Intra-operative emergencies!

HAEMORRHAGE
1. Obvious signs: shed blood at surgical site, pallor, weak pulse, tachycardia!
2. Estimate blood loss!
  1. Use crystalloids at 10ml/kg/hr to cover losses under normal conditions!
  2. 1. Weigh swabs
    1. 1ml of blood = 1g in weight
    2. Deduct weight of dry swab to those covered in blood
  3. 2. Suction bottle contents
    1. Volume of suction bottle (mls) - volume of flush (mls) = volume of blood (mls)
  4. 3. Other losses - drapes, on floor...etc.
3. Haemorrhage comes vasoconstriction. Need FLUID THERAPY!
  1. Less than 10% = crystalloids
  2. 10-20% = colloids
  3. Over 20% = blood products!
4. Blood loss (%) = [total blood loss (mls) / normal blood volume (mls)] x 100
HYPOTENSION
1. This is LOW blood pressure (very common) due to anaesthetic drugs on cardiovascular system to decrease output and cause vasoconstriction + potential for blood and fluid loss!
2. Signs: poor palpable pulse quality, tachycardia (compensatory measure). Can only be identified by measuring BP!
3. Causes: deep anaesthetic, blood loss, inappropriate tachycardia/bradycardia!
4. Tx: Depends on underlying cause, adjust anaesthesia depth if necessary, stop haemorrhage (vets job), IV fluid infusion!
ARRYTHMIAS
1. Irregularities of the heart rhythm that may reduce cardiac output and cause hypotension!
2. If left untreated some arrhythmias can deteriorate into more dangerous forms associated with cardiac arrest e.g. ventricular fibrillation
3. Causes: deep anaesthetic, electrolyte/blood gas abnormalities, pre-existing heart conditions, some medical conditions e.g. GDV
4. Tx: depends on underlying cause, diagnosis with ECG and the use of anti-arrhythmic drugs. Adjust anaesthetic and providing ventilation can restore a normal rhythm!

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Intra-operative emergencies!

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	Creado por sarah.denise hace alrededor de 11 años