MWD(56-63) Flashcards
Mild Sedation MWD
- Relax for examination, handling, reducing anxiety
- MWD will be calm but reactive to noise and stimulation
MWD Deep Sedation
- First line for fractious MWD
- MWD will not be able to walk, may be aroused with stimulation
Mild Sedation Drugs
Midazolam 0.3 mg/kg IM/IN AND Hydromorphone 0.2mg/kg IM/IN OR Morphine 0.2mg/kg IM/IN
Deep Sedation MWD
Midazolam 0.3 mg/kg AND Ketamine 5 mg/kg
or
Hydromorphone 0.1 mg/kg IM or Morphine 0.1 mg/kg IM/IN
MWD Analgesia Intermittent IV/IM
Hydromorphone 0.1-0.2 mg/kg (q2-4 hrs)
* Morphine Sulfate 0.2-0.5 mg/kg (q4-6 hrs)
* Fentanyl 2-10 mcg/kg (ONCE, then CRI)
MWD CRI
Fentanyl 2-10 mcg/kg/hr
Morphine 0.1-0.25 mg/kg/hr
Hydromorphone 0.02-0.05 mg/kg/hr
MWD Naloxone
0.01-0.02 mg/kg to effect
What will hydromorphone cause in MWDs?
Excessive panting
MWD CPR
- Compression 100/min over widest part of chest
- Intubate(8-10/min)
- EKG
- IV/IO
- 2J/kg x 3 times with 1 cycle in between(2 min)
- Epi 0.01 mg/kg or vasopressin 0.8 U/kg once and lido 2 mg/kg or amiodarone 5-10 mg/kg
Asystole/PEA
- Atropine 0.04 mg/kg
- Epi 0.01 mg/kg and vaso 0.8 mg/kg ONCE
MWD GDV Fluids
- Fluids x 4/hr(wt*10) q 10-20
- If refractory then hetastarch 10-20 mL/kg x 2, for BP
MWD GDV Stomach decompression
- Position on left side
- Palpate last rib, move hand 2 inches caudal, midway between spine and the ventral border of the abdomen on the right side
- Decompress 2 times MAX
MWD Heat injury classifications
Mild: Excessive thirst with CONTROLLED panting(alcohol test)
Moderate: Weakness, UNCONTROLLED panting
Severe: AMS. Seizures, abnormal pupils, ataxia
Moderate Heat exhaustion MWD
- IV 3-5 mL/kg/hr
- Soak hair to the skin with room temp water
Severe Heat Stroke MWD
- Airway, O2, IV
- Aggressively cool until <105
Normal temp MWD
99.5-103
When to cease cooling MWD
103
Seizure MWD heat
0.3 mg/kg midazolam/diazepam IV/IO/IN
What do MWDs commonly display after heat stroke?
Prolonged clotting time, platelet abnormalities
MWD Normal Vitals
60-120
16-32
120/80
99.5-103
30-35 kg
MWD Fluid Therapy
- 90ml/kg in one hour
- HES 10-20 ml/kg over 5-10 min if after 2 boluses indications do not disperse
- HTS 4mL/kg over 5 min after 2 or 3 boluses of fluid and 1 or 2 boluses of HES
- TXA 10mg/kg in 100 mL over 15 min, not later than 3 hrs
