CAL - emergency stabilisation Flashcards
Tx - hypovolaemic shock
- IV catheter in peripheral vein (short, large bore)
- bolus at 30mL/kg over 20 minutes
- aim to restore the intravascular space very rapidly
Why are large bore catheters better for fluid boluses?
Long catheters tend to have small diameters (eg, 22-Gauge) and the increase length adds to the resistance, such that the flow rate is compromised.
Is a HR of 260bpm likely to be complensatory to hypovolaemia?
No - more likely cardiogenic shock where the very poor cardiac output resulting in the CS of collapse, poor pulses and congested lungs.
What does a normal CRT in hypovolaemic shock suggest?
vasomotor tone not affected
How does hypovolaemic shock affect the heart?
results in a sinus tachycardia (a compensatory response that increases cardiac output) that typically does not cause such high heart rates (
T/F: in maldistributive shock the MMs are typically injected
True
What do dull ventral lung sounds and significant dyspnoea suggest?
pleural space disease –> perform thoracocentesis
Diuretics are better for acute management of pulmonary oedema or pleural space disease?
pleural space disease
In an animal in pain, how are HR and pulses affected?
- tachycardia
- bounding pulses
- (contrast hypovolaemic shock where tachycardia is present but pulses are weak and MMs are pale)
Classic signs of maldistributive shock
injected MMs with inappropriately slow CRT
Classic signs - LRT disease
expiratory dyspnoea + wheezing
Classic sign - URT disease
Noise on inspiration
What are crackles associated with?
- pulmonary parenchymal disease
- paradoxical abdominal movement (other causes of this too)
What is pleural space disease associated with?
dull lung sounds
For a dog with marked inspiratory dyspnoea + stridor, what is best tx?
- O2 therapy
- sedative (as airway swelling made worse with animal distress)
- emergency tracheostomy (to bypass obstructed airway but only indicated if sedation and steroids fail and dyspneoa worsens)
- active cooling
