4. Flashcards
hemoperitoneum can be divided into
hemoabdomen clinical signs
- shock
- Pale mm, ↑CRT
- Weak pulses
- Tachycardia
- Cardiac Arrhythmias
- Abdominal distention
- Minimal response to fluid therapy
- Bruising around
umbilicus
average amount of blood in dog and cat
dog : 90 ml/kg
cat: 60 ml/kg
clinical signs with 15-30% acute blood loss
resting tachycardia, BP normal
clinical signs with 30-40% acute blood loss
hypoperfusion (long CRT, pale), decreased urine output
clinical signs with >40% acute blood loss
circulatory collapse, marked hypotension
belly wraps should not be used with
- careful with respiratory distress pt and diaphragmatic hernias
+ abdominocentesis for hemoabdomen will show
sanguineous nonclotthing fluid with large numbers of RBC
* blind- 50% false negative, need 5-25 ml/kg
* AFAST guided
* can be open or closed technique
xrays of hemoabdomen can show
- Loss of abdominal detail
- Small intestinal displacement
- Lack of normal splenic position
- Occasionally gas within the spleen
ultrasound usually more helpful
when to bring hemoabdomen to surgery
- Failure to achieve hemodynamic stability of patient
- Evidence of continued bleeding
- Evidence of
pneumoperitoneum, hernia or mass effect on diagnostic imaging
1st organs to check for unknown hemoabdomen
spleen
liver
kidneys/adrenals
how to do pringle maneuver
- place index finger through epiploic region into omental bursa
- compress hepatic artery and portal vein
- hold pressure- replace with clamp
- still bleeding= injury to retrohepatic vena cava or hepatic veins
where to clamp aorta
just cranial to left adrenal near celiac artery
how often to release aortic cross clamp
every 5 minutes
* use non crushing- bulldog or rumel tourniquet
what can be used for small volume bleeding
gelfoam
surgicel
collagen mesh
tissue glue
omental packing
