Manual of Small Animal Emergency and Critical Care Medicine, Second Edition presents essential information on common emergencies in small animals using a concise, practical outline format. Offering a thorough update to this classic reference, the new edition provides new chapters on orthopedic injuries and wound management, significant revisions to the treatment protocols, and expanded toxicology information, as well as new references and drug information. The book retains its logical division into two parts, the first covering initial stabilization and the second offering a systems approach…mehr
Manual of Small Animal Emergency and Critical Care Medicine, Second Edition presents essential information on common emergencies in small animals using a concise, practical outline format. Offering a thorough update to this classic reference, the new edition provides new chapters on orthopedic injuries and wound management, significant revisions to the treatment protocols, and expanded toxicology information, as well as new references and drug information. The book retains its logical division into two parts, the first covering initial stabilization and the second offering a systems approach to specific conditions. As in the previous edition, chapters are extensively indexed and cross-referenced to facilitate ease of use in emergency situations. With many formulas, tables, drug dosages, and illustrations, Manual of Small Animal Emergency and Critical Care Medicine is an indispensable, convenient resource for busy emergency clinicians, whether they are new graduates or seasoned professionals.
Douglass K. Macintire was previously Director of Intensive Care, College of Veterinary Medicine, Department of Small Animal Surgery and Medicine, Auburn University and a Diplomate of ACVIM and ACVECC. Kenneth J. Drobatz is Director, Trauma Emergency Service, and Professor and Chief of Critical Care, Matthew J. Ryan Veterinary Hospital, University of Pennsylvania, and a Diplomate of ACVIM and ACVECC. Steven C. Haskins is Director, Small Animal Intensive Care Unit, Veterinary Medical Teaching Hospital, University of California, Davis and is a Diplomate of ACVA and ACVECC. William D. Saxon is Telemedicine Consultant, IDEXX and a Diplomate of ACVIM and ACVECC.
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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
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
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