BOOK
Emergency and Critical Care, An Issue of Veterinary Clinics of North America: Equine Practice, E-Book
(2014)
Additional Information
Book Details
Abstract
Drs. Diana Hassel and Vanessa Cook have put together an expert team of authors focused on emergency and critical care topics. Articles include: Field Triage of the Neonatal Foal, CPR in the neonatal foal: has RECOVER changed our approach?, Update on the management of neonatal sepsis, SIRS or endotoxemia?, Ultrasound of the equine acute abdomen, Evaluation of the colic: Decision for referral, The utility of lactate in critically ill adults and neonates, Crystalloid and colloid therapy, Acute hemorrhage and blood transfusions, Coagulopathies, and more!
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Emergency andCritical Care | i | ||
| Copyright | ii | ||
| Contributors | iii | ||
| Contents | vii | ||
| Veterinary Clinics Of North America: Equine Practice | xi | ||
| Preface | xiii | ||
| Field Triage of the Neonatal Foal | 283 | ||
| Key points | 283 | ||
| Introduction | 283 | ||
| Physical examination of the newborn foal | 283 | ||
| Dysphagia/Loss of Suckle/Milk Regurgitation | 285 | ||
| Triage of the weak neonatal foal | 286 | ||
| Sepsis | 286 | ||
| PAS | 286 | ||
| Prematurity/Dysmaturity | 287 | ||
| Specific Treatment of Sepsis | 287 | ||
| Specific Treatment of PAS | 287 | ||
| Specific Treatment of Prematurity | 288 | ||
| General therapy for the weak recumbent foal | 288 | ||
| Nutrition Support | 288 | ||
| Partial parenteral nutrition | 289 | ||
| Enteral feeds | 289 | ||
| FPT | 290 | ||
| IV Fluid Support of the Foal | 290 | ||
| Maintenance fluid therapy | 290 | ||
| Supportive Care | 291 | ||
| Respiratory Support | 291 | ||
| Other common disorders of the neonate | 292 | ||
| Neonatal Isoerythrolysis | 292 | ||
| Disorders of the Lungs | 292 | ||
| Pneumonia | 292 | ||
| Treatment | 292 | ||
| Apneustic breathing | 293 | ||
| CPR in the Neonatal Foal | 301 | ||
| Key points | 301 | ||
| What is RECOVER? | 301 | ||
| Causes for CPA in equine neonates | 302 | ||
| CPR training and team dynamics | 302 | ||
| Preparation | 303 | ||
| CPR—basic and advanced life support | 303 | ||
| Basic life support | 303 | ||
| What to Do | 304 | ||
| Patient Positioning | 304 | ||
| Ventilation | 304 | ||
| RECOVER Recommendations for Ventilation | 305 | ||
| Thoracic Compressions | 305 | ||
| RECOVER Recommendations | 305 | ||
| Recommendation | 306 | ||
| Advanced life support | 306 | ||
| Vasopressor and Vagolytic Therapy | 306 | ||
| Epinephrine dose | 306 | ||
| Vasopressin Versus Epinephrine | 307 | ||
| Atropine | 307 | ||
| Defibrillation | 307 | ||
| Defibrillation Technique | 307 | ||
| Antiarrhythmic Drug Therapy | 307 | ||
| Electrolyte Therapy | 308 | ||
| Other Therapies | 308 | ||
| Intratracheal Drug Administration | 308 | ||
| Open Chest CPR | 308 | ||
| Monitoring | 309 | ||
| Monitoring Patients During CPA | 309 | ||
| When to Stop | 310 | ||
| Post–cardiac arrest care | 310 | ||
| Resuscitation at the time of foaling | 311 | ||
| Summary | 311 | ||
| References | 312 | ||
| Update on the Management of Neonatal Sepsis in Horses | 317 | ||
| Key points | 317 | ||
| Introduction | 317 | ||
| The septic neonatal foal | 318 | ||
| Management strategies in neonatal sepsis | 321 | ||
| Infection Control | 322 | ||
| Antimicrobials | 322 | ||
| Plasma therapy | 322 | ||
| Hemodynamic Support | 324 | ||
| Fluid therapy | 324 | ||
| Vasoactive agents | 325 | ||
| Respiratory support | 326 | ||
| Antimediator Therapy | 327 | ||
| Supportive therapy | 329 | ||
| Tight Glucose Control | 330 | ||
| Corticosteroid Replacement Therapy | 330 | ||
| Summary | 332 | ||
| References | 333 | ||
