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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

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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

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4
Q

what is a cardiopulmonary arrest?

A

cessation of effective cardiac activity and respiration

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5
Q

what is return of spontaneous circulation?

A

ROSC - re-establishment of sustained CO without assitance

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6
Q

what is basic life support?

A

compressions and assisted ventilation

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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

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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
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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
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11
Q

how do you carry out CPR?

A

in R lateral recumbency

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

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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

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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

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24
Q

what is atropine?

A

muscarinic antagonist

increases HR as anti-para

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25
what is lidocaine?
neuronal Na channel blocker | -antiarrhythmic and local anaesthetic
26
what % dehdration is needed before a skin tent remains and have dry mm and sunken eyes?
8-10%
27
what % of dehydration is needed for hypovolaemia signs?
over 12%
28
What are the signs of hypovolaemia?
``` tachycardic low pulse pressure low jugular filling tachypnoea cold extremitis low urine output ```
29
what are signs of dehydration?
prolonged skin tent tacky mm sunken eyes
30
how do you calculate the fluid defecit?
BW (kg) x %dehydrated (10% = 0.1)
31
what happens if you give propofol too fast?
``` tachycardia hypotension apnoea --cardiopulmonary arrest -start CPR and antagonise a2 and turn off any inhalant ```
32
what can cause tachycardia during surgery?
``` pain too light hypovolaemia hypotensive hypoxaemia hypercapnia hyperthermia hypovolaemia ```
33
what can indicate the anaesthetic is too light?
tachycardic tachypnoeic hypertensive
34
what can cause reduced SpO2?
- Et tube obstruction | - medetomidine causing vasoconstriction in first 10-15 mins
35
what are the 4 types of circulatory shock?
hypovolaemic maldistributive cardiogenic obstructive
36
what is shock?
significant compromise in oxygen delivery to tissues
37
what are the 3 ways to get shock?
- 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)
38
what are hyperdynamic pulses?
taller as greater difference between diastolic and systolic pressure
39
what is different about cats in shock?
can get bradycardia as their HR is closely regulated to core temp so if get cold then HR slows down
40
What is hypovolaemic shock?
tissue hypoperfusion secondary to a lack of circulating blood volume -fluid lost from intravascular volume
41
what is the difference between dehydration and hypovolaemia?
-dehydration is fluid loss from all 3 compartments - intracascular, interstitial and intracellular whereas hypovolaemia is reduced intravascular volume
42
what can cause hypovolaemia?
haemorrhage fluid loss into GIT fluid loss into third space
43
what are some consequences of hypovolaemia?
reduced venous return, mismatch in o2 supply/demand, anaerobic metabolism and lactate build up
44
what are signs seen in early compensatory hypovolaemic shock?
``` HR 130-150 MM normal or even pinker - rapid CRT bounding hyperdynamic pulses easily palpable metatarsal pulse lactate 3-5 mmol/L ```
45
what are signs seen in late decompensated hypovolaemic shock?
``` HR 170-220 white / grey MM long or absent CRT weak / thready pulses absent metatarsal pulses lactate over 8 mmol/L maybe low bp ```
46
what is the treatment for hypovolaemic shock?
- IV fluid bolus (isotonic crystalloids) 10-40ml/kg in 20 mins then reases - monitor for dyspnoea
47
what is dog blood volume?
60-90 ml/kg
48
what is cat blood volume?
40-60 ml/kg
49
what is a consideration in fluid therapy in large dogs?
the volume needed isnt possible in short amount of time so could give hypertonic crystalloids
50
what may colloids be used in hypovolaemia?
