Emergency & Critical Care Flashcards
Do NOT use epinephrine to treat
Cardiac effects due to (other) alpha agonists (ie, alpha 2 agonists such as detomidine, dexmedetomidine, medetomidine, xylazine)
Epinephrine actions
Alpha and beta adrenergic agonist that:
relaxes smooth muscle in the bronchi and iris
Antagonizes histamine effects
Increases glycogenolyisis/ raises BG
Direct stimulation of heart (given rapidly IV); increased contractility and SBP
Decreases total peripheral resistance b/c of beta activity
Factors contributing to hypotension
Bradycardia, hypothermia, hypercalcemia, anemia
Bradycardia (definition)
HR < 120 bpm
Cats differ from dogs (& humans) in that when their sympathetic system is stimulated, …
…the parasympathetic system is also stimulated (vagal nerve firing), which means we don’t see compensatory tachycardia. Will see normal HR or bradycardia b/c of concurrent vagal firing.
With hypothermia, SVR __
Drops
If you see this on ECG, your patient requires warming (is hypothermic)
J-wave or osborne wave
Hypocalcemia can result in decreased
Cardiac contactility and SVR
Acidosis can cause
Depressed myocardial contractility
Resistance to catecholamines
Peripheral arteriolar vasodilation
Acidosis (definition)
pH < 7.2
Common causes of low iCa2+
CKD
Acute pancreatitis
Eclampsia
The “triad of death” (drop what you are doing for this patient!)
Bradycardia
Hypothermia
Hypotension
Stop active rearming when patient temp reaches
~98°
For improved contractility, reach for
Dopamine (IV CRI @ 10 mg/kg/min)
OR
Epinephrine/norepinephrine
Clinical signs of reduced SVR (vasodilation)
Hyperemic mucous membranes
Brisk CRT (<1s)
Hyperkinetic (bounding) pulses
