Assessment and Treatment of Shock Flashcards
hypoperfusion - define
Local or generalized deficit in tissue blood flow which
results in inadequate oxygen and nutrient delivery and
failure to remove metabolic by-products
Forms/types of shock
Hypovolaemic
Cardiogenic
Obstructive
Maldistributive
Contributors to shock state but not direct causes
Anaemia
Hypoxaemia
key determinants of tissue oxygen delivery
Cardiac output - most important
Perfusion - vasomotor tone
Oxygen carrying capacit
Cardiovascular assessment
Mucous membrane colour Capillary refill time • Heart rate: normal 60-120 dog, 140-200 cat Pulse quality Auscultation Cross reference
causes of hypovolaemia
Haemorrhage, third spacing, severe other fluid losses
Decr venous return
Mismatch in oxygen supply/demand
Anaerobic metabolism
Incr plasma lactate concs
Compensatory through to decompensated stages of
shock
the bodies reaction to hypovolaemia
incr HR white mucous membranes incr CRT decr in pulse amplitude + duration decr metatarsal pulse incr lactate concs
causes of cardiogenic shock
Forward failure
Valvular disease
Cardiomyopathies
Conduction abnormalities
assessment of cardiogenic shock
Signalment and history
Murmur or gallop
Usually left sided failure
Findings in animals with cardiogenic shock
Membranes may be pink
Lactate may be normal
May not be hypotensive
No murmur in some DCM / bradycardic cats
Radiography - Enlarged cardiac silhouette, May have congestive signs
Large left atrium
Treatment of cardiogenic shock
Positive inotropes
Anti-arrhythmics
Furosemide
Vasodilators
SIRS [systemic inflammatory distress syndrome] - define
clinical diagnosis of systemic inflammation, systemic vasculitis and oedema, multiple organ dysfunction or failure
Sepsis - define
SIRS + documented infection site
Septic shock - define
sepsis + hypotension
Septicaemia - define
sepsis and bacteraemia
