shock Flashcards
signs of shock
- Pale MM, prolonged CRT
- Cool extremities
- Rapid, weak pulse
- Rapid and shallow respirations
- Hypotension
- Hypothermia
- Weakness
- Tachycardia or Bradycardia are possible
treatment for shock
- control active bleeding
- fluid therapy
- medications
- oxygen supplementation
- vasopressors
- identify underlying cause
shock dose fluid therapy rates
mild to moderate: 20-40 ml/kg
severe dog: 60-90 ml/kg
severe cat: 40-60 ml/kg
hypovolemic
Perfusion failure results from a decrease in the circulating blood volume
causes: Trauma, burns, hemorrhage, severe diarrhea and/or vomiting
treatment:
- Fluid Replacement-IV route is preferred
- Correct and treat underlying problem
- Supply supplemental oxygen (mask, cage)
cardiogenic
Perfusion failure from decreased cardiac output
causes:
- Primary heart disease (cardiomyopathy, valve disease and cardiac arrhythmias)
- Heartworm disease
- Often see pulmonary edema or ascites
- Myocardial infarction (heart attack)
treatment:
- Decrease fluid load with diuretics- eg furosemide
- Support heart contractility- eg digoxin
- ACE inhibitors- eg enalapril
- Positive inotropes- pimobendan (VetMedin®)
neurogenic
Damage to CNS or spinal cord, lack of innervation to blood vessels, dilation and decreased blood pressure
causes:
- Head trauma (HBC)
- Prolonged O2 deprivation
- Spinal anesthesia- epidural
- Cerebral edema??
- Deep general anesthesia
treatment:
- Fluids
- Mannitol IV if blood-brain barrier (BBB) intact
- Supportive therapy until lidocaine is metabolized
- Lessen plane of general anesthesia
- Reversal agents, decrease vaporizer setting
septic
presence of pathogenic organisms and/or their toxins in the blood (blood poisoning)
- High Fever
- High cardiac output from high metabolic needs
causes:
- Peritonitis (ruptured intestine, ruptured uterus), pyometra, severe burns, generalized staph or strep
infections
- Infection can be primary or secondary
treatments:
- Intravenous antibiotics
- Intravenous fluids
- Supplemental oxygen
anaphylactic
Due to severe antigen-antibody reaction (Large release of histamine, vasodilation, decrease blood pressure)
causes: Bee sting, antibiotic administration, IV vaccine
treatment:
- Epinephrine is essential-give ASAP
- Antihistamines
- Diphenhydramine
- Famotidine
- Corticosteroids (Dexamethasone)
hypoxic
Normal tissue perfusion but abnormal oxygenation or oxygen unloading to tissues and cells
causes: hypoxemia (low partial pressure of O2 or low hemoglobin saturation due to pulmonary disease), anemia
treatment:
- Oxygen therapy
- IPPV for patients with pulmonary disease
- Blood transfusion or other hemoglobin-containing substances
what types of shock does distributive include
septic
anaphylactic
neurologic
heatstroke
shock
A severe hemodynamic disturbance in which the circulatory system fails to maintain adequate perfusion of the vital organs
specific disturbances with shock
- decreased blood flow (tissue perfusion)
- impaired oxygen delivery
- inadequate cellular energy production
- limited waste product removal