they stay in intravascular volume for longer than crystalloids which equally diffuse across all compartments
51
what catheter will give least resistance to IVFT?
short and wide
52
What is maldistributive shock?
inappropriate vasodilation leading to alteration in distribution of blood flow between the tissues
53
what can cause maldistributive shock?
SIRS - systemic inflammatory response syndrome | sepsis
54
what are the signs of maldistributive shock?
- red injected MM - very fast CRT - sepsis
55
what is SIRS?
systemic inflammation and oedema, multiple organ dysfunction
56
what is sepsis?
SIRS and documented infection site
57
what is septic shock?
sepsis and hypotensive
58
what is septicaemia?
sepsis and bacteraemia
59
how do you treat maldistributive shock/.
fluids | inotropes/vasopressors to improve BP, perfusion and vascular tone
60
what is cardiogenic shock?
failure of the heart as a pump
61
what can cardiogenic shock be secondary to?
cardiomyopathies valvular disease arrhytmias
62
what is seen with cardiogenic shock?
resp signs | very high HR
63
how do you treat cardiogenic shock?
-diureticcs -inotropes, anti-arrhytmics, vasodilators NO fluids
64
what is obstructive shock?
obstruction to blood flow
65
what can cause obstructive shock?
pericardial effusion pulmonary thromboembolism GDV putting pressure on VC and aorta
66
what is a cardiopulmonary arrest?
cessation of effective cardiac activity and respiration
67
what is return of spontaneous circulation?
ROSC - re-establishment of sustained CO without assitance
68
what is basic life support?
compressions and assisted ventilation
69
what is advanced cardiac life support?
basic life support + medical + electrical intervention
70
what often preceeds a cardiopulmonary arrest?
hypoventilation | bradycardia
71
what are some ECG changes to look out for?
``` ventricular tachycardia ventricular flutter 3rd degree AV block atrial standstill ST depression R on T phenomenon ```
72
What is a vagal arrest?
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
73
how do you carry out CPR?
in R lateral recumbency | on an AmbuBag for 100% oxygen and +ve pressure ventilation
74
what rate of respiration should you do with CPR?
12-15 bpm
75
when is closed chest CPR suitable
under 7 kg do cardiac pump and over 7kg do thoracic pump
76
what is the rate of chest compressions?
100 bpm | let thorax spring back completley
77
when is open chest CPR considered?
- already under anaesthesia - very large dogs - pleural space / pericardial disease - penetrating chest trauma - haemoabdomen
78
When would you give adrenaline?
pulseless electrical activity | asystole
79
when would atropine be given?
sinus bradycardia
80
when would lidocaine be given?
sinus tachycardia
81
when is calcium gluconate given?
if have hypocalcaemia and hyperkalaemia
82
when would you give sodium bicarbonate?
acidic ph
83
when would you give lidocaine?
ventricular tachycardia
84
what drugs can be given via an ET tube?
``` Naloxene Atropine Vasopressin Epinephrine Lidocaine ``` NAVEL
85
what is Naloxene?
an opioid antagonist
86
what is atropine?
muscarinic antagonist | increases HR as anti-para
87
what is lidocaine?
neuronal Na channel blocker | -antiarrhythmic and local anaesthetic
88
what % dehdration is needed before a skin tent remains and have dry mm and sunken eyes?
8-10%
89
what % of dehydration is needed for hypovolaemia signs?
over 12%
90
What are the signs of hypovolaemia?
``` tachycardic low pulse pressure low jugular filling tachypnoea cold extremitis low urine output ```
91
what are signs of dehydration?
prolonged skin tent tacky mm sunken eyes
92
how do you calculate the fluid defecit?
BW (kg) x %dehydrated (10% = 0.1)
93
what happens if you give propofol too fast?
``` tachycardia hypotension apnoea --cardiopulmonary arrest -start CPR and antagonise a2 and turn off any inhalant ```
94
what can cause tachycardia during surgery?
``` pain too light hypovolaemia hypotensive hypoxaemia hypercapnia hyperthermia hypovolaemia ```
95
what can indicate the anaesthetic is too light?
tachycardic tachypnoeic hypertensive
96
what can cause reduced SpO2?
- Et tube obstruction | - medetomidine causing vasoconstriction in first 10-15 mins
97
what are the 4 types of circulatory shock?
hypovolaemic maldistributive cardiogenic obstructive
98
what is shock?
significant compromise in oxygen delivery to tissues
99
what are the 3 ways to get shock?
- 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
what are hyperdynamic pulses?
