Shock1; articles cards 26-41 Flashcards
Calculate volume needed for blood transfusion?
Bloodneeded(ml)=
weight(kg)xDesiredPCV−RecipientPCV
_______________________
Donor’sPCV
Then multiply that number ×70(cat)or90(dog)*
Note: A rough estimate is 2.2ml of blood/kg of body weight increases the recipient’s PCV by 1%.
FAST (Focused Assessment With Sonography for Trauma) Protocol to Detect Free Abdominal Fluid in Dogs
Uses two ultrasonographic views (transverse and longitudinal) for what four regions of the abdomen?
Also included is the conclusion made by Lisciandro jvecc 2009
1Subxiphoid region
2Midline position over the bladder
3Right flank in right and left lateral recumbency, caudal to ribs
4Left flank in left and right lateral recumbency, caudal to ribs
Lisciandro 09: Initial and serial AFAST (A=abdominal) with applied AFS (abdominal fluid scoring) allowed rapid, semiquantitative measure of free abdominal fluid in traumatized patients, was clinically associated with severity of injury, and reliably guided clinical management. Where possible, AFAST and AFS should be applied to the management of blunt trauma cases.
Shock dose for animal with severe pulmonary, cardiac, or renal dz?
one-quarter to one-half the calculated shock dose is administered over 15 to 30 minutes, and the patient is carefully reassessed for changes in vital signs.
Oxygen delivery equation? DO2 = …
DO2 = CO x CaO2
Cardiogenic shock?
results from inability of heart to propel blood through circulation; can be interference with diastolic filling or with the ability to pump (systolic failure). Also can be extracardiac like compression of heart or great vessels by some other pathology (sometimes referred to as obstructive shock as its own category)
hypovolemic shock?
inadequate circulating volume causing decreased preload, thus reduced CO
Distributive shock?
impairment of the mechanisms regulating vascular tone, with maldistribution of the vascular volume and massive systemic vasodilation. Decreased systemic vascular resistance causes “relative” hypovolemia and reduction in venous return. (ie sepsis, SIRS, anaphylactic reactions, or neurogenic shock caused by severe damage to CNS with loss of autonomic stimulation on vessels.
Hypoxic Shock?
inadequate arterial oxygen content of cellular oxygen utilization. Most common causes are anemia (reduced hemoglobin concentration–anemic hypoxia), and hypoxemia associated with respiratory failure
Equation for cardiac output….CO = …?
CO = SV x HR
3 factors that determine stroke volume (SV)?
preload, afterload, and contractility
Preload?
Load imposed on a resting muscle to stretch it to a new length. Preload = End Diastolic Volume; An increase in End Diastolic Volume augments the strength of cardiac contractions (Frank-Starling mechanism). Factors that influence preload: splenic contraction, retention of Na and H2O, and increased thirst
Afterload?
The force that opposes muscle contraction, and in cardiac muscle, it is equivalent to the ventricular wall tension developed during systole. Afterload= “pressure in the left ventricle required to eject blood into systemic circulation”
Afterload is influence mainly by ___ ____ ____.
systemic vascular resistance. Low BP is the major determinant of decreased afterload.
Contractility?
the force and velocity of cardiac muscle contraction
Arterial Oxygen Content (CaO2) Equation?
CaO2 = Hb x SaO2 x 1.34 + PaO2 x 0.003*
Thus, oxygen content depends mainly on Hb concentration and oxygen saturation of Hb in arterial blood (SaO2; measured as %).
(*oxygen solubility coefficient)
SaO2 is the percentage of available hemoglobin that is bound to ____?
oxygen