CAL - emergency stabilisation

Question 1

Tx - hypovolaemic shock

Answer 1

• IV catheter in peripheral vein (short, large bore)
• bolus at 30mL/kg over 20 minutes
• aim to restore the intravascular space very rapidly

Question 2

Why are large bore catheters better for fluid boluses?

Answer 2

Long catheters tend to have small diameters (eg, 22-Gauge) and the increase length adds to the resistance, such that the flow rate is compromised.

Question 3

Is a HR of 260bpm likely to be complensatory to hypovolaemia?

Answer 3

No - more likely cardiogenic shock where the very poor cardiac output resulting in the CS of collapse, poor pulses and congested lungs.

Question 4

What does a normal CRT in hypovolaemic shock suggest?

Answer 4

vasomotor tone not affected

Question 5

How does hypovolaemic shock affect the heart?

Answer 5

results in a sinus tachycardia (a compensatory response that increases cardiac output) that typically does not cause such high heart rates (

Question 6

T/F: in maldistributive shock the MMs are typically injected

Answer 6

True

Question 7

What do dull ventral lung sounds and significant dyspnoea suggest?

Answer 7

pleural space disease –> perform thoracocentesis

Question 8

Diuretics are better for acute management of pulmonary oedema or pleural space disease?

Answer 8

pleural space disease

Question 9

In an animal in pain, how are HR and pulses affected?

Answer 9

• tachycardia
• bounding pulses
• (contrast hypovolaemic shock where tachycardia is present but pulses are weak and MMs are pale)

Question 10

Classic signs of maldistributive shock

Answer 10

injected MMs with inappropriately slow CRT

Question 11

Classic signs - LRT disease

Answer 11

expiratory dyspnoea + wheezing

Question 12

Classic sign - URT disease

Answer 12

Noise on inspiration

Question 13

What are crackles associated with?

Answer 13

• pulmonary parenchymal disease

- paradoxical abdominal movement (other causes of this too)

Question 14

What is pleural space disease associated with?

Answer 14

dull lung sounds

Question 15

For a dog with marked inspiratory dyspnoea + stridor, what is best tx?

Answer 15

• O2 therapy
• sedative (as airway swelling made worse with animal distress)
• emergency tracheostomy (to bypass obstructed airway but only indicated if sedation and steroids fail and dyspneoa worsens)
• active cooling