Shock Flashcards
What is shock?
Decreased flow of oxygen to tissues, thereby causing a decreased use of oxygen by tissues
What three mechanisms cause decreased distribution of oxygen to tissues (D02)?
Cardiogenic shock
Distributive shock
Hypovolemic shock
What are examples of hypovolemic or circulatory shock?
Severe dehydration
Hemorrhage
Trauma
What are examples of cardiogenic shock?
Cardiac arrhythmias
Cardiac tamponade
Congestive heart failure
Drug overdose
What are examples of distributive shock?
Anaphylaxis
Obstruction (thrombus, heartworm, etc.)
Sepsis
What are examples of hypoxemic shock?
Anemia
Carbon monoxide toxicity
Methomeglobinemia
Pulmonary disease
What are examples of metabolic shock?
Cyanide intoxication
Cytopathic hypoxia secondary to sepsis
Hypoglycemia
What clinical signs are noted with hyperdynamic/ compensatory phase of shock?
Elevated or normal HR Elevated or normal RR Injected/ hyperemic MM Rapid CRT (< 1 sec) Bounding or normal peripheral pulses Increased/ normal blood pressure
Cats have slight different signs:
Pale MM
Hypothermic and cool extremities
Generalized weakness
What clinical signs are noted with hypodynamic/ early decompensatory phase of shock?
Hypothermia Poor peripheral pulse quality Pale MM Normal/ decreased blood pressure Prolonged CRT Tachycardia Oliguria Dull mentation
What clinical signs are noted with terminal/ late decompensatory phase of shock?
Stupor/ coma Hypothermia Bradycardia Weak/ peripheral pulses Pale/ cyanotic MM
What mean blood pressure do want to keep above during shock
> 65 mmHg
What should minimum urine output be?
> 1-2 mL/kg/day
What is the first goal of therapy for shock?
Restoring the circulatory system and supportive to cardiac system with IV fluids
What should blood lactate levels be normally? When is this a poor prognostic indicator?
Normal: < 2.5
Poor prognosis: > 7.0
When should plasma be administered to patients?
When a coagulopathy is present
When should whole blood be administered to patients?
When anemia is present
What are physical exam signs of cardiogenic shock?
Respiratory distress Tachycardia Hypothermia Heart murmur Gallop rhythm Jugular distension
What is urticaria?
Superficial skin allergic reaction resulting in wheals
What is angioedema?
Deep inflammation of blood vessels resulting in edema and localized swelling
What is anaphylaxis?
A severe allergic reaction occurring 30 minutes after an insult
Patients should be monitored 12-24 hours after event
What is the main shock organ in dogs? What are common clinical signs of anaphylaxis in dogs?
Liver is shock organ Excitability Vomiting Defecation Urination Respiratory depression Collapse Peracute death
What is the main shock organ in cats? What are common clinical signs of anaphylaxis in cats?
Respiratory and GI tracts Facial pruritus Hypersalivation Ataxia Dyspnea Vomiting Diarrhea Collapse Peracute death
What insects can cause anaphylaxis?
Bees Hornets Wasps Yellow jackets Ants
What medicines can cause anaphylaxis?
Vaccines
Antibiotics (penicillins, sulfa, BNP in cats)
Food allergies
Contact Allergies
