Small Animal ECC Flashcards by Dana Dyches

What should an initial triage include

brief history, quick PE, resuscitation status

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What are the ABC’s of a primary survey

Airway, attitude
Breathing, bleeding
Cardiovascular, circulation

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What should you always do if in doubt of patient respiratory status

start supplemental oxygen until further assessment can be completed

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What is inspiratory dyspnea

long slow inspirations with short exhalations

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What is usually the cause of inspiratory dyspnea

extrathoracic airway obstruction, such as larpar or swelling associated w/ an acute hypersensitivity reaction

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What is expiratory dyspnea

increased abdominal effort on expiration

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What causes expiratory dyspnea

intrathoracic obstruction, such as mass compressing the airway or inhaled foreign body

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Labored breathing is

prolonged and deep

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restrictive breathing is

fast, short, and shallow; (usually from impaired ability to expand the lungs like rib fractures, effusion, etc.)

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Orthopnea is

maintaining a specific posture to ease breathing

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orthopneic patients can become _ or _ if repositioned

distressed or aggressive

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Decreased mentation can indicate

shock

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Vitals of the cardiovascular system

Menatation
HR and rhythm
Pulse quality
Extremity temperature
MM color
CRT

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Elevated _ levels can be extremely bad for a patient with increase intracranial pressure and traumatic brain injury

carbon dioxide

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What is anisocoria

one big pupil and one little pupil

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Signs of severe abdominal pain

arched back, praying posture

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What is tympany

swelling of the abdomen with air or gas

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What should be looked for upon quick abdominal palpation

pain, tympany, a fluid wave

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Common causes of dehydration

v/d, excessive panting, PU, decreased water intake

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Clinical signs of dehydration

tacky or dry MM
lack of skin turgor
mental status
body weight

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Common laboratory abnormalities in dehydrated patients

-Hemoconcentration (abnormally high concentration of blood)

-Azotemia (too much nitrogen, creatinine, and other waste products in the blood)

-Hypernatremia (a rise in serum sodium concentration due to net water loss or excess sodium intake)

-Elevated albumin

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Hypovolemia is

a loss of intravascular volume

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Hypovolemia commonly occurs with

shock, trauma, hemorrhage or profuse v/d

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vitals of hypovolemic shock

tachycardia
weak pulses
hypotension
prolonged CRT

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What is needs to be done immediately for a hypovolemic patient

restore blood volume quickly

High-yield diagnostics that determine overall patient stability

PCV TP BG Blood gas analysis BP Pulse ox ECG FAST scan

What should be provided throughout the initial stabilization, diagnostics, and secondary tx phases

fluid therapy

Shock is a complex syndrome resulting from

altered blood flow or impaired delivery of oxygen to tissues

What does early stages of shock look like

-Depressed or anxious -Tachycardic and tachypneic -Normal, decreased, or increased pulse

Terminal stage of shock looks like

Massive vasodilation, hypotension, cardiac arrest

What type of shock is described? -Most common type in cats and dogs -Trauma, hemorrhage, severe v/d -Decreased intravascular fluid volume -Delayed CRT, weak pulse, pale mm, altered mentation -Tx: restore intravascular volume (IV fluids +/- transfusion)

Hypovolemic shock

What type of shock is described? -Maldistribution of blood flow, from inappropriate vasodilation leading to pooling of blood in capillaries -Anaphylaxis, heat stroke, and envenomation -Weak or bounding pulse, pink mm -Tx: fluid therapy, vasopressors

Distributive shock

What type of shock is described? -Venous return to heart is impaired -GDV or pericardial tamponade (collapse of right atrium) -Tx: tx underlying cause

Obstructive shock

What type of shock is described? -Secondary to heart problems -Weak pulse, hypotension, pale mm, +/- cold extremities, pulmonary edema, heart murmur -Fluids are contraindicated!!! -Tx: improve heart function; diuretics needed to resolve pulmonary edema

Cardiogenic shock

What type of shock is described? -Severe infection insult (pneumonia, parvo, bowel perf. , bite wounds, etc. -Can also occur as a sequela to severe tissue damage (ex: heat stroke, pancreatitis) -Bright red mm, fever, and bounding pulse -As it progresses, mm turn pale and weaker pulses -Tx: tx source of infection, fluid therapy, and broad- spectrum antbx