taller as greater difference between diastolic and systolic pressure
101
what is different about cats in shock?
can get bradycardia as their HR is closely regulated to core temp so if get cold then HR slows down
102
What is hypovolaemic shock?
tissue hypoperfusion secondary to a lack of circulating blood volume -fluid lost from intravascular volume
103
what is the difference between dehydration and hypovolaemia?
-dehydration is fluid loss from all 3 compartments - intracascular, interstitial and intracellular whereas hypovolaemia is reduced intravascular volume
104
what can cause hypovolaemia?
haemorrhage fluid loss into GIT fluid loss into third space
105
what are some consequences of hypovolaemia?
reduced venous return, mismatch in o2 supply/demand, anaerobic metabolism and lactate build up
106
what are signs seen in early compensatory hypovolaemic shock?
``` HR 130-150 MM normal or even pinker - rapid CRT bounding hyperdynamic pulses easily palpable metatarsal pulse lactate 3-5 mmol/L ```
107
what are signs seen in late decompensated hypovolaemic shock?
``` 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
what is the treatment for hypovolaemic shock?
- IV fluid bolus (isotonic crystalloids) 10-40ml/kg in 20 mins then reases - monitor for dyspnoea
109
what is dog blood volume?
60-90 ml/kg
110
what is cat blood volume?
40-60 ml/kg
111
what is a consideration in fluid therapy in large dogs?
the volume needed isnt possible in short amount of time so could give hypertonic crystalloids
112
what may colloids be used in hypovolaemia?
they stay in intravascular volume for longer than crystalloids which equally diffuse across all compartments
113
what catheter will give least resistance to IVFT?
short and wide
114
What is maldistributive shock?
inappropriate vasodilation leading to alteration in distribution of blood flow between the tissues
115
what can cause maldistributive shock?
SIRS - systemic inflammatory response syndrome | sepsis
116
what are the signs of maldistributive shock?
- red injected MM - very fast CRT - sepsis
117
what is SIRS?
systemic inflammation and oedema, multiple organ dysfunction
118
what is sepsis?
SIRS and documented infection site
119
what is septic shock?
sepsis and hypotensive
120
what is septicaemia?
sepsis and bacteraemia
121
how do you treat maldistributive shock/.
fluids | inotropes/vasopressors to improve BP, perfusion and vascular tone
122
what is cardiogenic shock?
failure of the heart as a pump
123
what can cardiogenic shock be secondary to?
cardiomyopathies valvular disease arrhytmias
124
what is seen with cardiogenic shock?
resp signs | very high HR
125
how do you treat cardiogenic shock?
-diureticcs -inotropes, anti-arrhytmics, vasodilators NO fluids
126
what is obstructive shock?
obstruction to blood flow
127
what can cause obstructive shock?
pericardial effusion pulmonary thromboembolism GDV putting pressure on VC and aorta
128
what is a cardiopulmonary arrest?
cessation of effective cardiac activity and respiration
129
what is return of spontaneous circulation?
ROSC - re-establishment of sustained CO without assitance
130
what is basic life support?
compressions and assisted ventilation
131
what is advanced cardiac life support?
basic life support + medical + electrical intervention
132
what often preceeds a cardiopulmonary arrest?
hypoventilation | bradycardia
133
what are some ECG changes to look out for?
``` ventricular tachycardia ventricular flutter 3rd degree AV block atrial standstill ST depression R on T phenomenon ```
134
What is a vagal arrest?
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
how do you carry out CPR?
in R lateral recumbency | on an AmbuBag for 100% oxygen and +ve pressure ventilation
136
what rate of respiration should you do with CPR?
12-15 bpm
137
when is closed chest CPR suitable
under 7 kg do cardiac pump and over 7kg do thoracic pump
138
what is the rate of chest compressions?
100 bpm | let thorax spring back completley
139
when is open chest CPR considered?
- already under anaesthesia - very large dogs - pleural space / pericardial disease - penetrating chest trauma - haemoabdomen
140
When would you give adrenaline?
pulseless electrical activity | asystole
141
when would atropine be given?
sinus bradycardia
142
when would lidocaine be given?
sinus tachycardia
143
when is calcium gluconate given?
if have hypocalcaemia and hyperkalaemia
144
when would you give sodium bicarbonate?
acidic ph
145
when would you give lidocaine?
ventricular tachycardia
146
what drugs can be given via an ET tube?
