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Anatomy & Physiology > Emergency & Critical Care > Flashcards

Emergency & Critical Care Flashcards

1
Q

What are the 3 aims of first aid?

A

Preserve life
Prevent suffering
Prevent deterioration of a patients condition

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2
Q

What year is the veterinary surgeon act made?

A

1966

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3
Q

What does schedule 3 in the veterinary surgeons act propose anyone in an emergency situation can do?

A

Anyone can give first aid to an animal in an emergency situation.
Provided it is for the purpose of saving a life or relieving suffering.

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4
Q

What should you carry out in a primary survey?

A

Identify any life threatening conditions and treat them
Carry out ABC
Look out for consciousness or unconsciousness, look out for neurological signs

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5
Q

What does ABC stand for when providing first aid?

A

Airways - any obstructions, pull tongue out

Breathing - apnoea, struggling, resps per minute

Circulation - strong/weak, rhythm, mm, CRT

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6
Q

What would you provide in cases of hypovolaemic shock?

A

IVFT

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7
Q

What should you carry out on a secondary survey?

A

Checking for any abnormalities or injuries by completing a head to tail check.

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8
Q

In an emergency situation, what sort of questions should you ask an owner?

A

Any diagnosed conditions?
Ingestion of poisons?
When the pet ate last?
Any illness/ on any medication?

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9
Q

What are 4 pointers when moving a casualty?

A

Animal should be on a firm surface.
Animal unable to escape.
Animal feels secure- carry in a towel
Adequate ventilation

Stretchers can be used for larger dogs and should be rigid and supporting

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10
Q

Name 6 signs of respiratory distress.

A 
Cyanosis - blue mucous membranes 
Abducted elbows
Extended neck
Paradoxical abdominal movements (when abdomen moves in and chest moves out)
Dilated pupils
Anxious facial expressions
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11
Q

Name one advantage and one disadvantage of a transtracheal catheter when providing oxygen.

A

Advantage- useful in patients with upper respiratory issues

Disadvantage- difficult to maintain

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12
Q

Name two disadvantages of an oxygen tank.

A

CO2 build up

Patient can become hot

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13
Q

Name an advantage and a disadvantage of an oxygen tent.

A

Advantage- minimal stress, allows 90% O2 delivery

Disadvantage- expensive

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14
Q

What is a disadvantage of flow-by oxygen?

A

Doesn’t allow high concentration of oxygen

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15
Q

Name some disadvantages of nasal prongs

A

Not tolerated well

Fall out frequently

Cause sneezing

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16
Q

Name an advantage and disadvantage of a nasal catheter

A

Advantage- cheap and easy to place with practice

Disadvantage - may require sedation, irritating and cause sneezing

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17
Q

What is paresis?

A

Weakness

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18
Q

What is plegia?

A

Paralysis (unable to move)

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19
Q

What is quadriplegia?

A

Paralysis of all 4 limbs

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20
Q

What is paraplegia?

A

Paralysis of 2 limbs

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21
Q

What does hemiplegia mean?

A

Paralysis of one side of the body

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22
Q

What does hypermetria mean?

A

Exaggerated Limb movement

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23
Q

What does obtunded mean?

A

Mentally dull

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24
Q

What does stuporous mean?

A

Semi-conscious

Only roused by painful stimulus

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25
Q

Define a patient in a coma

A

Unconscious, unable to be roused

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26
Q

Name 4 things CPR helps the body to do.

A

Ventilates the lungs & pumps blood around body

Allows blood to become oxygenated

Oxygenated blood flows through the body to the brain

Prevents tissue death

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27
Q

How many people are required to perform CPR?

A

2

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28
Q

When carrying out IPPV, how many breaths should be given In a minute and what care should be taken?

A

6-12 breaths per minute

Care taken not to overinflate the lungs

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29
Q

Explain how to carry out CPR.

A

Have animal in right lateral recumbency - neck and forelimbs extended cranially

Apply compressions where elbow lies against chest

100 compressions PER MINUTE - using heel of hands

For every 30 compressions carry out 2-3 breaths

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30
Q

When performing CPR ideally what should an animal be connected to? And how often should you stop to check for any returning of pulse/resp?

A

Blood pressure monitor

Stop every 30 seconds to check

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31
Q

Describe a simple fracture?

A

Bone broken with only one fracture line

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32
Q

Describe a comminuted fracture?

A

Broken bone with more than one fracture line

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33
Q

Describe a green stick fracture?

A

When the bone is not completely broken in two, break in cortex of bone (common in young animals)

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34
Q

Describe the term Arulsion

A

When a broken bone comes away from an area of break

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35
Q

What is a compound fracture?

A

An open fracture - punctured through the skin

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36
Q

Name the 4 steps of first aid for fractures.

