Shock Flashcards
what is shock
critical imbalance between delivery of O2 and nutrients to cells and utilization of O2 and nutrients by cells
Delivery
untreated shock (all forms) can cause
1) decreased peripheral ciculation (cold/pale)
2) decreased CO, decreased BP, weak pulse
3) decreased urine production (bc low BP= low functioning liver/kidney)
4) tissue anoxia/ death
earliest signs of shock (all forms)
depressed/ anorexia, tachycardia, tachypnea
what kind of shock is hypovolemic shock
fluid loss
possible causes of hypovolemic shock
- deacreased blood volume in circulation= blood loss, dehydration, plasma loss (burn victims epithelial tissue not holding in moisture)
- severe diabetes (hypoglycemia from increase in insulin)
- v/d
signs of hypovolemic shock
all bc of peripheral constriction (shuts down peripheral blood vessles)= prolonged CRT, weak pulse, pale/cyanotic MM, cool extremeties
What kind of shock is Cardiogenic shock
lack of O2 delivery bc poor cardiac funciton
possible causes of cardiogenic shock
heart disease (like cardiomyopathy), heart failure, vascular disorders, heartworm, tumors, hardware disease
signs of cardiogenic shock
weak pulse, hypotension, pale MM, pulmonary edema (lungs filled w fluid) or acites (free fluid in abdomen)
how hypovolemic shock is treated
restore intravascular volume (fluids or tranfusion)
ways to treat cardiogenic shock
antiarrythmics, diuretics (remove fluid)
why cardiogenic shock can cause pulmonary edema or acites
heat inefficiency causes an increase in venous pressure
inefficiency on right side of heart v left
R= blood backed up in vena ceva (dilates and leaks)-> acites L= blood backed up in L atria and pulmonary vein (dilates and leaks) -> pulmonary edema
what is altered blood flow/ distributive shock
conditions that cause generalized vasodilation (and blood pooling) caused by inapropriate blood flow
possible causes of altered blood flow/ distributive shock
drug side effects, heart stroke (dilates blood vessels), sepsis (systemic infection), anaphylaxis, CNS trauma
common cause of altered blood flow/ distributive shock
HBC (hit by car)
bodies are __% water, what percent of this is intracellular fluid __ %
60%, 30-40% intracellular
extracellular fluid is made up of interstitial fluid and intravascular fluid, what are the differences between the two
interstitial= between cells (3/4 ECF) intravascular= plasma in blood vessels (1/4 ECF)
volume of circulating blood in dogs, cats, horses
dogs= 80-90 ml/kg cats= 40-60 ml/kg horses= 80 ml/kg
cell membranes and blood vessels have different degrees of permiability.
which can water move thro? electrolytes? colloids?
water= can move thro cell membranes and blood vessel walls electrolytes= can move thro BV walls, stays in ECF, cant go into cells colloids= cant move thro either, stays in blood vessles
what is osmolality
concentration
difference between hypotonic, isotonic, and hypertonic osmolality in comparison to blood
hypo= osmolality blood
components of a crystalloid fluid
water+ small molecular weight electrolytes
difference between colloid and crystaloid fluids (where they go)
colloids= stays in vascular system (intravascular fluid)and doesnt diffuse into interstitial fluid (bc large molecular weight solutes) crystalloids= readily diffuse in and out of vascular system (anywhere within ECF)
what kind of fluid would we give for extreme head trauma
hypertonic fluid, shifts fluid from interstitial -> vascular space (like hypertonic saline) (draws off edema/ swelling)
Shock volume ( emergency high amount of fluids) for dogs, and cats (first 15 min v first hour)
dogs= 20-40 ml/kg over first 15 min
70-90 ml/kg over first hour
cats= 10-20 ml/kg over first 15 min
35-50ml/kg first hour
normal amount of fluids one would give a cat/dog in a DAY
dog= 25-30ml/kg cat= 12-18 ml/kg
fluid pump vs buretrol
fluid pump= not dep on postion of patient or gravity, maintains amount delivered
buretrol= gravity fed, prevents over hydration, has to be replenished
signs of overhydration
increased lung sounds, increased BP, serous (clear) nasal discharge, edema, conjuntiva edema (check weight/ urine output)
aditional therapies for shock
O2
warm the animal
drugs
why glucocorticoids(steroids) are sometimes used as therapy for shock
stabilize blood vessels (decreasing leakiness), causes vasoconstriction, anti-inflammatory
how to treat septic shock (form of altered bloodflow/ distributive shock) specifically
antibiotics
how to treat cardiogenic shock specifically
lidocaine to decrease arrythmias, cardiac inotropes ( drugs that increase strength of muscles like dobutamine, dopamine, ephedrine)
how to treat shock caused by trauma (distributive shock)
replace fluids (blood or saline), anti-inflammatories, analgesics
how to treat toxic shock (form of distributive shock)
antitoxin or antivenom
how to treat anaphylactic shock
antihistimines (diphenhydramine/ Benadryl), epinephrine (if severly dyspnic (opens airways)
