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year 3 principles > Emergency and critical care > Flashcards

Emergency and critical care Flashcards

1
Q

what can increase the success rate of CPR?

A

being under anaesthesia as will be on 100% oxygen so get a while longer before heart stops

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2
Q

what can increase the success rate of CPR?

A

being under anaesthesia as will be on 100% oxygen so get a while longer before heart stops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what can increase the success rate of CPR?

A

being under anaesthesia as will be on 100% oxygen so get a while longer before heart stops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a cardiopulmonary arrest?

A

cessation of effective cardiac activity and respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is return of spontaneous circulation?

A

ROSC - re-establishment of sustained CO without assitance

How well did you know this?
1
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2
3
4
5
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6
Q

what is basic life support?

A

compressions and assisted ventilation

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3
4
5
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7
Q

what is advanced cardiac life support?

A

basic life support + medical + electrical intervention

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8
Q

what often preceeds a cardiopulmonary arrest?

A

hypoventilation

bradycardia

How well did you know this?
1
Not at all
2
3
4
5
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9
Q

what are some ECG changes to look out for?

A 
ventricular tachycardia
ventricular flutter
3rd degree AV block
atrial standstill
ST depression
R on T phenomenon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is a vagal arrest?

A

very high vagal tone causing life threatening bradycardia

  • give oxygen and atropine
  • high vagal tone from vomiting, defecation, resp/abd disease, ocular or neck surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

how do you carry out CPR?

A

in R lateral recumbency

on an AmbuBag for 100% oxygen and +ve pressure ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what rate of respiration should you do with CPR?

A

12-15 bpm

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13
Q

when is closed chest CPR suitable

A

under 7 kg do cardiac pump and over 7kg do thoracic pump

How well did you know this?
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3
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5
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14
Q

what is the rate of chest compressions?

A

100 bpm

let thorax spring back completley

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15
Q

when is open chest CPR considered?

A
  • already under anaesthesia
  • very large dogs
  • pleural space / pericardial disease
  • penetrating chest trauma
  • haemoabdomen
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16
Q

When would you give adrenaline?

A

pulseless electrical activity

asystole

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17
Q

when would atropine be given?

A

sinus bradycardia

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18
Q

when would lidocaine be given?

A

sinus tachycardia

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19
Q

when is calcium gluconate given?

A

if have hypocalcaemia and hyperkalaemia

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20
Q

when would you give sodium bicarbonate?

A

acidic ph

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21
Q

when would you give lidocaine?

A

ventricular tachycardia

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22
Q

what drugs can be given via an ET tube?

A 
Naloxene
Atropine
Vasopressin
Epinephrine
Lidocaine

NAVEL

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23
Q

what is Naloxene?

A

an opioid antagonist

How well did you know this?
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2
3
4
5
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24
Q

what is atropine?

A

muscarinic antagonist

increases HR as anti-para

How well did you know this?
1
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2
3
4
5
Perfectly
25
Q

what is lidocaine?

A

neuronal Na channel blocker

-antiarrhythmic and local anaesthetic

How well did you know this?
1
Not at all
2
3
4
5
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26
Q

what % dehdration is needed before a skin tent remains and have dry mm and sunken eyes?

A

8-10%

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27
Q

what % of dehydration is needed for hypovolaemia signs?

A

over 12%

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28
Q

What are the signs of hypovolaemia?

A 
tachycardic
low pulse pressure
low jugular filling
tachypnoea
cold extremitis
low urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are signs of dehydration?

A

prolonged skin tent
tacky mm
sunken eyes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how do you calculate the fluid defecit?

A

BW (kg) x %dehydrated (10% = 0.1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what happens if you give propofol too fast?

A 
tachycardia
hypotension
apnoea
--cardiopulmonary arrest
-start CPR and antagonise a2 and turn off any inhalant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

what can cause tachycardia during surgery?

