Dyspnea Flashcards

1
Q

“Darn if you do and darn if you don’t”

A

cannot perform all diagnostics-may worsen animal

decisions based on: PE Hx SIG

minimize stress for all

prioritize checks: cant do all at once

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2
Q

Abnormal Breathing Patterns

A

Dyspnea - any visible resp distress. animal may invest up to 30% of total energy on breathing

Tachypnea-might be caised by stress or heat

Orthopnea-extreme dyspnea-extended neck, rotated elbows

Trepopnea-breathing is easier in a specific position
Apnea

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3
Q

Dyspnea classifications

A
Upper respiratory obstruction
Lower respiratory obstruction
Lung parenchymal disease
Pleural disease
Flail chest
PTE 
Abdominal enlargement
lookalikes - reverse sneezing
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4
Q

Inspiratory Sounds

A

Stridor - larynx
Strertor - nasopharynx
Reverse sneeze-nasopharynx, not serious
Mega esophagus may dilate and be heard during breathing

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5
Q

Expiratory Lung Sounds

A

Increased lung sounds:

Crackles – pus/blood/water:
fluids in alveoli. most common

Wheezes – allergic/inflammatory:
not common. Chronic. thick bronchioles-resistance

Friction rubs - pleuraitis

Decreased/no lung sounds:

Dorsally: pneumothorax

Ventrally: Pleural effusion

Diaphragmatic Hernia/Mass effect: one sided focal decreased lung/heart sounds

Referred upper respiratory:
Stertor, Megaesophagus

Murmur

lack of lung sound may be indication for thoracocentesis

always look in the mouth!

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6
Q

Emergency Treatments

A

Oxygen - never CI
sedation/analgesia
Thoracocentesis - may be done prior to any Dx other than FAST

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7
Q

FAST

A

Focused Assessment with Sonography for Trauma/Triage:
T-FAST - thorax
A-FAST - abdomen
addition to PE, may negate the need for other Dx (which may be CI). probe at 4 points- bladder diaphragm, sides - for detection of fluids in abd thrx prcrd pneumothorax

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8
Q

Oxygen

A
mask - 40-60%
cage - 60%
nasal tube-40%
two nasal tubes - 60-70%
ET-100%

CI for Nasal O2-

head trauma
glaucoma
severe stress

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9
Q

Analgesia/sedation

A

the sicker they are the lower the dose!

Butorphanol - safe, expensive
butor.+midazolam - if no IV. may relax breathing mm.
for pain- fentanyl, demerol-CI on cats and IV

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10
Q

Thoracocentesis

A

Syringe, stop-cock, extension set, needle or butterfly

7-9th ICS, Cranial to rib

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11
Q

Objective ways for evaluating Resp. function

A

to gauge hypoxia

Pulse oximetry
used more in anesthesia
noninvasive
SpO2 estimates PaO2
lots of FN - environmental/patient factors
dose not evaluate tissue usage, ventilation
not good with CO/metHb

Arterial blood gas
GS
provides info on oxigenation, ventilation, acid/base
invasive
hard to take
painful
usually in sedated&ventilated - to evaluate when to disconnect

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12
Q

Radiographs

A

After stabilization!
be prepared with ET, O2, ambu
Consider DV view only

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13
Q

Common Thoracic Emergencies

A

Thoracic Trauma (HBC)

Rule out:
Lung contusions (increased lung sounds, radioopaque-bleeding)
Pneumothorax (decreased lung sounds dorsally)
DH (muffled heart sounds, decreased lung sounds ventrally)
Hemothorax (decreased lung sounds ventrally)
Broken ribs - Dyspnea from pain

CHF

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14
Q

CHF-dog

A
PE-
increased sounds-crackles (very rarely effusion)
tachycardia
mumur
cold extremities
cachexia
ascites(if bilat CHF)

Hx -
cough, exercise intolerance

CXR-
cardiomegaly
(perihilar) pulmonary edema
venous congestion

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15
Q

CHF - cat

A

PE-
difficult to hear normal sounds in healthy cat
increased/decreased sounds, crackles
tachycardia/bradicardia
usually no murmur (intermittent gallop in 50%), no cough
hard to notice exercise intolerance

Hx-
usually acute, usually arrive in chf

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16
Q

CHF – Emergency diagnosis

A

LA/Ao > 1.5:1 in CHF - baby US

17
Q

CHF - treatment

A

FON
Furosamide, O2, Nitroglycerine

Fusid - for pulmonary edema
2-10mg/kg
monitor BP, electrolites.
may harm kidneys
ok 2 doses before Dx

Nirto - vasodilator