CALS: Emergency Stabilisation (Shock and Fluids) Flashcards
1
Q
Tx cardiogenic shock?
A
- O2
- Diuretics
- ECG (and management of arrythmias if necessary)
2
Q
Tx all other types of shock (other than cardiogenic)
A
- IV catheter (short, large bore, peropheral vein)
- Bolus Hartmanns @ 30ml/kg over 20mins
- If big dog can use 7% hypertonic saline
3
Q
How is compensated and decompensated shock classified?
A
- compensated but be tachycardic but is not showing other clinical signs of shock (eg. pale, CRT may be fast)
- decompensated shows tachycardia but still showing clinical signs (pale mms, long CRT)
4
Q
Tx of upper airway blockage?
A
- O2
- sedation
- topical steroids to v inflam (otherwise vibrations will cause swelling and worsen everything)
5
Q
What amount of dehydration is needed before considering fluid bolus?
A
> 10%
6
Q
What losses sum to give the amount of dehydration?
A
> Sensible - V+ - urine (~30-40ml/kg/day) > INsensible - sweat - feaces - resp ~10-20ml/kg/day
7
Q
What rate should you use intitially to rehydrate a patient?
A
10ml/hr over 24-48hrs
8
Q
What is the average maintainance fluid requirement?
A
50-80ml/kg/DAY
9
Q
Signs of overhydration
A
- chemosis
- serous nasal discharge
- gelatinous skin
- wt gain
- tachynpnoea
- jugular v distension
10
Q
How does dehyrdration and hypovolaemia in horses differ to smallies?
A
- dehydration and hypovolaemia commonly co-exist (cf. smallies where you should try to distinguish the 2 from each other and tx independantly)
- d/t interstitial fluid being quickly mobilised intravascularly
11
Q
What type of catheter should be used for horses?
A
- 10-12G or 2x14G bilaterally
- over the needle catheter
12
Q
How do you calculate fluid needs?
A
[[[Fluid deficit + Maintainance + Ongoing losses]]] Fluid deficit (Litres) = BW (kg) x % dehydration Maintainance = 50-80ml/kg/day Ongoing losses = estimate eg. 5L D+ over 2 hours etc.
