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SAM Final > 18. Cardiopulmonary resuscitation. Basics of the fluid therapy and parenteral feeding > Flashcards

18. Cardiopulmonary resuscitation. Basics of the fluid therapy and parenteral feeding Flashcards

1
Q

indications of CPR

A

cardiac arrest
pulmonary arrest
cardiopulmonary arrest

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2
Q

Clinical signs of an arrest

A

Loss of consciousness
Loss of spontaneous ventilation
Loss of palpable pulse
Loss of cardiac sounds on auscultation

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3
Q

Predisposition of an arrest

A

Heart Failure
Severe pul disease
coagulopathy
trauma
Brain trauma
SIRS
sepsis
neoplasia
toxicosis
anaesthesia

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4
Q

Potential reversible causes of an arrest

A

Hypovolemia
Hypoxia
Hydrogen ions (acidosis)
Hyper/ o kalaemia
Hypoglycaemia
Toxins
Tension ptx
Thromboembolism
tamponade
trauma

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5
Q

considerations before cpr

A

underlying disease
will of owner
timing (perform cpr within 3-5mins of arrest)
equipment needed
staff

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6
Q

5 stpes of cpr

A
  1. preparedness and prevention
  2. bls
  3. als
  4. monitoring
  5. post reuscitation care
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7
Q

aim of CPR

A

provide oxygen and blood to the heart and brain

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8
Q

Process of CPR

A

10second physical exam to detect breaths, heartbeats, degree of bradycardia
1. airways
2. breathing
3. circulation
4. drugs
5. ecg
6. fluid therapy

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9
Q

how to stimulated the ren zhong acupuncture point

A

on ventral philtrum until you reach bone
spontaneous breathing can be stimulated
10-12breaths/ min

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10
Q

where to place hands for compressions

A

Large dog - widest part of chest
Medium dog - over heart
Small dog / cat - fingers & thumb over heart

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11
Q

how many compression per min

A

100-120

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12
Q

what are the emergency drugs

A

adrenaline
atropine
NaHCO3
glucose
furosemide

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13
Q

function of adrenaline

A

peripheral arteriolar vasoconstrictor
coronary and cerebral perfusion pressure increase

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14
Q

function of atropine

A

used during vagotonia induced asytole and severe brady cardia
increased HR, BP, systemic vascular resistance

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15
Q

Function of NaHCO3

A

Used in metabolic acidosis & hyperkalaemia

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16
Q

function of furosemide

A

only in pulmonary oedema

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17
Q

why perform an ecg

A

evaluate arrhythmias

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18
Q

if animal is in asystole

A

give adrenaline then atropine

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19
Q

if the animal is in ventricular tachycardia

A

defib x3
lignocaine/ amiodarone

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20
Q

if animal is in ventriuclar fib / flutter

A

defib x3
adrenaline / lignocaine

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21
Q

if animal is in sinus bradycardia

A

atropine –> adrenaline –> atropine -> adrenaline

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22
Q

when to give adrenaline

A

asystole
VF
PEA

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23
Q

when to give atropine

A

asystole
sinus brady cardia

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24
Q

when to give sodium bicardonate

A

severe met acidosis
during cpr

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25
Q

when to give amiodaron

A

refractory VF
pulseless - VT

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26
Q

when to give lidocaine

A

v. flutter
VF after failed defibrillation

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27
Q

when to give naloxone

A

reversal of opioids

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28
Q

what is the goal of fluid therapy post cpr

A

the normalisation of vital signs
contraindicated in pulmonary oedema cases

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29
Q

Isotonic balanced crystalloid solution
shock dose

A

Dog - 60-90ml / kg
Cat - 45-60ml / kg

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30
Q

Synthetic colloids shock dose

A

expand intravascular colume
Dog - 5ml / kg
Cat - 1-3ml / kg
given in IV boluses over 20mins

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31
Q

Hypertonic saline dose

A

1-2ml / kg over 4mins

32
Q

crysalloid bolus to give if animal is euvolemic

A

Dog - 20ml/ kg
Cat - 10ml / kg

33
Q

Monitorring of critically ill patients

A

Temperature
Pulse
Resp rate
CRT
Blood Glucose
ECG
BP
SPO2

34
Q

Possible consequences of CPR

A

irreversible nervous system damage
shock
dic
reperfusion injuries
increased intracranial pressure

