emergency 3 Flashcards
IV fluid administration
Isotonic crystalloid solutions administered at a rapid rate
o Lactated Ringer’s, normal saline (0.9% NaCL), Normosol-R
Hypertonic saline administered in small doses
o 7.5% NaCL
Colloids can be used to maintain blood volume expansion caused by isotonic crystalloid fluid administration
o Synthetic colloids (hetastarch,dextran70)
o Plasma- worry aroub reactions
o Whole blood or packed RBC’s (must use if PCV/Hb levels are low)
Monitoring the patient in shock
o Physical parameters Respiration Cardiovascular function o Physiologic parameters Oxygen saturation Blood pressure • Laboratory parameters
Laboratory parameters
o Hematocrit and total solids
o Electrolytes
o Blood gases
o Lactate
Hematologic emergencies
Most hematologic emergencies in small animals involve excessive bleeding and/or anemia
Conditions are life-threatening if not recognized and left untreated
Thrombocytopenia
Decreased platelet production
Increased platelet consumption
Increase platelet destruction
Immune-mediated thrombocytopenia (IMT)
Primary hemostasis abnormalities
Thrombocytopenia
Thrombopathia
von Willebrand’s Factor (vWF) deficiency
Thrombopathia
Inherited
Acquired
von Willebrand’s Factor (vWF) deficiency
Most common hereditary bleeding defect in dogs
Mucosal surface bleeding and hemorrhage often seen after surgery or trauma
Administer cryoprecipitate high in vWF concentrations preoperatively
Secondary hemostasis abnormalities
Coagulation factor deficiencies
Coagulation factor deficiencies
Hereditary
Acquired- Anticoagulant rodenticide toxicity, of liver disease, Disseminated intravascular coagulation (DIC)
Anticoagulant rodenticide toxicity
Toxins antagonize vitamin K activity
Prevent activation of coagulation factors II, VII, IX, X
Treat w/ vitamin K supplementation +/- coagulation factor administration
Liver disease
Liver unable to synthesize coagulation factors
Aquired
Disseminated intravascular coagulation (DIC)
Condition in which coagulation is increased
Clots form throughout circulatory system
Leads to hemorrhage due to consumption of coagulation factors and platelets
Typically caused by inflammatory mediators that cause tissue factor expression during systemic inflammatory response syndrome (SIRS)
Sepsis, neoplasia, massive tissue trauma or ischemia (shock, GDV, heat stroke, crushing injury, pancreatitis)-
Prolonged PT, aPTT, ACT, low fibrinogen, increased FDP’s
Anemia
Condition characterized by an abnormally low number of circulating RBC’s May result from: Increased RBC loss– hemorrhage Increased RBC destruction– hemolysis Decreased RBC production in bone marrow
Causes of Increased RBC destruction
Immune-mediated hemolytic anemia
Erythrocyte metabolism defect
Toxins (onions, zinc)
