Chapter 170 - Management of Hemorrhagic Shock Flashcards
Blood loss inducing signs of shock (dogs/cats)?
Patients will demonstrate signs of shock when as little as 15–20% of their blood volume is lost: approximately 15–20 mL/kg in the dog or 10–15 mL/kg in the cat.
Volume of abdominal effusion inducing fluid wave ?
Patients with abdominal haemorrhage may have a fluid wave or positive ballotment, but this may not be apparent until hemorrhage is significant (40 mL/kg)
How much coagulation factors must decrease to induce prolonged PT/aPTT?
> 70% of one or more of these clotting factors
Thrombocytopenia level to induce spontaneous hemorrhage?
Patients are typically at risk for spontaneous hemorrhage when platelet counts are less than 30 000–50 000/Ul
Efficacy of epinephrine into a nasal cavity when localized hemorrhage?
Often ineffective as it is rapidly diluted by ongoing hemorrhage
Risks of massive transfusion?
Massive transfusion predisposes patients to electrolyte (K, Ca, Mg) abnormalities, coagulopathies, thrombocytopenia, hypothermia, metabolic acidosis, delayed wound healing, and increased infection rates
Outcome of autologous blood transfusion compared to bank blood in humans undergoing oncological surgery? Risks?
No worse outcome in patients with ABT compared to banked blood. If the ABT has GI contamination,
culture, susceptibility, and antibiotic therapy are warranted.
Blood that has been in a peritoneal cavity for prolonged periods may contain inflammatory mediators
that could contribute to systemic inflammation, warranting careful monitoring for SIRS.
What is the acute traumatic coagulopathy (ATC) (also called trauma-induced coagulopathy and acute coagulopathy of trauma shock) and what are its key factors? Treatment of choice?
Severe coagulopathy described in human and veterinary trauma patients.
Key factors: tissue damage, inflammation, hypoperfusion, hemodilution, hypothermia, and acidosis. Animals experiencing ATC may benefit from antifibrinolytic therapy (tranexamic acid or epsilon-aminocaproic acid),
