ALWAYS read the relevant monographs.

Cardiac emergencies

• Asystole or pulseless electrical activity
  • Adrenaline: 10 μg (micrograms)/kg i.v every 3–5 minutes until return of spontaneous circulation. – this is equivalent to 1 ml/10 kg using 1:10,000 concentration (100 μg/ml). Double dose if used intratracheally.
• Hyperkalaemic myocardial toxicity
  • Calcium: 50–150 mg/kg calcium (boro)gluconate = 0.5–1.5 ml/kg of a 10% solution i.v. over 20–30 min
  • or Soluble insulin: 0.5 IU/kg i.v. followed by 2–3 g of dextrose/unit of insulin (for urinary tract obstruction but not hypoadrenocorticism). Half the dextrose should be given as a bolus and the remainder administered i.v. over 4–6 h.
• Other bradyarrhythmias
  • Atropine: 0.01–0.03 mg/kg i.v. – this is equivalent to 0.3–1 ml/20 kg using 0.6 mg/ml solution.
• Ventricular tachycardia
  • Lidocaine:
  • Dogs: 2–8 mg/kg i.v. in 2 mg/kg boluses, followed by a constant rate i.v. infusion of 0.025–0.1 mg/kg/min.
  • Cats: 0.25–2.0 mg/kg i.v. slowly in 0.25–0.5 mg/kg boluses followed by a constant rate i.v. infusion of 0.01–0.04 mg/kg/min.

Metabolic emergencies

• Anaphylaxis
  • Adrenaline: 10 μg (micrograms)/kg i.v. = 1 ml/10 kg of 1:10,000 concentration (100 μg/ml).
• Hypocalcaemia
  • Calcium: 50–150 mg/kg calcium (boro)gluconate = 0.5–1.5 ml/kg of a 10% solution i.v. over 20–30 min.
• Hypoglycaemia
  • Glucose: 1–5 ml 50% dextrose i.v. slowly over 10 min.

Neurological emergencies

• Status epilepticus control
  • Diazepam: 0.5 mg/kg i.v. or rectal – repeat after 3 minutes for up to 3 doses or Midazolam: 0.3 mg/kg i.v. or rectal – repeat after 3 minutes for up to 3 doses.
  • If the seizures have been controlled, maintain on an i.v. infusion of midazolam at 0.3 mg/kg/h while establishing or changing maintenance therapy
  • If seizures not controlled by above: Propofol: induce with 1–4 mg/kg i.v. and then maintain with 0.1–0.4 mg/kg/min.
• Raised intracranial pressure (impending herniation)
  • Mannitol: 0.25–1 g/kg i.v. infusion of 15–20% solution over 30 min. May repeat 1–2 times after 4–8 hours as long as hydration and electrolytes monitored. (For acute glaucoma see monograph.)

Anaesthesia emergencies

• Reversing agents
  • Naloxone: 0.01–0.04 mg/kg i.v., i.m., s.c., intratracheal (give to effect).
  • Atipamezole: Five times the previous medetomidine or dexmedetomidine dose i.m.; if that dose is unknown, use 100 μg (micrograms)/kg i.m. or very slow i.v.