Management Of Shock/trauma Flashcards

1
Q

Define shock

A

Inadequate cellular energy production

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2
Q

What is distributive shock

A

Flow maldistribution

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3
Q

Initiating causes of distributive shock

A

Sepsis, anaphylaxis, trauma, neurogenic

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4
Q

What is hypoxic shock

A

Decrease in o2 content of arterial blood.

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5
Q

What is metabolic shock

A

Tissues in the body have inadequate supply of nutrients for cellular energy production or when the cells are unable to use it

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6
Q

What is obstructive shock

A

From physical obstruction in the circulatory system

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7
Q

What are some initiation causes of obstructive shock

A

HW disease, gastric torsion, pulmonary embolism, pericardial effusion

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8
Q

What is hypovolemic shock

A

Caused by Decrease intravascular volume

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9
Q

What is the most common form of shock seen in animals

A

Hypovolemic shock

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10
Q

Define cardiac output

A

The product of stroke volume and heart rate

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11
Q

What is stroke volume

A

The amount of blood pumped out of the heart with each beat

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12
Q

What is the main carrier of oxygen in the blood

A

Hemoglobin

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13
Q

Vasodilation contributes to what type of shock

A

Distributive shock

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14
Q

What are the physical assessments that indicate a bleeding problem (anemia)

A

Pale mm, prolonged CRT, increased HR

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15
Q

What are the physical assessments that indicate a coagulation problem

A

Petechia,ecchymosis, epistaxis, hematuria, hemothorax, hemoabdomen, lethargic

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16
Q

Explain backward CHF

A

Buildup of blood that causes fluid to leak into the lungs and other body cavities

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17
Q

Explain forward CHF

A

Low output from the heart

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18
Q

What are the steps for Basic life support

A

Compressions
Airway
Breathing

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19
Q

How many breaths per minute when giving basic life support

A

10

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20
Q

What BPM should compressions be at during CPR

A

100-120bpm

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21
Q

End tidal values (ETCO2) should be around what

A

40-45mm hg

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22
Q

Epinephrine should be given at low dose _______ and administered every __to__min.

A

0.01mg/kg,
3-5min

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23
Q

What is Vasopressin and when would it be used

A

It is a Vasoconstrictor
Used in treatment of cardiac arrest

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24
Q

What is the suggested dose of vasopressin and how often should is he given?

A

0.8units/kg every 3-5min

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25
Q

What is the recommended dose for atropine

A

0.04mg/kg

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26
Q

What would ventricular fibrillation look like on a ECG

A

Chaotic electrical activity (quivering back of worms if viewed)

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27
Q

What does asystole on an ECG look like

A

Straight line, no electrical or mechanical activity

28
Q

What is trauma triad of death

A

Acidosis
Hypothermia
Coagulopathy

29
Q

What is the goal for albumin values

A

> 2.0

30
Q

What is the goal value for TS

A

> 4.5

31
Q

What is the goal value of the pulse oximeter

A

> 94

32
Q

Most common hereditary bleeding defect in dogs is

A

Von Willebrand disease

33
Q

What is hypoxemia ?

A
34
Q

A patient is hypotensive when the MAP BP lower than ____ mm Hg

A

60

35
Q

What monitor should be used to asses ventilation in anesthetized patients

A

Capnometry

36
Q

Describe and asystole ECG reading

A

Straight line
There is no electrical or mechanical activity

37
Q

What drugs are typically used to treat Asystole rhythm

A

Epinephrine, vasopressin, atropine

38
Q

Describe a ventricular tachycardia ECG rhythm

A

No pulse is detected, but looks like large hills and valleys
Considered a shockable rhythm
Greater than 200BPM

39
Q

How much SQ fluid can you administer safely at one site

A

10ml/kg

40
Q

What is the most common type of fluid used in vet med

A

Isotonic crystalloids

41
Q

What type of transfusion therapy is used for post trauma with significant blood loss

A

Whole blood

42
Q

What type of transfusion therapy is used for coagulation disorders or hypoalbuminemia

A

Fresh frozen plasma

43
Q

What type of transfusion therapy is used for increased RBC destruction or decreased RBC production

A

Packed RBC

44
Q

Which type of canine blood is the most antigenic and should only be given to patients with the same blood type

A

DEA 1 positive

45
Q

What type of transfusion reaction is seen in a patent with edema, respiratory distress, coughing, hypertension and jugular distention

A

Transfusion associated circulatory overload

46
Q

What type of transfusion reaction is seen in patients with facial swelling, urticaria, fever to anaphylaxis

A

Hypersensitivity type 1

47
Q

What type of transfusion reaction is seen in patients that have a fever, salivation, vomiting, DIC, and hemoglobinuria

A

Acute hemolytic reaction

48
Q

You have a patient with pale mm, tachycardia, slightly prolonged CRT. Which phase of shock is your patient most likely in

A

Compensated

49
Q

Shock index =

A

HR/ systolic BP

50
Q

What do you expect PCV and TP to be in dehydration patients

A

Both increased

51
Q

What is the goal of ETCO2 measurement during CPR

A

> 15mm Hg

52
Q

What is the most appropriate action when the ECG reading indicates Ventricular fibrillation

A

Perform defibrillation

53
Q

What is the most appropriate action when your patient has a cardiopulmonary arrest during anesthesia

A

Reverse or stop all anesthetic agents

54
Q

What are the 3 findings that make up the trauma triad of death

A

Hypothermia, coagulopathy, acidosis

55
Q

Hypothermia During trauma is associated with

A

Higher morbidity and mortality

56
Q

What is the goal for systolic blood pressure for trauma patients

A

Between 90-130mm hg

57
Q

What is the imbalance between bleeding, coagulation, and fibrinolysis that is often caused by systemic inflammation

A

Disseminated intravascular coagulation

58
Q

What is a condition of hyaocoagulability and hyper fibrinolysis that can occur within an hour of trauma

A

Acute traumatic coagulopathy

59
Q

Decrease in PCV or RBC count indicates

A

Anemia

60
Q

Volume of blood entering the heart is

A

Preload

61
Q

Force against which the head ejects =

A

After load

62
Q

What is it called when the heart no longer is able to pump blood efficiently and fluids build up in the lungs

A

CHF

63
Q

What category of drugs are used to decrease pulmonary edema

A

Loop diuretics

64
Q

What heart disease is caused by heart worms blocking the pulmonary artery

A

Caval syndrome

65
Q

Doses of analgesics may need to be decreased to ___ to____% of normal in critical patients

A

25-50%