Ecc

Question 1

Common sites for intraosseous line?

Answer 1

Trochanteric fossa of the femur
The greater tubercle of the humerus
The wing of ileum
The crest of the tibia

Question 2

Isotonic crystalloid fluids are mixtures of sodium chloride and other physiologically active solutes (k+ ca2+ or mg2+, glucose and buffer)

Answer 2

Generally isotonic to plasma and have sodium as the primarily osmotivally active solute.
Balanced crystalloid are generally given when the nature of the fluid losses are not known, are due to trauma and or electrolyte measurements are not available: an excellent replacement solution is lactated ringers (hartmanns) OR its equivalent

Question 3

Hypertonic crystalloid such as 7.5% saline have been recommended for shock therapy: much smaller volumes are given when compared to balanced crystalloid.

Answer 3

Hypertonic saline causes causes fluid shifts from the intracellular space to the intracellular space to the extracellular space resulting in improved venous return and cardiac output.

It is necessary to replenish the interstitial space with a balanced crystalloid.

Indicated where it is difficult to administer large volumes rapidly enough to resuscitate eg giant large breed gastric dilation and volvulus patients.

Also thought that hypertonic saline may be beneficial in treatment of traumatic brain injury by reducing brain oedema

Question 4

Synthetic colloids

Answer 4

Are large molecular weight solutions that do not cross capillary membranes readily and increase the serum colloid osmotic pressure.
Intravascular colloid oncotic pressure is important in maintaining intravascular volume.
Colloids are better blood-volume expanders than are isotonic crystalloids :50-80% of the infused vol remains in the intravascular space when the capillary membrane wall is uncompromised.

Colloids should be admibstered when crystalloids are not effectively improving or maintaining blood vol restoration or if oedema develops prior to adequate blood vol restoration