A 
pain
too light
hypovolaemia
hypotensive
hypoxaemia
hypercapnia
hyperthermia
hypovolaemia
How well did you know this?
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3
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33
Q

what can indicate the anaesthetic is too light?

A

tachycardic
tachypnoeic
hypertensive

How well did you know this?
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5
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34
Q

what can cause reduced SpO2?

A
  • Et tube obstruction

- medetomidine causing vasoconstriction in first 10-15 mins

How well did you know this?
1
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2
3
4
5
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35
Q

what are the 4 types of circulatory shock?

A

hypovolaemic
maldistributive
cardiogenic
obstructive

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36
Q

what is shock?

A

significant compromise in oxygen delivery to tissues

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37
Q

what are the 3 ways to get shock?

A
  • failure of circulatory system (circulatory shock)
  • failure of blood to carry enough oxygen (V/Q mismatch)
  • failure of tissues to utilise oxygen effectively (cyanide toxicity)
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38
Q

what are hyperdynamic pulses?

A

taller as greater difference between diastolic and systolic pressure

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39
Q

what is different about cats in shock?

A

can get bradycardia as their HR is closely regulated to core temp so if get cold then HR slows down

How well did you know this?
1
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3
4
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40
Q

What is hypovolaemic shock?

A

tissue hypoperfusion secondary to a lack of circulating blood volume
-fluid lost from intravascular volume

How well did you know this?
1
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4
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41
Q

what is the difference between dehydration and hypovolaemia?

A

-dehydration is fluid loss from all 3 compartments - intracascular, interstitial and intracellular whereas hypovolaemia is reduced intravascular volume

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42
Q

what can cause hypovolaemia?

A

haemorrhage
fluid loss into GIT
fluid loss into third space

How well did you know this?
1
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2
3
4
5
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43
Q

what are some consequences of hypovolaemia?

A

reduced venous return, mismatch in o2 supply/demand, anaerobic metabolism and lactate build up

How well did you know this?
1
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2
3
4
5
Perfectly
44
Q

what are signs seen in early compensatory hypovolaemic shock?

A 
HR 130-150
MM normal or even pinker - rapid CRT
bounding hyperdynamic pulses
easily palpable metatarsal pulse
lactate 3-5 mmol/L
How well did you know this?
1
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2
3
4
5
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45
Q

what are signs seen in late decompensated hypovolaemic shock?

A 
HR 170-220
white / grey MM
long or absent CRT
weak / thready pulses
absent metatarsal pulses
lactate over 8 mmol/L
maybe low bp
How well did you know this?
1
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2
3
4
5
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46
Q

what is the treatment for hypovolaemic shock?

A
  • IV fluid bolus (isotonic crystalloids) 10-40ml/kg in 20 mins then reases
  • monitor for dyspnoea
How well did you know this?
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47
Q

what is dog blood volume?

A

60-90 ml/kg

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48
Q

what is cat blood volume?

A

40-60 ml/kg

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49
Q

what is a consideration in fluid therapy in large dogs?

A

the volume needed isnt possible in short amount of time so could give hypertonic crystalloids

How well did you know this?
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50
Q

what may colloids be used in hypovolaemia?

A

they stay in intravascular volume for longer than crystalloids which equally diffuse across all compartments

How well did you know this?
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2
3
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5
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51
Q

what catheter will give least resistance to IVFT?

A

short and wide

How well did you know this?
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2
3
4
5
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52
Q

What is maldistributive shock?

A

inappropriate vasodilation leading to alteration in distribution of blood flow between the tissues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

what can cause maldistributive shock?

A

SIRS - systemic inflammatory response syndrome

sepsis

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54
Q

what are the signs of maldistributive shock?

A
  • red injected MM
  • very fast CRT
  • sepsis
How well did you know this?
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3
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55
Q

what is SIRS?

A

systemic inflammation and oedema, multiple organ dysfunction

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56
Q

what is sepsis?

A

SIRS and documented infection site

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57
Q

what is septic shock?

