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CASE 1Signalment A 40 kg (88 lb) Labrador Retriever has been hit by a car. It presents to the veterinary hospital about 20 minutes after the accident. Initial physical examination
Assessment Hypovolemia due to hemorrhagic shock fromtrauma. Initial fluid resuscitation Half of the calculated shock dose of fluid shouldbe infused. Shock dose = 90 ml/kg/hr (40 kg × 90 ml/kg)= 3600 ml Thus 1.5–2 l of a balanced crystalloid solution should be infused over 15–30 min. If an improvement in heart rate and other cardiovascular parameters is observed, then the infusion rate should be decreased. However, if no improvement is detected, then the remaining 50% should be infused, and thought should be given to supplemental colloid therapy (such as etherified starch) or blood transfusion. Failure to stabilize and persistent hypovolemia suggest ongoing hemorrhage. In some cases, an exploratory celiotomy is warranted to control the source of hemorrhage. Abdominal wraps are frequently used and may be beneficial provided respiratory impairment is not present. CASE 2 |
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