35
Q

RDA of fluids

A

40-60ml . kg/ day

36
Q

how is fluid lost

A

Sensible loss - urine, faeces
insensible loss - panting, evaporation
pathological - vomit, salivation, diarrhoea, polyuria

37
Q

what is hypovolemia

A

lack of fluid in intravascular space

38
Q

causes of hypovolemia

A

haemorrhage
diarrhoea
maldistribution
anaphylaxis

39
Q

what is dehydration

A

lack of fluid in the interstitium and intracellularly

40
Q

causes of dehydration

A

lack of fluid / food intake
excessive loss of fluid

41
Q

history when evaluating hydration status

A

anorexia
hypodipsia
vomitting
diarrhoea

42
Q

physical exam of evaluating hydration status

A

skin turgor
eye position
perfusion parameters - mm, crt, hr, pulse quality, jugular distension

43
Q

5% dehydration

A

no clinical signs

44
Q

5-6% dehydration

A

slightly dry mucosa

45
Q

6-8% dehydration

A

dry mucosa
loss of skin turgor

46
Q

8-10% dehydration

A

enophthalmos

47
Q

10-12% dehydration

A

skin tent stays
dull corneas
hypovolaemia

48
Q

> 12% dehydration

A

hypovolemiac shick
death

49
Q

stages of shock

A

compensatory stage
decompensatory stage

50
Q

compensatory stage

A

increased HR,
red mm
<1 crt
strong pulse

51
Q

decompensatory stage

A

decreased HR
pale mm
crt > 2 or none
weak / absent pulse
hypothermia

52
Q

types of infusions

A

Crystalloid
colloid

53
Q

Crysalloid infusion

A

small molecular weight compounds
isotonic - .9% NaCl
Hypotonic - 5% glucose, .45% NaCl
Hypertonic - 10% NaCl

54
Q

Colloid infusions

A

Large molecular weight solutes
Synthetic - starch, gelatine
Natural - albumin, plasma, blood

55
Q

Rehydration equation

A

Deficit = BWkg x 10 x % dehydrated

56
Q

Speed of Rehydration

A

Acute - 2-4hrs
Subacute - 12-48hrs -> 4-8hrs
Chronic - 12-48hrs

57
Q

Maintenance fluid

A

if patient is not eating/ drinking
sterofundin B
40-60ml/ kg / day
2-3ml / kg/ day

58
Q

subcutaneous Rehydration

A

for stable patients with mild dehydration
warmed isotonic crystalloids
no glucose or hypertonic
dorsal part of neck

59
Q

complications of fluid therapy

A

overhydration

60
Q

what can overhydration lead to

A

tachycardia
coughing
tachypnoea
dyspnoea
diarrhoes
ascites
exophthalmos
vomiting
pu
serous nasal discharge
tremor
restlessness

61
Q

types of parenteral treatment

A

subcutaneous injection
IM injection
IV injection
blood transfusions

62
Q

types of SC injections

A

injectable drugs
fluids
microchip
hormone implants

63
Q

contraindications of SC injections

A

oily injections
tissue irritative injections

64
Q

location of SC injections

A

caudal neck / thorax
insulin in area with thinner skin
FeLV & rabies given in abdomen

65
Q

types of IM injections

A

injectable drugs
oily injections
tissue irratitive drugs

66
Q

contraindication of IM injections

A

haemorrhagic diathesis

67
Q

location of IM injections

A

m. semi tendinosus/ membranosus
m. quad femoris
m. triceps brachii
m. supraspinatus et infraspinatus
dorsal lumbar muscles

68
Q

Types of IV injections

A

injections
situations where fast onset is required

69
Q

contraindications of IV injections

A

oily

70
Q

location of IV injections

A

cephalic
femoral
saphena
jugular (central line not for drugs)

71
Q

Preparations for blood transfusions

A

Fresh whole blood
whole blood in CPDA
rbc suspension
platelet rich plasma
fresh frozen plasma
frozen plasma

72
Q

what should the frozen plasma be deficient in

A

clotting factors V, VIII, WF

73
Q

When are blood transfusions given

A

acute blood loss / haemolysis
chronic anaemia

74
Q

crossmatching blood groups in dogs

A

No preformed antibodies in dogs
develop 1-2 weeks after incompatible infusion
therefore must perform xmatch befrore 2nd transfusion

75
Q

crossmatching blood groups in cats

A

98% of DSH are group A
other groups - B, AB

76
Q
A

SAM Final (48 decks)

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