A

sepsis and hypotensive

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58
Q

what is septicaemia?

A

sepsis and bacteraemia

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59
Q

how do you treat maldistributive shock/.

A

fluids

inotropes/vasopressors to improve BP, perfusion and vascular tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

what is cardiogenic shock?

A

failure of the heart as a pump

How well did you know this?
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Not at all
2
3
4
5
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61
Q

what can cardiogenic shock be secondary to?

A

cardiomyopathies
valvular disease
arrhytmias

How well did you know this?
1
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2
3
4
5
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62
Q

what is seen with cardiogenic shock?

A

resp signs

very high HR

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63
Q

how do you treat cardiogenic shock?

A

-diureticcs
-inotropes, anti-arrhytmics, vasodilators
NO fluids

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64
Q

what is obstructive shock?

A

obstruction to blood flow

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65
Q

what can cause obstructive shock?

A

pericardial effusion
pulmonary thromboembolism
GDV putting pressure on VC and aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

what is a cardiopulmonary arrest?

A

cessation of effective cardiac activity and respiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

what is return of spontaneous circulation?

A

ROSC - re-establishment of sustained CO without assitance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

what is basic life support?

A

compressions and assisted ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

what is advanced cardiac life support?

A

basic life support + medical + electrical intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

what often preceeds a cardiopulmonary arrest?

A

hypoventilation

bradycardia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

what are some ECG changes to look out for?

A 
ventricular tachycardia
ventricular flutter
3rd degree AV block
atrial standstill
ST depression
R on T phenomenon
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is a vagal arrest?

A

very high vagal tone causing life threatening bradycardia

  • give oxygen and atropine
  • high vagal tone from vomiting, defecation, resp/abd disease, ocular or neck surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

how do you carry out CPR?

A

in R lateral recumbency

on an AmbuBag for 100% oxygen and +ve pressure ventilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

what rate of respiration should you do with CPR?

A

12-15 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

when is closed chest CPR suitable

A

under 7 kg do cardiac pump and over 7kg do thoracic pump

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

what is the rate of chest compressions?

A

100 bpm

let thorax spring back completley

77
Q

when is open chest CPR considered?

A
  • already under anaesthesia
  • very large dogs
  • pleural space / pericardial disease
  • penetrating chest trauma
  • haemoabdomen
78
Q

When would you give adrenaline?

A

pulseless electrical activity

asystole

79
Q

when would atropine be given?

A

sinus bradycardia

80
Q

when would lidocaine be given?

A

sinus tachycardia

81
Q

when is calcium gluconate given?

A

if have hypocalcaemia and hyperkalaemia

82
Q

when would you give sodium bicarbonate?

A

acidic ph

83
Q

when would you give lidocaine?

A

ventricular tachycardia

84
Q

what drugs can be given via an ET tube?

A 
Naloxene
Atropine
Vasopressin
Epinephrine
Lidocaine

NAVEL

85
Q

what is Naloxene?

A

an opioid antagonist

86
Q

what is atropine?

A

muscarinic antagonist

increases HR as anti-para

87
Q

what is lidocaine?

A

neuronal Na channel blocker

-antiarrhythmic and local anaesthetic

88
Q

what % dehdration is needed before a skin tent remains and have dry mm and sunken eyes?

A

8-10%

89
Q

what % of dehydration is needed for hypovolaemia signs?

A

over 12%

90
Q

What are the signs of hypovolaemia?

A 
tachycardic
low pulse pressure
low jugular filling
tachypnoea
cold extremitis
low urine output
91
Q

what are signs of dehydration?

A

prolonged skin tent
tacky mm
sunken eyes

92
Q

how do you calculate the fluid defecit?

A

BW (kg) x %dehydrated (10% = 0.1)

93
Q

what happens if you give propofol too fast?

A 
tachycardia
hypotension
apnoea
--cardiopulmonary arrest
-start CPR and antagonise a2 and turn off any inhalant
94
Q

what can cause tachycardia during surgery?

