TECH164-1111: Nutrition in Critical Care Patients-Small Animal

INSTRUCTOR(S): Tony Johnson, DVM, DAVECC)

COURSE OPEN: November 8-December 15, 2011

REAL TIME SESSIONS (RTS): Tuesdays, November 15, 22, 29, and December 6, 2011; 8:00pm-9:30pm ET (USA)
*please note the session times
Course RTS Times in Your Area: World Clock Converter
Practice Sessions: In order to prepare you for a successful experience in your CE course, we request you attend a practice session prior to the first Real Time Session. Times and dates will be listed in your course confirmation email. Expect to spend up to 1 hour at one of the 2-4 practice sessions held prior to the first Real Time Session.

* The instructor for this course will be using audio which will require you to have a headset or speakers to listen. If you have any concerns regarding your computer's audio capabilities, please be sure to attend a Practice Session.

Level and Prerequisites: This advanced course is focused toward the veterinarian or experienced technician routinely dealing with critical care cases, or who has an interest in obtaining or has the VTS (ECC) and/or VTS (SAIM) designation. Participants should be versed in basics of critical care medicine and nutrition as basic knowledge of these parameters will be reviewed only briefly.
VSPN CE Course. This course is RACE approved for veterinarians and veterinary technicians.

Course Description:
The Nutrition in Critical Care course will cover indications for nutritional support of canine and feline ICU patients as well as practical methods for delivery of both enteral and parenteral nutrition to critical patients. Nutrition is an often overlooked aspect of patient care. The technician's and clinician's role in recognizing which patients will benefit from nutritional support will be explored. Various diseases that typically require nutritional support will serve as a framework for deeper discussions and critical thinking about the pathophysiology and consequences of starvation/malnutrition and the role of nutritional support as a part of an overall treatment plan.

This course will consist of four (4) Real Time Sessions of ninety (90) minutes each, supplemental library materials, interactive message board discussions, a mandatory end-of-course test, and may include online multiple choice quizzes (after each Real Time Session). Successful completion (scoring 80% or better) on the end-of-course test is required to be considered for a course certificate of completion.
** The lecture portion of this course will combine both text and audio presentation. Please be prepared to listen.

Upon completion of this course participants will be able to understand and discuss

• basic pathophysiology of starvation and malnutrition as well as methods of calculating nutritional requirements for dogs and cats.
• indications and contraindications for enteral feeding and parenteral nutrition.
• methods of delivery of enteral nutrition (NE/NG tubes, esophagostomy tubes, PEG tubes, jejunostomy tubes, etc.)
• methods of delivery of partial parenteral nutrition (PPN) and total parenteral nutrition (TPN) and proper guidelines for their use.
• complications that may arise with both enteral and parenteral nutrition and their management.
• nursing care associated with nutritional support of critically ill patients.

Course Materials: Course materials will be available in the course library prior to each Real Time Session.
Required Texbook(s): There is no required textbook for this course.
Recommended Textbooks:

• Chan, D. L. (2007). Nutritional support for the critically ill patient. In A. M. Battaglia (Ed.), Small Animal Emergency and Critical Care for Veterinary Technicians (2nd ed. pp. 85-108). Saunders Elsevier. VIN Store: https://store.vin.com/custom/edit.asp?p=82432
• Chan, D. L. & Freeman, L. M. (2006). Nutrition in Critical Illness. Vet Clin No America Small Anim Pract. 36(6):1225-1241.

About the Instructor: Dr. Tony Johnson is a 1996 graduate of Washington State University. After an internship and residency he became ACVECC certified in 2003. He practiced critical care medicine in Chicago and Maryland before joining VIN as a consultant and educator. He is on faculty at the Purdue University School of Veterinary Medicine, where he involved in running the ICU.

Course Outline:
Week 1 (Real Time Session November 15): Nutrition in Disease and Health
Content: Review of normal nutritional physiology basics and the deleterious effects of starvation and malnutrition on disease recovery. Formulation of the nutritional plan for your patient as well as a list of diseases that commonly require nutritional support will be covered. Pro's and con's of appetite stimulants and why force feeding is playing with fire will be discussed.

Week 2 (Real Time Session November 22): Tubes, Tubes, Tubes: Enteral Nutrition
Content: Delivery of nutrition using the GI tract. Why we put those tubes in all those places and how we select each one. Review of tube placement, maintenance and complications. The importance of keeping the GI tract healthy through the use of enteral nutrition will be discussed. All this, and how a can of Coke can save the day!

Week 3 (Real Time Session November 29): Mainline Calories: Parenteral Nutrition
Content: When the GI tract has to be bypassed due to illness or injury, patients require parenteral nutrition (PN). The various formulations of partial parenteral nutrition (PPN) and total parenteral nutrition (TPN) will be covered. Different methods for vascular access, complications and the hefty nursing requirements of PN will be covered.

Week 4 (Real Time Session December 6): The Whole Enchilada: Nutrition in the ICU, Day Practice and at Home
Content: The final week will cover the incorporation of nutritional support for general practices, outpatients, 24-ICUs and everything in between. For the technician and clinician practicing at all levels, there are many options for improving outcomes for your patients - you don't need a 24 hour ICU to provide nutritional support for your patients. Some resources for products and suppliers and a review of the major points from the previous sessions will be included.

CE HOURS: 6

Tuition: $120 ($108 early bird special if registered by October 25, 2011)
*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).
** To ensure participants are ready and prepared for classes, enrollment will close when the maximum number of participants is reached or at 5pm ET the day of the first Real Time Session unless otherwise noted. If the first Real Time Session is on a weekend, course will close on the Friday before the first Real Time Session.

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

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 1-800-700-INFO (4636) or email (VIN CE) CEonVIN@vin.com or (VSPN CE) VSPNCE@vspn.org). Please include the course title, your full name, and contact information in your correspondence.

Note: "This course has been approved for 6 continuing education credits in jurisdictions which recognize AAVSB RACE approval; however participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education." Call VSPN CE at 1-800-700-4636 for further information. (Attendees are encouraged to check with their licensing jurisdiction(s) for information regarding recognition by their board).

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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/VSPN office 1-800-700-INFO (4636) to discuss eligibility for a pro-rated refund.
**Note: To ensure rapid handling of your request for withdrawal, we recommend that you call the VIN/VSPN office at 1-800-700-INFO (4636).

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** For More Information on VSPN's upcoming CE Courses, check out https://www.vin.com/CE/VSPN/VSPN_M02231.htm

Nanette R. Walker Smith, M.Ed., RVT, CVT, LVT
VSPN Content Director & VSPN CE Director

VSPN CE Services: VSPNCE@vspn.org
1-800-846-0028 or 1-530-756-4881 or direct line to VIN/VSPN from the United Kingdom: 01452226154
Charlotte Waack (Charlotte@vspn.org), ext 193
Chris Upchurch (Chris@vspn.org); ext 197
Darci Palmer (Darci@vspn.org); ext 179
Debbie Bess (DBess@vspn.org); ext 178
Jennifer Withrow (Jennifer@vspn.org); ext 159
Nanette Walker Smith (Nanette@vspn.org); ext 187

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