Emergency 2

Question 1

Blood Gas Analysis

Answer 1

o Reveals acid-base and oxygenation abnormalities in animals
o Provide pH, Pco2, HCO3, Po2
o Helpful in identifying and determining severity of respiratory problems (pneumonia, CHF) and metabolic abnormalities (urinary tract obstruction, diabetic ketoacidosis)

Question 2

Lactate Concentration

Answer 2

o Lactic acid is produced during anaerobic metabolic
o Increased concentrations indicative of inadequate blood flow (oxygen delivery) to tissues
o Increased concentrations seen in shock, GDV, crushing traumatic injuries
o Good prognostic indicator

Question 3

Lactate Concentration

Answer 3

o Lactic acid is produced during anaerobic metabolism
o Increased concentrations indicative of inadequate blood flow (oxygen delivery) to tissues
o Increased concentrations seen in shock, GDV, crushing traumatic injuries
o Good prognostic indicator

Question 4

Coagulation Tests

Answer 4

o Coagulation abnormalities can develop in patients with rodenticide toxicity, thrombocytopenia, sepsis
o Coagulation tests include prothrombin time (PT), activated partial thromboplastin time (aPTT), activated clotting time (ACT), buccal mucosal bleeding time (BMBT), and platelet count.

Question 5

Cardiopulmonary Resuscitation

Answer 5

Performed following cardiopulmonary arrest (CPA)

CPA can result from any disease condition that ultimately affects cardiovascular or pulmonary function

Question 6

Possible causes of CPA

Answer 6

 infection, trauma, hypoxia, anesthetic drug administration, vagal stimulation, hypo- or hyperthermia, metabolic disorders
 Recognition of an impending CPA in a sick animal is critical

Question 7

Purpose of CPR

Answer 7

to provide the patient with adequate ventilation and circulation until spontaneous cardiopulmonary function is restored

Question 8

Preparation for CPR

Answer 8

o A team of 3-5 people on the CPR team is ideal
o The area where CPR takes place must:
 Be large enough to accommodate CPR team
 Have an oxygen source
 Have good lighting
 Have a solid surface on which to place the patient
o Prepare a crash cart containing all the necessary CPR supplies and equipment

Question 9

Clinical signs

Answer 9

	Unconsciousness
	Absence of respiration
	Absence of a heartbeat or pulse
	Fixed/dilated pupils
	Pale or bluish mucous membranes

Question 10

Phase One of CPR: Basic Life Support (BLS)

Answer 10

1. Establish Airway
2. Breath for the patient
3. Restore effective Circulation
4. Effectiveness of BLS procedures can be assessed by observing mucous membrane color, palpating peripheral pulse, Doppler probe on cornea, direct arterial pressure, end-tidal carbon dioxide monitor

Question 11

Establish Airway

Answer 11

 Endotracheal tube

 Tracheostomy tube

Question 12

2. Breath for the patient

Answer 12

 Attach to pure oxygen source

 Ventilate every 5 seconds

Question 13

3. Restore effective Circulation

Answer 13

 Perform external cardiac compressions at a rate of 80-120 per minute
 Thorax must be compressed by 1/3 to 1/2 of its normal diameter with each compression

Question 14

Phase Two of CPR: Advanced Life Support

Answer 14

1. Diagnose cause of ineffective CV function by use of an electrocardiogram (ECG)
2. Emergency drugs administered or defribrillation performed to re-establish CV function
3. Drugs may be administered by intravenous, intratracheal, or intraosseous routes

Question 15

Emergency drugs administered or defribrillation performed to re-establish CV function

Answer 15

	IV fluids
	Atropine
	Epinephrine
	2% Lidocaine 
	Sodium bicarbonate

Question 16

Cardiopulmonary Resuscitation

Answer 16

1. If giving drugs by IV injection

2. If giving drugs by intratracheal administration

Question 17

If giving drugs by IV injection

Answer 17

 Expect a 1-2 minute delay in onset of drug effect

 Flush peripheral catheter used to give drugs with 10-30 ml of saline (elevate extremity)

Question 18

If giving drugs by intratracheal administration

Answer 18

 Double dose and mix w/ 5-10 ml of saline
 Flush through ET tube using red rubber catheter
 Give a few breaths afterwards to distribute drug in lung tissue

Question 19

Phase Three of CPR: Prolonged Life Support

Answer 19

Consists of continued patient monitoring to ascertain the adequacy of cardiovascular, respiratory, and central nervous system (CNS) function

Question 20

Shock

Answer 20

Life-threatening condition characterized by inadequate blood flow to body tissues
It can be the end result of many disease processes

Question 21

Shock can develop via three different mechanisms:

Answer 21

1. Hypovolemic shock due to decrease intravascular volume
2. Cardiogenic shock due to cardiac pump failure
3. Distributive shock due to maldistribution of intravascular volume
4. Obstructive shock due to mechanical obstruction of blood flow in CV system

Question 22

Diagnosis of shock

Answer 22

o	History
o	Clinical signs
o	Mentation
o	Pale, cold, dry mucous membranes
o	Prolonged capillary refill time (CRT)
o	Tachycardia
o	Decreased pulse strength
o	Decrease heart sounds
o	Cold skin and extremities
o	Weakness

Question 23

Treatment of shock

Answer 23

1. Treat underlying cause
2. Provide supplemental oxygen
3. IV fluid administration