A 
pain
too light
hypovolaemia
hypotensive
hypoxaemia
hypercapnia
hyperthermia
hypovolaemia
95
Q

what can indicate the anaesthetic is too light?

A

tachycardic
tachypnoeic
hypertensive

96
Q

what can cause reduced SpO2?

A
  • Et tube obstruction

- medetomidine causing vasoconstriction in first 10-15 mins

97
Q

what are the 4 types of circulatory shock?

A

hypovolaemic
maldistributive
cardiogenic
obstructive

98
Q

what is shock?

A

significant compromise in oxygen delivery to tissues

99
Q

what are the 3 ways to get shock?

A
  • failure of circulatory system (circulatory shock)
  • failure of blood to carry enough oxygen (V/Q mismatch)
  • failure of tissues to utilise oxygen effectively (cyanide toxicity)
100
Q

what are hyperdynamic pulses?

A

taller as greater difference between diastolic and systolic pressure

101
Q

what is different about cats in shock?

A

can get bradycardia as their HR is closely regulated to core temp so if get cold then HR slows down

102
Q

What is hypovolaemic shock?

A

tissue hypoperfusion secondary to a lack of circulating blood volume
-fluid lost from intravascular volume

103
Q

what is the difference between dehydration and hypovolaemia?

A

-dehydration is fluid loss from all 3 compartments - intracascular, interstitial and intracellular whereas hypovolaemia is reduced intravascular volume

104
Q

what can cause hypovolaemia?

A

haemorrhage
fluid loss into GIT
fluid loss into third space

105
Q

what are some consequences of hypovolaemia?

A

reduced venous return, mismatch in o2 supply/demand, anaerobic metabolism and lactate build up

106
Q

what are signs seen in early compensatory hypovolaemic shock?

A 
HR 130-150
MM normal or even pinker - rapid CRT
bounding hyperdynamic pulses
easily palpable metatarsal pulse
lactate 3-5 mmol/L
107
Q

what are signs seen in late decompensated hypovolaemic shock?

A 
HR 170-220
white / grey MM
long or absent CRT
weak / thready pulses
absent metatarsal pulses
lactate over 8 mmol/L
maybe low bp
108
Q

what is the treatment for hypovolaemic shock?

A
  • IV fluid bolus (isotonic crystalloids) 10-40ml/kg in 20 mins then reases
  • monitor for dyspnoea
109
Q

what is dog blood volume?

A

60-90 ml/kg

110
Q

what is cat blood volume?

A

40-60 ml/kg

111
Q

what is a consideration in fluid therapy in large dogs?

A

the volume needed isnt possible in short amount of time so could give hypertonic crystalloids

112
Q

what may colloids be used in hypovolaemia?

A

they stay in intravascular volume for longer than crystalloids which equally diffuse across all compartments

113
Q

what catheter will give least resistance to IVFT?

A

short and wide

114
Q

What is maldistributive shock?

A

inappropriate vasodilation leading to alteration in distribution of blood flow between the tissues

115
Q

what can cause maldistributive shock?

A

SIRS - systemic inflammatory response syndrome

sepsis

116
Q

what are the signs of maldistributive shock?

A
  • red injected MM
  • very fast CRT
  • sepsis
117
Q

what is SIRS?

A

systemic inflammation and oedema, multiple organ dysfunction

118
Q

what is sepsis?

A

SIRS and documented infection site

119
Q

what is septic shock?

A

sepsis and hypotensive

120
Q

what is septicaemia?

A

sepsis and bacteraemia

121
Q

how do you treat maldistributive shock/.

A

fluids

inotropes/vasopressors to improve BP, perfusion and vascular tone

122
Q

what is cardiogenic shock?

A

failure of the heart as a pump

123
Q

what can cardiogenic shock be secondary to?

A

cardiomyopathies
valvular disease
arrhytmias

124
Q

what is seen with cardiogenic shock?

