAA Anesthesia Monitoring Guidelines (2025)⁠⁠ Referenced studies on Doppler vs. Invasive Blood Pressure in Veterinary Medicine: ⁠⁠da Cunha, A.F. ∙ Saile, K. ∙ Beaufrère, H. Measuring level of agreement between values obtained by directly measured blood pressure and ultrasonic Doppler flow detector in cats J Vet Emerg Crit Care. 2014; 24:272-278⁠⁠ ⁠⁠Kennedy, M.J. ∙ Barletta, M. Agreement between Doppler and invasive blood pressure monitoring in anesthetized dogs weighing 5 kg J Am Anim Hosp Assoc. 2015; 51:300-305⁠⁠ ⁠⁠Skelding, A. ∙ Valverde, A. Review of non-invasive blood pressure measurement in animals: part 2 – evaluation of the performance of non-invasive devices Can Vet J. 2020; 61:481-498⁠⁠ ⁠⁠Computed Tomography Assessment of Tidal Lung Overinflation in Domestic Cats Undergoing Pressure-Controlled Mechanical Ventilation During General Anesthesia⁠⁠ ⁠⁠Masimo (for information on plethysmograph variability and dynamic indices)⁠⁠ ⁠⁠Leonard Conky's "Veterinary Medicine, Animal Castration Surgery, and Obstetrics Simplified" (1890 text)⁠⁠ As always, we sincerely thank all of you who took the time out of your busy schedules to listen to this, as well as to our other episodes. If you have any suggestions or feedback for us, we’d love to hear from you! You can send us a message on social media (@CARESVetMed) or email us at hello@caresvetmed.com. Let us know if you’d like to join us on a future episode! Take care, friends!

    2025 ACVAA Monitoring Guidelines - What's New?
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About

Level up your veterinary anesthesia nursing skills with CARES VetMed! Each episode features tips, tricks, and expert advice to help you become a confident and compassionate professional. Plus, at the end of each episode, we'll challenge you with a #CARESaction to perform an act of kindness at work, and more! Grab your stethoscope, put on your headset, and join us. Let's learn, grow, and elevate the standard of veterinary patient care, together! Take care, friends!

Information

  • Creator
    CARES VetMed, LLC
  • Years Active
    2023 - 2026
  • Episodes
    16
  • Rating
    Explicit
  • Copyright
    © CARES VetMed, LLC
  • Show Website
    The CARES VetMed Podcast

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