E-Book Overview
This manual provides clear, concise management advice from a team of leaders in emergency veterinary medicine, making it a valuable text for the classroom and an indispensable resource for emergency situations in daily veterinary practice.Written in an easy-to-follow outline format, this book gives you rapid access to essential information needed to stabilize and treat the emergency and critical care patient. The first part of the book outlines initial care of the trauma or critical patient, followed by coverage that ranges from triage to basic fluid therapy, monitoring, and continuous care. The second part of the book features emergency care coverage organized by body system, beginning with the general approach to patients with emergent signs in each system and followed by protocols for specific conditions.
E-Book Content
Small Animal Emergency an.d Critical . Care Mediéine -:-----:=l - Douglass K. Macintire Kenneth J. Drobatz I Steven c. Haskins William D. Saxon 6.3 6. UD7bU¿~ MANUAL OF SMALL ANIMAL EMERGENCY AND CRITICAL CARE MEDICINE DOUGLASS K. MACINTIRE, MS, DVM Diplomate ACVIM and ACVECC Director of Intensive Care College of Veterinary Medicine Department of Small Animal Surgery and Medicine Aubum University Aubum, Alabama KENNETH J. DROBATZ, DVM, MSCE Diplomate ACVIM and ACVECC Director, Trauma Emergency Service Veterinary Hospital, University Philadelphia, of Pennsylvania Pennsylvania STEVEN C. HASKINS, MS, DVM Diplomate ACVA and ACVECC Direct01; Small Animal Intensive Care Unit Veterinary Medical Teaching Hospital University of Califomia Davis, Califa mi a WILLlAM D. SAXON, DVM Diplomate ACVIM and ACVECC Telemedicine Consultant, IDEXX Graton, Califomia r-.------w" ..... --. UNIVEi 2 seconds) Weak, thready, or absent pulses Active Hemorrhage Brick-red membranes, capillary refill < 1="" second,="" bounding="" pulses="" tachycardia="" (dog=""> 180; cat >250) Bradycardia (dog propofol > inhalational anesthetics in the lead. Respiratory depression is easy to manage as long as it is recognized. B. All anesthetic agents are dangerous and may be associated with adverse effects (including death) in precariously balanced critically ill patients. 1. It is most important to know the mechanisms behind the harmful effects of the drugs that you use. a. Most-common mechanisms include myocardial depression, excessive vasodilation (hypotension) or vasoconstriction Cimpaired tissue perfusion), hypotension, hypoventilation or hypoxemia 11. GUIDELlNES FOR ANESTHESIA CRITICAL PATIENTS IN A. The generic anesthetic induction technique: Rules that apply regardless of the agentes) chosen 1. Stabilize the underlying disease process as much as possible in the time available prior to induction. MANUAL OF SMALL ANIMAL EMERGENCY a. Preoxygenate animals with respiratory compromise. b. Correct severe anemia with transfusion or hemoglobin solution. c. Volume replace hypovolemic animals. d. Correct acid-base and electrolyte abnormalities in animals with impaired renal function. e. Monitor ECG, pulse oximetry, end-tidal CO2, and blood pressure during anesthesia. 2. Premedication may or may not be helpful or necessary. a. The animal should be outwardly and inwardly tranquil. Excited animals require higher induction dosages, predisposing them to overdosage or syrnpathetic-induced arrhythmias. b. Often this is accomplished by the underlying disease process, but if the animal is relatively awake and alert, a sedative should be administered. 1) Opioids are a common choice. 2) Benzodiazepines are unpredictable tranquilizers in dogs and