| Is it the Systemic Inflammatory Response Syndrome or Endotoxemia in Horses with Colic? | 337 | ||
| Key points | 337 | ||
| Introduction | 337 | ||
| SIRS | 338 | ||
| The innate immune system | 339 | ||
| Pattern-recognition receptors and their role in equine SIRS | 339 | ||
| TLR4 and its interactions with LPS | 340 | ||
| Signaling pathways initiated by TLR4 activation | 340 | ||
| Other equine TLRs and their PAMPs | 341 | ||
| Mediators released via TLR activation and their physiologic effects | 343 | ||
| Differences in responses of equine cells to TLR activation | 344 | ||
| Responses of Equine TLR4 to LPS | 344 | ||
| Agonist/Antagonist LPS Responses | 344 | ||
| Equine-Specific Cellular Responses to Flagellin | 345 | ||
| The focus on endotoxemia | 345 | ||
| Detection of LPS | 347 | ||
| SIRS or endotoxemia? | 347 | ||
| Treatment | 347 | ||
| Current Treatment Approach | 347 | ||
| Caution Regarding Extrapolating Future Treatments to Horses | 348 | ||
| References | 348 | ||
| Ultrasound of the Equine Acute Abdomen | 353 | ||
| Key points | 353 | ||
| Introduction and clinical indications | 353 | ||
| Technique and Equipment | 354 | ||
| Patient preparation | 355 | ||
| Transducers and ultrasound machines | 355 | ||
| Scanning technique | 355 | ||
| Limited examination | 355 | ||
| FLASH technique | 355 | ||
| Full examination | 356 | ||
| Machine settings | 356 | ||
| Examiner experience and diagnostic complexity | 356 | ||
| Normal Ultrasonographic Anatomy of the Equine Abdomen | 356 | ||
| Left abdomen | 357 | ||
| Right abdomen | 357 | ||
| Ventrum | 358 | ||
| Gastric Abnormalities | 359 | ||
| Small Intestinal Abnormalities | 360 | ||
| Small intestinal strangulating obstructions | 360 | ||
| Intussusception | 360 | ||
| Proximal enteritis | 361 | ||
| Other small intestinal lesions | 362 | ||
| Duodenal abnormalities | 362 | ||
| Large Intestinal Abnormalities | 363 | ||
| Left dorsal displacement | 363 | ||
| Right dorsal displacement | 364 | ||
| Colon torsion | 365 | ||
| Colitis | 366 | ||
| Intussusception | 366 | ||
| Sand/Enteroliths | 367 | ||
| Peritoneal Fluid | 367 | ||
| Masses, Neoplasia, and Abscessation | 370 | ||
| Abdominal neoplasia | 370 | ||
| Abdominal abscessation | 371 | ||
| Other | 373 | ||
| Urolithiasis | 373 | ||
| Cholelithiasis | 374 | ||
| Thoracic and cardiac causes of colic | 376 | ||
| Pleuritis | 376 | ||
| Pericarditis | 376 | ||
| Aortic root disease | 376 | ||
| Diaphragmatic hernia | 377 | ||
| References | 378 | ||
| Evaluation of the Colic in Horses | 383 | ||
| Key points | 383 | ||
| Introduction: nature of the problem | 383 | ||
| Patient history and signalment | 384 | ||
| Physical examination | 385 | ||
| Pain Assessment and General Appearance | 387 | ||
| Heart Rate | 387 | ||
| Temperature | 388 | ||
| Gastrointestinal Motility | 388 | ||
| Rectal Palpation | 388 | ||
| Presence of Gastric Reflux | 389 | ||
| Imaging and additional testing | 390 | ||
| Transabdominal Ultrasound | 390 | ||
| Abdominocentesis | 391 | ||
| Lactate | 393 | ||
| Glucose | 394 | ||
| Summary | 395 | ||
| References | 395 | ||
| Blood Lactate Measurement and Interpretation in Critically Ill Equine Adults and Neonates | 399 | ||
| Key points | 399 | ||
| Introduction | 399 | ||
| Measuring lactate concentrations | 400 | ||
| Lactate metabolism in the healthy animal | 401 | ||
| Lactate metabolism in disease | 402 | ||
| Increased Na+/K+–Adenosine Triphosphatase Activity in Response to Inflammatory Mediators | 402 | ||
| Inhibition of PDH | 403 | ||
| Lactate Production by Leukocytes | 403 | ||
| Decreased Hepatic Clearance | 403 | ||
| Other Potential Causes of Hyperlactatemia | 404 | ||
| Source of Lactate During Disease | 404 | ||
