CC Concepts: Shock Flashcards
For all forms of shock except cardiogenic, the mainstay of therapy involves -?
Rapid vascular access and administration of large volumes of isotonic crystalloid fluids
What are two therapies associated with cardiogenic shock?
Oxygen therapy and anxiolytics/ stress avoidance
A rise in sympathetic activity results in what cardiac and vasculature effects?
Vasoconstriction, increased cardiac contractility, and tachycardia with resultant rise in cardiac output
Describe what may be seen in early shock?
Normal pulses and BP, mild to moderate mental depression, tachycardia with normal or prolonged CRT, cool extremities, and tachypnea.
What may be seen as patient undergoes decompensated shock?
Pale MM, poor pulses and a drop in BP, depressed mentation, and if left untreated, reduced organ perfusion leads to organ failure.
Septic animals are initially _____dynamic, with clinical signs including -?
Hyperdynamic
Tachycardia, fever, bounding pulses, hyperemic MM
True or False: Feline patients are more likely to be in a hyperdynamic state of shock, with fairly obvious clinical signs.
False, feline patients are rarely in a hyperdynamic state, and are typically presenting with pale MM, weak pulses, cool extremities, hypothermia, and generalized weakness or collapse.
Lactate can be used as a method for evaluating -?
Inadequate oxygen delivery, oxygen uptake, or tissue perfusion resulting in cellular hypoxia
What are the appropriate shock dosages for fluid administration in canine and feline patients, respectively?
How should these fluids be administered?
Canine = 90 mL/kg Feline = 50 mL/kg
25 - 33% of the total shock fluid dose should be given over 30 minutes, and following reevaluation, the remainder should be administered
What fluid is recommended for shocks patients with a coexisting brain injury?
Hypertonic saline (0.9%)
In order to effectively increase the intravascular blood volume, what dosages can be used for colloid fluid administration?
For how long can colloids be administered, and how long do these effects lasts?
Canine = 10 - 20 mL/kg Feline = 5 - 10 mL/kg
Recommendations state to administer IV over 10 minutes, leading to a transient osmotic shift of fluid intravascularly for up to 30 minutes
When are packed RBC transfusions recommended?
To increase oxygen content in patients with severe anemia or in conjunction with fresh frozen plasma in coagulopathic shock patients
At what rate are packed RBC transfusions and fresh frozen plasma administered? Fresh whole blood?
Fresh frozen plasma/ packed RBC = 10 - 20 mL/kg
Fresh whole blood = 20 - 30 mL/kg
What is the medication of choice for cardiogenic shock patients? (Not an inotrope or vasopressor)
Furosemide (1 - 8 mg/kg)
