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Sem 6: SASx > Bite Wounds, Burns and Bullets > Flashcards

Bite Wounds, Burns and Bullets Flashcards

1
Q

Most common pathogen cultured from bite wounds in dogs and cats?

A

Pasteurella multocida

(NAVLE Q)

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2
Q

What communicable diseases can be transmitted in cat-to-cat bites?

A

FeLV and FIV

must do FeLV/FIV testing on arrival, and again 2 months later due to latency of infection

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3
Q

The canine jaw can generate a force of _______ psi

A

150 to 450 psi

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4
Q

Puncture wounds on the surface look innocent but extensive damage to underlying tissue is common in bite wounds. This is known as the ___________

A

Iceberg Effect

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5
Q

Where are large dog breeds more likely to have bite wounds compared to small dogs?

A

Large dogs = wounds on neck and face

Small dogs = wounds on dorsum, esp caudal to last rib

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6
Q

Do dog or cat bites have a greater risk of infection, and why?

A

Cat bites - usually a puncture wound inoculating bacteria deep into underlying tissue = greater risk of infection

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7
Q

What is BDLD?

A

Big dog little dog

  • combines lifting and shaking of the skin in addition to crushing and tearing
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8
Q

Avulsion injuries are common in dog bite wounds. What does this mean?

A

Damage to major direct cutaneous artery and vein with compromise to collateral vascular supply

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9
Q

Bite wounds “declare themselves” 3-7 days following initial bite wound. What does this mean?

A

Surrounding tissue and skin becomes necrotic following initial wound

(gets worse before getting better)

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10
Q

What is a further complication of cervical bite wounds?

A

Pneumomediastinum from damage to trachea

  • Give O2, pain meds, and stabilize prior to exploring
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11
Q

What is the initial management of a bite wound if the patient is stable for sedation/ anesthesia?

A
  • Aseptically probe (for assessment of dead space)
  • Debride wound edges until they bleed
  • Wound reconstruction using a penrose drain
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12
Q

Drains are usually NOT necessary for bite wounds located _________

A

On the head or extremities

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13
Q

What is the initial management of a bite wound located on the head or extremities?

A
  • Aseptically probe (for assessment of dead space)
  • Debride wound edges until they bleed
  • Use anatomic passive drain by making a stab incision ventral to the wound
  • Lavage and close, but keep stab incision open for draining
  • Bandage limb (not face)
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14
Q

Why are radiographs taken in patients with bite wounds?

A

Looking for penetration of thorax or ABD (Pneumomediastinum, pneumothorax, pneumoperitoneum, ascites, herniation, rib fractures)

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15
Q

What is the treatment protocol for a patient presenting with a clear ABD hernia due to a penetrating abdominal wound?

A
  • EMERGENCY
  • Perform immediate exploratory laparotomy

(Emergency due to inoculation of bacteria into normally bacteria free abdominal cavity)

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16
Q

What is the treatment protocol for a patient presenting with penetrating thoracic bite wounds?

A
  • Generally not a surgical emergency (unlike with penetrating ABD wounds)
  • Clip, clean, debride, and explore but be careful with lavage
  • Do rads
  • Loss of integrity to chest wall (Ex: multiple rib fractures) requires surgical reconstruction
17
Q

What is required for penetrating thoracic bite wounds resulting in extensive rib fractures?

A

Prosthetic mesh reconstruction (Prolene mesh implant) with thoracostomy tube placed (to restore neg thoracic pressure) and closed suction drain

18
Q

List the risk factors of penetrating thoracic wounds suggesting higher level of care will be needed

A
  • Pneumothorax (25x risk of requiring thoracotomy than if no pneumo)
  • Rib fracture(s)
  • Flail chest
    ALL CASES REFER TO SPECIALIST!!

(Risk of MORTALITY if pleural effusion or positive bacterial culture)

19
Q

List the risk factors associated with mortality in patients with penetrating thoracic wounds

A
  • Pleural effusion (penetrated lungs)
  • Positive bacterial culture (20x risk of dying)
20
Q

True or False: Multiple/severe bite wounds can initiate SIRS

A

TRUE

21
Q

Why is fresh frozen plasma sometimes indicated for patients with multiple/severe bite wounds?

A

Bite wounds can initiate SIRS → coagulopathy → MODS → ARDS

**FFP contains all coag factors + proteins

(check coag panel on BDLD cases)

22
Q

How is BD/BD different from BDLD wounds?

A

Less shearing/avulsion injury with BDBD bite wounds, iceberg effect is minimal

23
Q

What is the treatment protocol for bite wound abscesses?

A
  • FNA/cytology if needed
  • Surgical drainage mandatory → Lance with #15 blade → Lavage → OWM using non selective debridement then switch to MRD to allow for 2nd intention healing OR enbloc debridement and primary closure → tie over bandage
24
Q

Most common cause of thermal burns in pets?

A

Iatrogenic from stupid vets that use electrical heating pads, hot water bottles, etc

Use HotDog warming sytem or Bair Hugger!!!

25
Q

What is a superficial burn?

A

1st degree, involves outermost epidermis

  • Moist, painful, heals spontaneously within days
26
Q

What is a partial thickness burn?

A

2nd degree, involves epidermis and portion of the dermis

  • Painful w inflammation, can heal spontaneously but takes weeks to months
27
Q

What is a full thickness burn?

A

3rd degree, involves full thickness of epidermis and dermis

  • Dark brown, non painful, ESCHAR/ “Eschar Split”
28
Q

What type of burn is extension beyond the dermis?

A

4th degree

(Needs Sx/And intention

29
Q

What is “Eschar Split”?

A
  • When you gently lift scab and only see SQ and not dermis or epidermis
30
Q

Burn areas approaching ____% of TBSA may warrant euthanasia due to poor prognosis for recovery

A

50%

31
Q

When is chilled saline used for conservative therapy of burns?

A

If burn wound is assessed within 2 hours from injury

32
Q

Most common cause and location of shearing injuries?

A
  • Limb caught beneath car and dragged, ass with severe abrasion of soft tissue and malleoli
  • Involves tarsocrural joint (ankle)
32
Q

What topicals are commonly used for burn wounds?

A
  • Silver sulfadiazine!!
  • Manuka honey!!
  • Aloe vera
  • Chilled saline if fresh burn < 2hrs
33
Q

Treatment plan for degloving/shearing injuries?

A
  • If large flap of tissue has been avulsed = unlikely viable, primary closure will fail
  • Use OWM
  • Immobilize the tarsus with LATERALLY placed splint + modified Robert Jones bandage

Sem 6: SASx (4 decks)

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