Episode 19: Hemostasis

The VetEmCrit Academy built for ER vets who want to grow, level up, and learn together: https://academy.vetemcrit.com/join In this episode, Dr. Lance Wheeler, DVM, DACVECC continues building on the previous episodes' triage and serial-assessment foundations and shifts the focus to one of the most consequential physiologic systems in emergency and critical care — hemostasis. Drawing from Chapter 3 of Small Animal Critical Care Medicine (3rd edition) by Ronald Lee, Lance walks through hemostasis in a practical, stepwise way: the three stages of platelet activation (initiation, extension, stabilization), the cell-based model of coagulation (initiation, amplification, propagation, termination), the vitamin K–dependent factors, the tenase and prothrombinase complexes, fibrinolysis and its endogenous inhibitors, and the increasingly important concept of immunothrombosis and neutrophil extracellular traps in sepsis. Along the way, he weaves in the most current veterinary evidence — including 2024–2025 studies on trauma-associated coagulopathy, hyperfibrinolysis in cats, the TXA hemorrhagic shock trial in dogs, and the link between sepsis, fibrinolysis inhibitors, and NETs — and closes with a high-yield rapid-fire board review covering every key number worth memorizing. If you enjoy this episode and want the full experience — weekly deep-dives, interactive simulators, and clinical algorithms you can use on shift — come join us inside the VetEmCrit Academy.