``` Naloxene Atropine Vasopressin Epinephrine Lidocaine ``` NAVEL
147
what is Naloxene?
an opioid antagonist
148
what is atropine?
muscarinic antagonist | increases HR as anti-para
149
what is lidocaine?
neuronal Na channel blocker | -antiarrhythmic and local anaesthetic
150
what % dehdration is needed before a skin tent remains and have dry mm and sunken eyes?
8-10%
151
what % of dehydration is needed for hypovolaemia signs?
over 12%
152
What are the signs of hypovolaemia?
``` tachycardic low pulse pressure low jugular filling tachypnoea cold extremitis low urine output ```
153
what are signs of dehydration?
prolonged skin tent tacky mm sunken eyes
154
how do you calculate the fluid defecit?
BW (kg) x %dehydrated (10% = 0.1)
155
what happens if you give propofol too fast?
``` tachycardia hypotension apnoea --cardiopulmonary arrest -start CPR and antagonise a2 and turn off any inhalant ```
156
what can cause tachycardia during surgery?
``` pain too light hypovolaemia hypotensive hypoxaemia hypercapnia hyperthermia hypovolaemia ```
157
what can indicate the anaesthetic is too light?
tachycardic tachypnoeic hypertensive
158
what can cause reduced SpO2?
- Et tube obstruction | - medetomidine causing vasoconstriction in first 10-15 mins
159
what are the 4 types of circulatory shock?
hypovolaemic maldistributive cardiogenic obstructive
160
what is shock?
significant compromise in oxygen delivery to tissues
161
what are the 3 ways to get shock?
- 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
what are hyperdynamic pulses?
taller as greater difference between diastolic and systolic pressure
163
what is different about cats in shock?
can get bradycardia as their HR is closely regulated to core temp so if get cold then HR slows down
164
What is hypovolaemic shock?
tissue hypoperfusion secondary to a lack of circulating blood volume -fluid lost from intravascular volume
165
what is the difference between dehydration and hypovolaemia?
-dehydration is fluid loss from all 3 compartments - intracascular, interstitial and intracellular whereas hypovolaemia is reduced intravascular volume
166
what can cause hypovolaemia?
haemorrhage fluid loss into GIT fluid loss into third space
167
what are some consequences of hypovolaemia?
reduced venous return, mismatch in o2 supply/demand, anaerobic metabolism and lactate build up
168
what are signs seen in early compensatory hypovolaemic shock?
``` HR 130-150 MM normal or even pinker - rapid CRT bounding hyperdynamic pulses easily palpable metatarsal pulse lactate 3-5 mmol/L ```
169
what are signs seen in late decompensated hypovolaemic shock?
``` 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
what is the treatment for hypovolaemic shock?
- IV fluid bolus (isotonic crystalloids) 10-40ml/kg in 20 mins then reases - monitor for dyspnoea
171
what is dog blood volume?
60-90 ml/kg
172
what is cat blood volume?
40-60 ml/kg
173
what is a consideration in fluid therapy in large dogs?
the volume needed isnt possible in short amount of time so could give hypertonic crystalloids
174
what may colloids be used in hypovolaemia?
they stay in intravascular volume for longer than crystalloids which equally diffuse across all compartments
175
what catheter will give least resistance to IVFT?
short and wide
176
What is maldistributive shock?
inappropriate vasodilation leading to alteration in distribution of blood flow between the tissues
177
what can cause maldistributive shock?
SIRS - systemic inflammatory response syndrome | sepsis
178
what are the signs of maldistributive shock?
- red injected MM - very fast CRT - sepsis
179
what is SIRS?
systemic inflammation and oedema, multiple organ dysfunction
180
what is sepsis?
SIRS and documented infection site
181
what is septic shock?
sepsis and hypotensive
182
what is septicaemia?
sepsis and bacteraemia
183
how do you treat maldistributive shock/.
fluids | inotropes/vasopressors to improve BP, perfusion and vascular tone
184
what is cardiogenic shock?
failure of the heart as a pump
185
what can cardiogenic shock be secondary to?
cardiomyopathies valvular disease arrhytmias
186
what is seen with cardiogenic shock?
resp signs | very high HR
187
how do you treat cardiogenic shock?
-diureticcs -inotropes, anti-arrhytmics, vasodilators NO fluids
188
what is obstructive shock?
obstruction to blood flow
189
what can cause obstructive shock?
pericardial effusion pulmonary thromboembolism GDV putting pressure on VC and aorta

year 3 principles (20 decks)

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