A

resp signs

very high HR

125
Q

how do you treat cardiogenic shock?

A

-diureticcs
-inotropes, anti-arrhytmics, vasodilators
NO fluids

126
Q

what is obstructive shock?

A

obstruction to blood flow

127
Q

what can cause obstructive shock?

A

pericardial effusion
pulmonary thromboembolism
GDV putting pressure on VC and aorta

128
Q

what is a cardiopulmonary arrest?

A

cessation of effective cardiac activity and respiration

129
Q

what is return of spontaneous circulation?

A

ROSC - re-establishment of sustained CO without assitance

130
Q

what is basic life support?

A

compressions and assisted ventilation

131
Q

what is advanced cardiac life support?

A

basic life support + medical + electrical intervention

132
Q

what often preceeds a cardiopulmonary arrest?

A

hypoventilation

bradycardia

133
Q

what are some ECG changes to look out for?

A 
ventricular tachycardia
ventricular flutter
3rd degree AV block
atrial standstill
ST depression
R on T phenomenon
134
Q

What is a vagal arrest?

A

very high vagal tone causing life threatening bradycardia

  • give oxygen and atropine
  • high vagal tone from vomiting, defecation, resp/abd disease, ocular or neck surgery
135
Q

how do you carry out CPR?

A

in R lateral recumbency

on an AmbuBag for 100% oxygen and +ve pressure ventilation

136
Q

what rate of respiration should you do with CPR?

A

12-15 bpm

137
Q

when is closed chest CPR suitable

A

under 7 kg do cardiac pump and over 7kg do thoracic pump

138
Q

what is the rate of chest compressions?

A

100 bpm

let thorax spring back completley

139
Q

when is open chest CPR considered?

A
  • already under anaesthesia
  • very large dogs
  • pleural space / pericardial disease
  • penetrating chest trauma
  • haemoabdomen
140
Q

When would you give adrenaline?

A

pulseless electrical activity

asystole

141
Q

when would atropine be given?

A

sinus bradycardia

142
Q

when would lidocaine be given?

A

sinus tachycardia

143
Q

when is calcium gluconate given?

A

if have hypocalcaemia and hyperkalaemia

144
Q

when would you give sodium bicarbonate?

A

acidic ph

145
Q

when would you give lidocaine?

A

ventricular tachycardia

146
Q

what drugs can be given via an ET tube?

A 
Naloxene
Atropine
Vasopressin
Epinephrine
Lidocaine

NAVEL

147
Q

what is Naloxene?

A

an opioid antagonist

148
Q

what is atropine?

A

muscarinic antagonist

increases HR as anti-para

149
Q

what is lidocaine?

A

neuronal Na channel blocker

-antiarrhythmic and local anaesthetic

150
Q

what % dehdration is needed before a skin tent remains and have dry mm and sunken eyes?

A

8-10%

151
Q

what % of dehydration is needed for hypovolaemia signs?

A

over 12%

152
Q

What are the signs of hypovolaemia?

A 
tachycardic
low pulse pressure
low jugular filling
tachypnoea
cold extremitis
low urine output
153
Q

what are signs of dehydration?

A

prolonged skin tent
tacky mm
sunken eyes

154
Q

how do you calculate the fluid defecit?

A

BW (kg) x %dehydrated (10% = 0.1)

155
Q

what happens if you give propofol too fast?

A 
tachycardia
hypotension
apnoea
--cardiopulmonary arrest
-start CPR and antagonise a2 and turn off any inhalant
156
Q

what can cause tachycardia during surgery?

A 
pain
too light
hypovolaemia
hypotensive
hypoxaemia
hypercapnia
hyperthermia
hypovolaemia
157
Q

what can indicate the anaesthetic is too light?

A

tachycardic
tachypnoeic
hypertensive

158
Q

what can cause reduced SpO2?

A
  • Et tube obstruction

- medetomidine causing vasoconstriction in first 10-15 mins

159
Q

what are the 4 types of circulatory shock?

