VSPN TECH313-0722: Critical Care Nursing: Following Kirby’s Rule of 20

The real time sessions for this course will be presented via Zoom webinar platform.

Presenter: Courtney Waxman, CVT, VTS (ECC)


Course Open: July 19-September 9, 2022
Real Time Sessions (RTS):Tuesdays, July 26, August 2, 9, 16, 23, and 30, 2022; 9:00-10:00pm ET (USA)   World Clock Converter
Total CE Credit: 6
RACE Category: 6 hours Medical


Enroll Now  

Tuition: $132 ($119 early bird special if enrolled by July 5, 2022)
* Students currently enrolled in an AVMA accredited or CVMA 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.


Course Information:
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, the 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.

Learning Objectives: Upon completion of this course, 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 how to monitor fluid therapy, including fluid overload.
  • Understand the body’s essential electrolytes (Na, K, Cl, Mg, Ca, Phos) and electrolyte disturbances.
  • Understand normal acid-base pathophysiology.
  • Identify the four most common acid-base derangements.
  • Discuss basic blood gas interpretation.
  • 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 and discuss basic ECG interpretation.
  • Identify common tachyarrhythmias and bradyarrhythmias.
  • Understand the methodologies of obtaining a blood pressure.
  • Understand normal thermoregulation and the consequences of hypo/hyper-thermia.
  • Understand normal pulmonary pathophysiology.
  • Define oxygenation and ventilation.
  • Understand disease processes that can affect oxygenation and ventilation.
  • Understand the essential functions of RBCs and hemoglobin.
  • Understand hemostasis and the component of the clotting cascade.
  • Understand renal anatomy and physiology and 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 nutritional requirements of patients.
  • Calculate the nutritional needs of a patient.
  • Understand what refeeding syndrome is.
  • Understand the role of glucose and the consequences of hypo/hyper-glycemia.
  • Understand wound and bandage care in the ECC setting.
  • Identify the 5 rights of drug administration.
  • Understand the physiology of pain.
  • Utilize pain scoring systems in practice .
  • Understand how to implement Kirby’s Rule of 20 in practice.
Level and Prerequisites: This intermediate VSPN CE course will be open for enrollment to veterinary technicians/technologists.

RACE Accreditation: This program has been approved for 6 hours of continuing education credit in jurisdictions which recognize RACE approval. (20-911202)

Course Agenda:

Week 1 (Real Time Session July 26): Fluid Balance, Electrolytes/Acid-Base, & Albumin/Oncotic Pull
This real-time session will cover what patient care checklists and bundles are as well as parameters in Kirby’s Rule of 20. To give an appropriate level of information and attention to each parameter, the following parameters included in this session are fluid balance, electrolytes and acid-base, and albumin/oncotic pull.

Week 2 (Real Time Session August 2): Mentation, Heart Rate/Rhythm/Contractility, Blood Pressure, & Body Temperature
This real-time session will cover parameters in Kirby’s Rule of 20. To give an appropriate level of information and attention to each parameter, the following parameters included in this session are mentation, heart rate, rhythm, and contractility, blood pressure, and body temperature.

Week 3 (Real Time Session August 9): Oxygenation & Ventilation, RBCs & Hemoglobin, & Coagulation Cascade
This real-time session will cover parameters in Kirby’s Rule of 20. To give an appropriate level of information and attention to each parameter, the following parameters included in this session are oxygenation and ventilation, RBCs and hemoglobin, and the coagulation cascade.

Week 4 (Real Time Session August 16): Renal Function, GI Motility & Integrity, Nutrition, & Glucose
This real-time session will cover parameters in Kirby’s Rule of 20. To give an appropriate level of information and attention to each parameter, the following parameters included in this session are renal function, GI motility and integrity, nutrition, and blood glucose.

Week 5 (Real Time Session August 23): Immune Status/Antibiotics, Would Healing & Bandages, Drug Dosage & Metabolism, & Pain Control
This real-time session will cover parameters in Kirby’s Rule of 20. To give an appropriate level of information and attention to each parameter, the following parameters included in this session are immune status and antibiotics, would healing and bandages, drug dosage and metabolism, and pain control.

Week 6 (Real Time Session August 30): Case-Based Approach, Nursing Care, & TLC
This real-time session will cover the final two parameters in Kirby’s Rule of 20, nursing care and TLC. To apply the concept of using Kirby’s Rule of 20 in critical patient populations, 3 case studies will be used to show the practicality.

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.
Reading the weekly library materials prior to the real time session is essential to meet the objectives of this course.
Required Textbook(s): There is no required textbook for this course.


Enroll Now  

Tuition: $132 ($119 early bird special if enrolled by July 5, 2022)
* Students currently enrolled in an AVMA accredited or CVMA 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 July 26, 2022 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.
Enrollment qualifications:
  1. VIN CE Courses:
    1. VIN CE courses are open to VIN member, VIN student member, and non-member veterinarians.
    2. Veterinary support staff must be VSPN members in order to enroll in a VIN CE course open to VSPN member enrollment.
  2. VSPN CE Courses:
    1. VSPN CE courses are open to veterinary support staff and veterinarians.
    2. Only VIN and VSPN members can enroll in a VSPN CE course.
    3. Veterinarians will only receive credit for those VSPN CE courses that specify in the Accreditation statement that the course is accredited for veterinarians.
  3. Please check the course Level and Prerequisites, Accreditation, and Tuition before enrolling.
  4. Each enrollee must be able to receive emails from @vspn.org and @vin.com addresses.
    1. Email is our major form of communication with participants; personal emails are highly recommended rather than clinic/hospital email addresses.
  5. 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.


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. 792 to discuss eligibility for a pro-rated refund.

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

VSPN CE Services:
800-846-0028 or 530-756-4881; ext. 792
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