| Interpretation of blood lactate concentrations in critically ill horses | 404 | ||
| Lactate Measurement and Interpretation in Adult Horses | 405 | ||
| Lactate Measurement and Interpretation in Equine Neonates | 406 | ||
| Limitations in the Clinical Use of Blood Lactate Concentrations | 408 | ||
| Summary | 409 | ||
| References | 409 | ||
| Crystalloid and Colloid Therapy | 415 | ||
| Key points | 415 | ||
| Hyperchloremia | 416 | ||
| Colloid research revisited | 417 | ||
| The No-Absorption Rule | 417 | ||
| Retraction of Studies Supporting Colloid Use | 418 | ||
| Remaining Evidence Addressing Colloid Use | 418 | ||
| Fluid overload | 419 | ||
| Treatment of Fluid Overload | 420 | ||
| The basic components of a fluid therapy plan | 421 | ||
| Are Intravenous Fluids Indicated? | 421 | ||
| Type of Fluid | 422 | ||
| Initial Resuscitation Fluid | 422 | ||
| Rate of Fluid Administration | 422 | ||
| End Points to Fluid Administration | 422 | ||
| References | 423 | ||
| Acute Hemorrhage and Blood Transfusions in Horses | 427 | ||
| Key points | 427 | ||
| Introduction | 427 | ||
| Acute hemorrhage | 427 | ||
| Recognizing Acute Hemorrhage in the Horse | 427 | ||
| Physiologic Hemostasis and Medical Management | 428 | ||
| Surgical and Topical Hemostasis | 429 | ||
| Blood transfusion | 430 | ||
| Criteria for Transfusion | 430 | ||
| Blood Products | 430 | ||
| Blood Donors and Pretransfusion Testing | 431 | ||
| Blood Collection and Storage | 431 | ||
| Transfusion Volume and Technique | 433 | ||
| Adverse Effects | 433 | ||
| Alternative Sources of Blood | 434 | ||
| Summary | 434 | ||
| References | 434 | ||
| Coagulopathies in Horses | 437 | ||
| Key points | 437 | ||
| Introduction | 437 | ||
| Nature of the Problem | 437 | ||
| Definitions | 437 | ||
| Normal hemostasis | 437 | ||
| Coagulopathy | 439 | ||
| Clinical findings | 440 | ||
| Physical Examination | 440 | ||
| Excessive bleeding | 440 | ||
| Excessive thrombosis | 440 | ||
| DIC | 440 | ||
| Underlying Disease | 441 | ||
| Diagnostics | 441 | ||
| Clinical Pathology | 441 | ||
| Other Tests | 441 | ||
| Decision Algorithms | 444 | ||
| Treatment options | 445 | ||
| For Excessive Bleeding | 445 | ||
| For Excessive Thrombosis | 445 | ||
| References | 449 | ||
| Trauma and Wound Management | 453 | ||
| Key points | 453 | ||
| Introduction | 453 | ||
| Classification of wounding potential | 454 | ||
| Impact energy | 454 | ||
| Bullet design | 456 | ||
| Tissues involved | 457 | ||
| Bullet wound classification system | 458 | ||
| Energy | 458 | ||
| Vital structures involved | 459 | ||
| Wound | 459 | ||
| Fractures | 459 | ||
| Contamination | 459 | ||
| Treatment of bullet wounds | 460 | ||
| Head, neck, and spine injuries | 461 | ||
| Thoracic wounds | 462 | ||
| Abdominal wounds | 463 | ||
| Soft tissue injuries and musculoskeletal trauma | 463 | ||
| Legal considerations | 464 | ||
| Acknowledgments | 465 | ||
| References | 465 | ||
| Infection Control in Equine Critical Care Settings | 467 | ||
| Key points | 467 | ||
| Importance of infection control in the critical care setting | 467 | ||
| General infection control concepts | 468 | ||
| Challenges of infection control in the critical care setting | 469 | ||
| Risks Associated with Caretaker-Patient Contacts | 469 | ||
| Risks Associated with Intravenous Catheterization | 470 | ||
| Special Considerations When Managing Critically Ill Foals | 470 | ||
| Risks associated with managing critical care patients | 470 | ||
| What Are the Risks? | 470 | ||
| Specific Agents of Concern | 471 | ||
| Eliminating Environmental Persistence of Potential Pathogens | 471 | ||
| Summary | 472 | ||
| References | 472 | ||
| Index | 475 |