Septic shock

Shock results in widespread _ _ and damage, and the inflammation can progress from local to systemic

tissue hypoxia

Systemic inflammatory response syndrome (SIRS) can lead to

Disseminated intravascular coagulation (DIC)- concurrent thrombosis and bleeding

Another complication of shock and sepsis is Multiple organ dysfunction syndrome (MODS), secondary to SIRS. This causes?

permanent organ failure and death

Prep for abdominocentesis

left lateral recumbency, aseptic prep, 20/22-g needle or catheter placed in the 4 quadrants around umbilicus

If abdominal fluid seems hemorrhagic, observe for _

clotting; if clot develops, this is fresh blood vs free fluid in the abdomen

Thoracic drain placement (AKA chest tube) may be necessary with large amounts of fluid or air and should be placed if:

more than 2 thoracocenteseses are needed within a few hours

Mechanical ventilation is a means of

long term intensive respiratory support to critically ill patients

Complications of mechanical ventilation

pressure ulcers peripheral edema edematous tongue pneumonia

Cardiopulmonary arrest (CPA) is

cessation of spontaneous respirations and lack of perfusing heart rhythm

Some animals will have _ _ before a full CPA- timing is crucial for survival

respiratory arrest

Absence of _ is sufficient to start CPR

respiration

Advanced life support methods

medications defibrillation open-chest procedures

Delaying compressions is worse than

performing them on an animal not in CPA

how much breathes should you deliver to a patient during CPR and how often

10brpm; 1-second inspiration and 5-second expiration

How should CPR be performed on cats and small dogs <5-7kgs

lateral recumbency, one hadn't circling the ventral chest, compressions performed directly over heart using whole hand

CPR for keel-chested dogs (greyhounds)

at 5th intercostal space with dog in lateral position

Round-chested cpr (chest w/ similar width and depth)

apply compressions to widest part of chest with dog in lateral

For quality chest compressions, you should compress the thoracic walk by

30-50%

CPR bpm for cats and dogs

100-12o bpm

As compressions restore perfusion, ETCO2 should rise and reach _mm Hg or higher

Check every _-_ seconds for return of spontaneous circluation (ROSC)

10-15

What is open chest CPR

making an incision in the left 5th intercostal space, freeing the heart from its attachments, and directly massaging the heart from apex to base

If patient is still in CPA after the first cycle, _ +/- _ are often employed

medications; defibrillation

What is asystole

complete cessation of all mechanical and electrical activity in the heart

What is it called when the electrical system of the heart is functioning (as evidence by ECG) but no mechanical heartbeat occurs in response to electrical stimulation

PEA

V-fib is highly disorganized contractile activity of the heart, often preceded by a

rapid pulseless ventricular tachycardia

initial dose of defibrillation

4 joules per kg (.4J / kg with open chest paddles)

NAVEL stands for

Naloxone, atropine, vasopressin, epi, and lidocaine

Endotracheal tube drug doses are _times IV dose

Up to _% undergo another CPA within 12 hours

overall survival rate for all causes of CPA is

4-9%

After successful CPR, tx should focus on

treating the underlying cause of CPA and treating the systemic effects of the CPA and resuscitation

_ may be needed in immediate post arrest period

Ventilation

How does hypoxia and hypotension effect GI tract

leads to breakdown of GI mucosal barrier, which can cause transiocation of bacteria into systemic circulation. Potential for sepsis

How to monitor kidneys post arrest

monitor fluid in and out to maintain fluid balance

Anoxic, hypoxic, and repercussion injury manifest as _ edema

cerebral

Furosemide should NOT be used with

hypovolemia

_ and _ are especially sensitive to alterations in BP

brain and kidneys

BP cuff width should be _-_% of the circumference of the limb at the site of cuff placement

30-50

Arterial BP: during each cardiac cycle, BP varies from a max (systolic pressure) and a minimum pressure (diastolic pressure). MAP is the average and should range from _-_

70-100mm Hg

Most common sites of catheterization of artery

dorsal metatarsal and femoral

Four basic features of ECG

HR, Heart rhythm, P-QRS-T waveforms and intervals, Mean electrical axis (MEA)

Small Animal ECC Flashcards

(77 cards)