Table of Contents
Contributors x
Preface to the First Edition xi
Preface to the Second Edition xii
Acknowledgments xiii
Part I Life Support and Initial Stabilization, Monitoring, and Intensive Care of the Critically Ill patient 1
1 Approach to the Emergency Patient 3
Steve C. Haskins and Douglass K. Macintire
Initial Preparation and Management 3
The Primary Survey: Initial Examination to Identify Life-Threatening Problems 4
Brief History 12
Thorough Secondary Survey 12
2 Emergency Room Readiness 17
Steve C. Haskins and Douglass K. Macintire
Being Prepared 17
Equipment Recommendations 17
Recommended Supplies 18
Recommended Drugs 19
3 Cardiopulmonary-Cerebral Resuscitation (CPCR) 21
Steve C. Haskins
Causes 21
Clinical Signs 21
The Nature of Cell Injury During Cardiac Arrest 21
Prognosis/General Recommendations 22
Treatment 22
Electrical Activity of the Heart 27
Postresuscitative Care 28
4 Shock 30
Steve C. Haskins
Definition 30
Categories of Shock 30
Systemic Inflammatory Response 30
Multiple Organ Dysfunction 31
Monitoring and Identifying Treatment Opportunities 31
Treatment of Shock with Special Emphasis on Septic Shock and MODS 31
Treatment of Anaphylactic Shock 40
5 Anesthesia and Analgesia 41
Steve C. Haskins
Overview of Anesthesia in Critically Ill Patients 41
Guidelines for Anesthesia in Critically Ill Patients 42
Specific Drugs Used for Anesthesia in Critical Patients 44
Anesthesia Concerns and Protocols for Common Conditions 54
Overview of Analgesia 57
Analgesia Drugs and Techniques 58
6 Fluid Therapy 63
Steve C. Haskins and Douglass K. Macintire
Body Fluid Compartments 63
Crystalloid Solutions 65
Colloid Solutions 69
Specific Conditions Requiring Fluid Therapy 75
7 Monitoring 85
Steve C. Haskins
Cardiovascular Monitoring 85
Respiratory Monitoring 102
Urologic Monitoring 106
Neurologic Monitoring 109
8 Nutritional Support of Critical Patients 116
Steve C. Haskins
Acute Malnutrition 116
Methods and Procedures of Providing Enteral Nutrition 117
Methods and Procedures of Providing Parenteral Nutrition 132
Nutrition as an Aid to Medical Therapy (Pharmaconutrition) 134
Part II Specific Protocols and Procedures for Emergency Conditions 137
9 Respiratory Emergencies 139
Kenneth J. Drobatz and Douglass K. Macintire
General Approach/Methods of Oxygen Delivery 139
Upper Airway Obstruction (Pharynx, Larynx, Trachea) 142
Pleural Space Disease 154
Lower Airway Disease 171
Parenchymal Disease 179
Cyanosis 185
Mechanical Ventilation 185
10 Cardiac Emergencies 192
Douglass K. Macintire
Clinical Signs 192
Diagnosis 193
Diagnostic and Monitoring Procedures 193
Management of Specific Conditions 199
11 Gastrointestinal Emergencies 226
Douglass K. Macintire
Clinical Signs, Diagnosis 226
Diagnostic and Monitoring Procedures 226
Management of Specific Conditions 231
12 Urologic Emergencies 269
Kenneth J. Drobatz and William D. Saxon
Clinical Signs, Diagnosis 269
Diagnostic and Monitoring Procedures 270
Management of Specific Conditions 279
13 Neurologic Emergencies 297
Michelle B. Carnes Douglass K. Macintire and William D. Saxon
Clinical Signs, Diagnosis 297
Diagnostic and Monitoring Procedures 297
Management of Specific Conditions 298
14 Hematologic Emergencies 333
Douglass K. Macintire
Clinical Signs, Diagnosis 333
Diagnostic and Monitoring Procedures 335
Management of Specific Conditions 342
15 Endocrine and Metabolic Emergencies 355
William D. Saxon, Kenneth J. Drobatz, and Douglass K. Macintire
Clinical Signs, Diagnosis 355
Diagnostic and Monitoring Procedures 355
Management of Specific Conditions 359
16 Reproductive Emergencies 397
Douglass K. Macintire and William D. Saxon
Clinical Signs, Diagnosis 397
Diagnostic and Monitoring Procedures 398
Management of Specific Conditions 399
17 Pediatric Emergencies 405
Douglass K. Macintire and William D. Saxon
Resuscitation of Neonates (Birth to 2 weeks) 405
Diseases of Infant Animals (2–6 weeks) 410
Diseases of Juvenile Animals (6–12 weeks) 413
18 Ocular Emergencies 418
William D. Saxon and Deborah Mandell
Clinical Signs, Diagnosis 418
Diagnostic and Monitoring Procedures 419
Management of Specific Conditions 421
19 Dermatologic Emergencies 441
Robert Kennis and Douglass K. Macintire
Clinical Signs and Diagnosis 441
Diagnostic Procedures 442
Management of Specific Conditions 443
20 Toxicological Emergencies 453
Kenneth J. Drobatz
Diagnosis, Clinical Signs 453
Initial Approach to the Poisoned Patient 454
Management of Specific Toxicities 457
21 Miscellaneous Emergencies 479
William D. Saxon, Kenneth J. Drobatz, and Douglass K. Macintire
Heat Illness 479
Hypothermia 481
Frostbite 484
Near Drowning (Submersion Injury) 485
Insect and Spider Bites 487
Snakebites 490
Electrocution 493
Fever of Unknown Origin 495
Appendices 499
A. Calibration Tables for the Schiötz Tonometer 499
B. Normal Values for the Canine and Feline Electrocardiogram 501
C. CPCR Guidelines 502
D. Common Equations 505
E. Constant Rate Infusions 506
F. Conversion Tables 511
G. Normal Values for Oxygen and Hemodynamic Parameters 514
H. Toxicology 517
I. Transfusion Guide 522
J. Drug Formulary 524
K. Guidelines for Anesthesia in Animals with Critical Problems 652
Index 657