A

hypovolaemic
maldistributive
cardiogenic
obstructive

160
Q

what is shock?

A

significant compromise in oxygen delivery to tissues

161
Q

what are the 3 ways to get shock?

A
  • failure of circulatory system (circulatory shock)
  • failure of blood to carry enough oxygen (V/Q mismatch)
  • failure of tissues to utilise oxygen effectively (cyanide toxicity)
162
Q

what are hyperdynamic pulses?

A

taller as greater difference between diastolic and systolic pressure

163
Q

what is different about cats in shock?

A

can get bradycardia as their HR is closely regulated to core temp so if get cold then HR slows down

164
Q

What is hypovolaemic shock?

A

tissue hypoperfusion secondary to a lack of circulating blood volume
-fluid lost from intravascular volume

165
Q

what is the difference between dehydration and hypovolaemia?

A

-dehydration is fluid loss from all 3 compartments - intracascular, interstitial and intracellular whereas hypovolaemia is reduced intravascular volume

166
Q

what can cause hypovolaemia?

A

haemorrhage
fluid loss into GIT
fluid loss into third space

167
Q

what are some consequences of hypovolaemia?

A

reduced venous return, mismatch in o2 supply/demand, anaerobic metabolism and lactate build up

168
Q

what are signs seen in early compensatory hypovolaemic shock?

A 
HR 130-150
MM normal or even pinker - rapid CRT
bounding hyperdynamic pulses
easily palpable metatarsal pulse
lactate 3-5 mmol/L
169
Q

what are signs seen in late decompensated hypovolaemic shock?

A 
HR 170-220
white / grey MM
long or absent CRT
weak / thready pulses
absent metatarsal pulses
lactate over 8 mmol/L
maybe low bp
170
Q

what is the treatment for hypovolaemic shock?

A
  • IV fluid bolus (isotonic crystalloids) 10-40ml/kg in 20 mins then reases
  • monitor for dyspnoea
171
Q

what is dog blood volume?

A

60-90 ml/kg

172
Q

what is cat blood volume?

A

40-60 ml/kg

173
Q

what is a consideration in fluid therapy in large dogs?

A

the volume needed isnt possible in short amount of time so could give hypertonic crystalloids

174
Q

what may colloids be used in hypovolaemia?

A

they stay in intravascular volume for longer than crystalloids which equally diffuse across all compartments

175
Q

what catheter will give least resistance to IVFT?

A

short and wide

176
Q

What is maldistributive shock?

A

inappropriate vasodilation leading to alteration in distribution of blood flow between the tissues

177
Q

what can cause maldistributive shock?

A

SIRS - systemic inflammatory response syndrome

sepsis

178
Q

what are the signs of maldistributive shock?

A
  • red injected MM
  • very fast CRT
  • sepsis
179
Q

what is SIRS?

A

systemic inflammation and oedema, multiple organ dysfunction

180
Q

what is sepsis?

A

SIRS and documented infection site

181
Q

what is septic shock?

A

sepsis and hypotensive

182
Q

what is septicaemia?

A

sepsis and bacteraemia

183
Q

how do you treat maldistributive shock/.

A

fluids

inotropes/vasopressors to improve BP, perfusion and vascular tone

184
Q

what is cardiogenic shock?

A

failure of the heart as a pump

185
Q

what can cardiogenic shock be secondary to?

A

cardiomyopathies
valvular disease
arrhytmias

186
Q

what is seen with cardiogenic shock?

A

resp signs

very high HR

187
Q

how do you treat cardiogenic shock?

A

-diureticcs
-inotropes, anti-arrhytmics, vasodilators
NO fluids

188
Q

what is obstructive shock?

A

obstruction to blood flow

189
Q

what can cause obstructive shock?

A

pericardial effusion
pulmonary thromboembolism
GDV putting pressure on VC and aorta

year 3 principles (20 decks)

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