Shock and Resuscitation Flashcards
what should you ensure stability of with a patient in shock?
heart
brain
lungs
what is shock?
a syndrome characterized by reduced tissue perfusion, impaired oxygen delivery and inadequate cellular energy productin
what are the types of shock?
hypovolemic
septic
cardiogenic
neurogenic
anaphylactic
what are the mechanisms of shock?
intravascular volume loss
loss of vascular tone
cardiac pump failure
others
what are clinical signs of shock?
altered mentation
tachypnea
tachycardia
cool extremities
hypotension: late
what are the compensatory mechanisms for hypovolemic shock?
increased heart rate
increased stroke volume
increased vascular tone
what is required for you to give hypertonic saline?
pre-existing normovolemia
what are crystalloids?
small molecules in water that freely cross interstitium
what is septic shock?
endotoxin release into systemic circulation
trigger inflammatory mediators
how can you increase vascular tone in septic shock?
dopamine
norepinephrine
what are clinical signs of cardiogenic shock?
tachycardia
poor pulse quality
murmur/gallop
crackles
jugular venous distension
hypothermia
what are some vasodilators?
nitroglycerin paste
nitroprusside
hydralazine
how can you identify shock?
abnormalities of heart, brain, lungs apparent on physical exam
clear evidence of systemic disease
when is hypertonic saline preferred?
large dogs
small bore IVC
head trauma or lung injury?
what is the dose of hypertonic saline?
3-5 ml/kg
what are hyperdynamic dogs like?
fever
injected MM
short CRT
bounding pulses
tachycardia
what are broad spectrum antibiotic options for septic shock?
cefazolin + gentamicin + metronidazole
ampicillin + enrofloxacin
how can you increase cardiac output with septic shock?
dobutamine
what are the benefits of glucocorticoids in septic shock?
anti-inflammatory
what is cardiogenic shock?
diminished cardiac output due to myocardial disease
what are some positive inotropes for cardiogenic shock?
dobutamine
digoxin
