Management Of Shock/trauma Flashcards
Define shock
Inadequate cellular energy production
What is distributive shock
Flow maldistribution
Initiating causes of distributive shock
Sepsis, anaphylaxis, trauma, neurogenic
What is hypoxic shock
Decrease in o2 content of arterial blood.
What is metabolic shock
Tissues in the body have inadequate supply of nutrients for cellular energy production or when the cells are unable to use it
What is obstructive shock
From physical obstruction in the circulatory system
What are some initiation causes of obstructive shock
HW disease, gastric torsion, pulmonary embolism, pericardial effusion
What is hypovolemic shock
Caused by Decrease intravascular volume
What is the most common form of shock seen in animals
Hypovolemic shock
Define cardiac output
The product of stroke volume and heart rate
What is stroke volume
The amount of blood pumped out of the heart with each beat
What is the main carrier of oxygen in the blood
Hemoglobin
Vasodilation contributes to what type of shock
Distributive shock
What are the physical assessments that indicate a bleeding problem (anemia)
Pale mm, prolonged CRT, increased HR
What are the physical assessments that indicate a coagulation problem
Petechia,ecchymosis, epistaxis, hematuria, hemothorax, hemoabdomen, lethargic
Explain backward CHF
Buildup of blood that causes fluid to leak into the lungs and other body cavities
Explain forward CHF
Low output from the heart
What are the steps for Basic life support
Compressions
Airway
Breathing
How many breaths per minute when giving basic life support
10
What BPM should compressions be at during CPR
100-120bpm
End tidal values (ETCO2) should be around what
40-45mm hg
Epinephrine should be given at low dose _______ and administered every __to__min.
0.01mg/kg,
3-5min
What is Vasopressin and when would it be used
It is a Vasoconstrictor
Used in treatment of cardiac arrest
What is the suggested dose of vasopressin and how often should is he given?
0.8units/kg every 3-5min
What is the recommended dose for atropine
0.04mg/kg
What would ventricular fibrillation look like on a ECG
Chaotic electrical activity (quivering back of worms if viewed)
What does asystole on an ECG look like
Straight line, no electrical or mechanical activity
What is trauma triad of death
Acidosis
Hypothermia
Coagulopathy
What is the goal for albumin values
> 2.0
What is the goal value for TS
> 4.5
What is the goal value of the pulse oximeter
> 94
Most common hereditary bleeding defect in dogs is
Von Willebrand disease
What is hypoxemia ?
A patient is hypotensive when the MAP BP lower than ____ mm Hg
60
What monitor should be used to asses ventilation in anesthetized patients
Capnometry
Describe and asystole ECG reading
Straight line
There is no electrical or mechanical activity
What drugs are typically used to treat Asystole rhythm
Epinephrine, vasopressin, atropine
Describe a ventricular tachycardia ECG rhythm
No pulse is detected, but looks like large hills and valleys
Considered a shockable rhythm
Greater than 200BPM
How much SQ fluid can you administer safely at one site
10ml/kg
What is the most common type of fluid used in vet med
Isotonic crystalloids
What type of transfusion therapy is used for post trauma with significant blood loss
Whole blood
What type of transfusion therapy is used for coagulation disorders or hypoalbuminemia
Fresh frozen plasma
What type of transfusion therapy is used for increased RBC destruction or decreased RBC production
Packed RBC
Which type of canine blood is the most antigenic and should only be given to patients with the same blood type
DEA 1 positive
What type of transfusion reaction is seen in a patent with edema, respiratory distress, coughing, hypertension and jugular distention
Transfusion associated circulatory overload
What type of transfusion reaction is seen in patients with facial swelling, urticaria, fever to anaphylaxis
Hypersensitivity type 1
What type of transfusion reaction is seen in patients that have a fever, salivation, vomiting, DIC, and hemoglobinuria
Acute hemolytic reaction
You have a patient with pale mm, tachycardia, slightly prolonged CRT. Which phase of shock is your patient most likely in
Compensated
Shock index =
HR/ systolic BP
What do you expect PCV and TP to be in dehydration patients
Both increased
What is the goal of ETCO2 measurement during CPR
> 15mm Hg
What is the most appropriate action when the ECG reading indicates Ventricular fibrillation
Perform defibrillation
What is the most appropriate action when your patient has a cardiopulmonary arrest during anesthesia
Reverse or stop all anesthetic agents
What are the 3 findings that make up the trauma triad of death
Hypothermia, coagulopathy, acidosis
Hypothermia During trauma is associated with
Higher morbidity and mortality
What is the goal for systolic blood pressure for trauma patients
Between 90-130mm hg
What is the imbalance between bleeding, coagulation, and fibrinolysis that is often caused by systemic inflammation
Disseminated intravascular coagulation
What is a condition of hyaocoagulability and hyper fibrinolysis that can occur within an hour of trauma
Acute traumatic coagulopathy
Decrease in PCV or RBC count indicates
Anemia
Volume of blood entering the heart is
Preload
Force against which the head ejects =
After load
What is it called when the heart no longer is able to pump blood efficiently and fluids build up in the lungs
CHF
What category of drugs are used to decrease pulmonary edema
Loop diuretics
What heart disease is caused by heart worms blocking the pulmonary artery
Caval syndrome
Doses of analgesics may need to be decreased to ___ to____% of normal in critical patients
25-50%
