Shock

Question 1

Shock

Answer 1

Defined as cellular hypoxai

Question 2

4 catgories of shock

Answer 2

1 Cardiogenic shock
2 Distructive Shock
3 Obstructive shock
4 Hypovolaemic shock

Question 3

Cardiogenic Shock

Answer 3

inneffective forward blood flow, poor tissue persusion and O2 delivery

Question 4

Disruptive shock

Answer 4

occurs when blood vessels expand vasodilate and normal volume of blood not sufficient to fill the vessels

Question 5

Obstructive shock

Answer 5

mechanical obstructions of the vessels eg GDV

Question 6

Hypovolaemic shock

Answer 6

loss of circulating blood volume

Question 7

how to recognise shock

Answer 7

1 mentation 
2 MM colour 
3 CRT 
4 HR 
5 Pulse quality 
6 extremity Temp.

Question 8

MM colour pale/white

Answer 8

cause of vasoconstriction

Question 9

MM colour bright pink or red

Answer 9

cause of vaso dilation

Question 10

Decompensation shock

Answer 10

when the heart rate is slow or normal when all other pareters are normal

Question 11

A palpable femoral pulse is consistant with what systolic blood pressure

Answer 11

greater than 60 mmHg

Question 12

A palpable doral metatarsal pulse is consitant with what systolic blood pressure

Answer 12

greater than 90 mmHg

Question 13

extremity temp.

Answer 13

usualy 4 degrees lower thant the core temperature

Question 14

3 stages of shock (dogs)

Answer 14

1 compensatory shock
2 early decompensatory
3 late decompensatory

Question 15

Compensatory shock signs

Answer 15

tachycardia, bounding pulses, CRT < or equal to 1 sec, normal to increased arterial blood pressure, normal mentation

Question 16

early decompensatory shock signs

Answer 16

tachycardia, weak or absent pulses, pale MM, Prolonged CRT, hypotension, depression, ddecreased body temp.

Question 17

Late decompensatory shock signs

Answer 17

normal to decreased HR, white MM, very slow or absent CRT, no peripheral pulses, hypotension, decreased level of consciousness

Question 18

what is increased lactate levels in the blood a sign of

Answer 18

poor perfusion

Question 19

emergency stabilisation of shock

Answer 19

1 Oyygen supplemtation 
2 Secure IV access 
3 start crystalloid fluids 
4 add colloids hypertonic saline
5 vasopressor 
6 analgesia

Question 20

what size catheter should you use

Answer 20

ideally a 16gague, or a 22-18 gaugue catheter at first and then switch to bgger gauge when veins improve

Question 21

what type of shock should you not give fluids to

Answer 21

cardiogenic shock

Question 22

what is the total blood volume of a dog

Answer 22

80-90ml/kg

Question 23

what is the total blood volume of a cat

Answer 23

60 ml/kg

Question 24

what is the goal or end point when treating shock patients

Answer 24

normal perfusion parameters

Question 25

fluid resucitation rate for a dog

Answer 25

1/4 of the calculated shock dose as a bolus 22.5ml/kg given over 15 mins, checked every 5 mins oof perfusion parameters

Question 26

fluid resucitation rate for a cat

Answer 26

1/4 of the calculated shock dose as a bolus 10-15ml/kg given over 15mins and checked every 5 mins for perfusion parameters

Question 27

what is a standard crystalloid shock dose for dog

Answer 27

one complete blood volume (80-90ml/kg)

Question 28

what is the standard crystalloid shock dose for a cat

Answer 28

one complete blood volume 50-55 ml/kg

Question 29

how long should you replace the calculated deficits after the shock has been stabilised

Answer 29

over 6-8 hrs depeding on comorbidities

Question 30

what to do if 50% of the calculated shock volume of isotonic crystalloid has not caused any improvement

Answer 30

either switch to a colloid or add colloids to the isotonic fluids

Question 31

what does giving hypertonic saline cause

Answer 31

fluid to shift from IC space to the EC space which causes improved venous return and cardiac output

Question 32

what volume of colloids stays in the intravascular space

Answer 32

50-80% of infused colloid

Question 33

what is the shock dose of colloids for dogs

Answer 33

5ml/kg bolus over 10 mins

Question 34

what is the shock dose of colloids for cats

Answer 34

2.5ml/kg bolus over 10mins

Question 35

when to administer colloids

Answer 35

when increased tissue perfusion and O2 delivery needed
if oedema develops prior to adequate blood volume restoration
when total protein is 35g/L or albumen is 15g/L

Question 36

when should you administer vasopressors

Answer 36

when patient is unresponsive to fluid therapy

Question 37

what analgesia drugs should you avoid during resuscitation

Answer 37

non steroiddal anti-inflammatories

alpa 2 agonists