By Rebecca Kirby, Andrew Linklater
Monitoring and Intervention for the seriously ailing Small Animal: the guideline of 20 offers information for assessing the sufferer, examining diagnostic attempt effects, and choosing acceptable tracking procedures.
- Based on Rebecca Kirby’s time-tested Rule of 20, with a bankruptcy dedicated to every one merchandise at the checklist
- Provides complete suggestions for tracking a severely sick small animal patient
- Emphasizes the interaction of every parameter with one another
- Designed for quick entry at the health facility ground, with probably life-saving rules, suggestions, lists and procedures
- Presents tables, schematics, algorithms, and drawings for speedy reference
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Extra info for Monitoring and intervention for the critically ill small animal: the rule of 20
The inferior vena cava diameter as a marker of dry weight in chronic hemodialyzed patients. Artif Organs. 1995;19(12):1237–42. 77. Seif D, Perera P, Mailhot T, Riley D, Mandavia D. Bedside ultrasound in resuscita tion and the rapid ultrasound in shock protocol. Crit Care Res Pract. 2012;2012:503254. 78. Brennan JM, Blair JE, Goonewardena S, et al. Reappraisal of the use of inferior vena cava for estimating right atrial pressure. J Am Soc Echocardiogr. 2007;20(7):857–61. Sefidbakht S, Assadsangabi R, Abbasi HR, Nabavizadeh A.
It is a highly branched polysaccha ride closely resembling glycogen, formed by the reaction between ethylene oxide and amylopectin in the presence of an alkaline cat alyst. The molecular weight and molar substitution can be adjusted by the degree of substitution of hydroxyl groups with hydroxyethyl groups at the C2, C3, and C6 positions on the glucose molecule. The greater the substitution on position C2 in relation to C6 (C2:C6 ratio), the slower the degradation of the molecule by amylase .
Source Complication Intervention Fluid overload Tachypnea Labored breathing Pleural effusion Nasal discharge Hypotension Hypertension Heart murmur Cardiac arrhythmia Change in mentation Change in level of consciousness Peripheral edema (pitting) Ascites Hypothermia Electrolyte alterations Hyponatremia Hypernatremia Hyperchloremia Acidosis, alkalosis Hypokalemia Change in tonicity of fluids Hyperglycemia Hyperosmolar fluid shifts causing dehydration Hyponatremia if D5W Cellular swelling if D5W Renal injury reported with dextran use and in humans receiving HES (not seen in dogs and cats) Inadequate fluid resuscitation Careful fluid selection using colloids to support intravascular retention of fluids Reassess total fluid infused vs output Employ careful monitoring procedures Physical perfusion parameters PCV/TP Changes in body weight, urine output Blood pressure, CVP, ECG, SpO2 Assess cardiac function Reduce fluid input Careful diuretic administration + Thoracentesis or abdominocentesis Compression wrap if limb edema Reassess and recalculate fluid needs Choose isotonic, balanced crystalloids Monitor electrolytes, acid–base status Supplement potassium during maintenance fluid therapy Support renal function Glucose‐containing fluids Renal injury Anemia Sudden increase in intravascular hydrostatic pressure Coagulopathy Dilution of RBCs Coagulopathy Dislodge clot in damaged vessel or organ Extravasation of intravascular fluids Dilutional from fluids Interference with coagulation with HES, dextran Use isotonic balanced crystalloids Monitor electrolytes and blood glucose Use D5W only to replace solute‐free water or as carrier for CRI drugs Promote GFR Assure adequate blood pressure Use crystalloids with colloids to replace hydration deficits quickly Avoid using dextrans Monitor PCV/TP Administer RBCs if necessary Choose small‐volume resuscitation technique to reach low normal endpoints Careful titration of fluid volume Anticipate potential for vessel injury Monitor quantity of colloid given Administer plasma if needed CRI, constant rate of infusion; CVP, central venous pressure; D5W, 5% dextrose in water; ECG, electrocardiogram; GFR, glomerular filtration rate; HES, hydroxyethyl starch; PCV, packed cell volume; RBCs, red blood cells; SpO2, pulse oximetry; TP, total protein.
Monitoring and intervention for the critically ill small animal: the rule of 20 by Rebecca Kirby, Andrew Linklater