Assessment and Treatment of Shock Flashcards Preview

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Flashcards in Assessment and Treatment of Shock Deck (23)
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1
Q

hypoperfusion - define

A

Local or generalized deficit in tissue blood flow which
results in inadequate oxygen and nutrient delivery and
failure to remove metabolic by-products

2
Q

Forms/types of shock

A

Hypovolaemic
Cardiogenic
Obstructive
Maldistributive

3
Q

Contributors to shock state but not direct causes

A

Anaemia

Hypoxaemia

4
Q

key determinants of tissue oxygen delivery

A

Cardiac output - most important
Perfusion - vasomotor tone
Oxygen carrying capacit

5
Q

Cardiovascular assessment

A
Mucous membrane colour 
Capillary refill time 
• Heart rate: normal 60-120 dog, 140-200 cat 
Pulse quality
Auscultation 
Cross reference
6
Q

causes of hypovolaemia

A

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

7
Q

the bodies reaction to hypovolaemia

A
incr HR
white mucous membranes
incr CRT
decr in pulse amplitude + duration
decr metatarsal pulse
incr lactate concs
8
Q

causes of cardiogenic shock

A

Forward failure
Valvular disease
Cardiomyopathies
Conduction abnormalities

9
Q

assessment of cardiogenic shock

A

Signalment and history
Murmur or gallop
Usually left sided failure

10
Q

Findings in animals with cardiogenic shock

A

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

11
Q

Treatment of cardiogenic shock

A

Positive inotropes
Anti-arrhythmics
Furosemide
Vasodilators

12
Q

SIRS [systemic inflammatory distress syndrome] - define

A

clinical diagnosis of systemic inflammation, systemic vasculitis and oedema, multiple organ dysfunction or failure

13
Q

Sepsis - define

A

SIRS + documented infection site

14
Q

Septic shock - define

A

sepsis + hypotension

15
Q

Septicaemia - define

A

sepsis and bacteraemia

16
Q

Hypodynamic sepsis/SIRS - PE

A

Tachycardia
Congested/cyanotic mucous membranes
Fast CRT
Tall narrow pulses

17
Q

cats - 2 types of response to sepsis

A

Compensated (Completely happy)

Decompensated (Dead or dying)

18
Q

maldistributive shock - PE

A

Bradycardia (<140BPM – that’s a relative bradycardia)
Hypotension
Hypothermia
Pale mucous membranes

19
Q

maldistributive shock - treatment

A

fluids*

treat underlying disease

20
Q

Obstructive shock - causes

A
Poor filling pressures due to obstruction 
Pericardial effusion 
Gastric dilatation and volvulus 
Tension pneumothorax 
Pulmonary thromboembolism
21
Q

obstructive shock - diagnosis

A
Signalment 
History 
Auscultation 
Palpation 
Radiographs - Size of caudal vena cava relative to perfusion status
22
Q

Pericardial effusion - signs on PE

A
Muffled heart sounds 
No apex beat 
Pulsus paradoxus 
Weak femoral pulses 
Jugular distension
23
Q

Treatment of obstructive shock

A

Address underlying disease
Can you relieve the “obstruction”?
Not necessarily fluids, but can be used in conjunction in certain cases