A
  1. Do not handle the fracture site
  2. Provide analgesia
  3. Dress any wounds
  4. Immobilise fracture site (splint/Robert jones)

(Any bandage must cover fracture and the nearest joint - with even pressure and toes free to check for swelling)

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37
Q

What is the service available for help with poisons?

A

VPIS

veterinary poisons informations service

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38
Q

Name the 4 steps of first aid for poisons.

A

1- remove source of poison if possible

2- induce vomiting - apomorphine
(Do not induce if substance is volatile or if patient is not fully conscious)

3- IVFT - especially if poison affects kidney function

4- Administer specific antidote
(Vitamin K for warfarin)

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39
Q

What is the antidote for warfarin poisoning?

A

Vitamin K

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40
Q

Other than inducing vomiting - what else can be done to treat poisons?

A

Gastric lavage- stomach tube to wash out the Poison

Absorbative agent - charcoal can be fed to absorb poison

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41
Q

Name the 6 steps of treating burns and scalds.

A

1- remove the source

2- carry out primary exam - is it life threatening

3- apply copious amounts of cold water for 10 minutes - avoid hypothermia

4- clip area to expose

5- dress the area - non adherent such as grassolind, clingfilm

6- provide analgesia

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42
Q

What are signs of cardiac arrest?

A 
Agonal breathing pattern
Absence of breathing
Absence of pulse or heart beat
Loss of consciousness 
Fixed, dilated pupils
Lack of reflexes
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43
Q

What are the 3 steps for tracheostomy placement ?

A

Dorsal recumbency

Hyper extensions of the neck

Mid- cervical region clipped and prepped

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44
Q

Name 5 drugs it is important to have in a crash kit/box

A 
Adrenaline 
Atropine
Lidocaine 
Diazepam 
Analgesics
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45
Q

What is hypvolaemic shock and name 3 causes?

A

It is deceased circulating blood volume

Causes:
Haemorrhage
Severe vomiting and diarrhoea
Loss of fluid into body cavities

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46
Q

What is distributive shock? And name 3 causes.

A

It is abnormal distribution of body fluids - dilation of all blood vessels

Causes:
Sepsis
Systemic inflammatory response (severe pancreatitis)
Severe allergic reaction

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47
Q

What is cardiogenic shock? And name 2 causes

A

Failure of heart to act as an effective pump.

Causes:
Dilated cardiomyopathy
Severe arrhythmias

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48
Q

What is obstructive shock? And name 3 causes

A

Physical obstruction to blood flow within the vascular system

Causes:
Pulmonary
Thromboembolism
Pericardial effusion

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49
Q

Describe central venous catheters. Where are they placed? And why are they used?

A

Placed under sedation/GA

Long catheters placed into jugular vein and end of catheter sits in vena cava

Used in critical care cases where prolonged venous access is required
Used for parental nutrition OR hypertonic fluids

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50
Q

What is phlebitis and name 4 signs

A

Inflammation of the vessel wall in reaction to a catheter

Signs:
Erythema (red skin)
Swelling
Pain
Heat
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51
Q

What is thrombosis

A

Formation of a blood clot within a vessel

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52
Q

What is the correct terminology for when fluids/drugs enter tissues around a vein?

A

Extravasation

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53
Q

What species would you use a 24G catheter?

A

Rabbits or very small cats

54
Q

When would you use a 18G catheter

A

In large or giant dogs

55
Q

What catheter care should be provided every 4 hours?

A

Check bandage for dampness/ tightness

Check site for pain, swelling

Flush with heparinised saline to check patency and prevent clots forming

56
Q

How long after placement of a catheter should it be removed?

A

3 days

57
Q

How often should recumbent patients be turned?

A

Every 4 hours

Prevent decubitus ulcers and hypostatic pneumonia

58
Q

With regards to patient handover, what does SOAP stand for?

A

Subjective -bright, flat etc

Objective - TPR etc

Assessment - appetite, neurological function

Plan - repeating care, time of feeds

59
Q

What does an ECG measure and detect?

A

Measures electrical activity of the heart

Detects acid base balance

60
Q

What does blood pressure measure?

A

Measurement of cardiac output and tissue flow

61
Q

What is systolic blood pressure?

A

Maximum pressure in arteries when the heart contracts and pushers blood into the body

62
Q

What is Diastolic blood pressure

A

Minimum pressure in the arteries between beats when the heart relaxes to fill with blood

63
Q

In dogs What type of blood can patients that are DEA 1.1 receive?

A

Can receive 1.1 negative

Or 1.1 positive blood

64
Q

In dogs, what blood can patients that are DEA negative receive?

A

Can only receive DEA 1.1 negative

65
Q

What is the most common blood type in cats?

A

Blood type A

66
Q

Name the 3 blood types for cats.

A

A
B
AB

67
Q

Why wouldn’t you give a type B cat Type A blood transfusion?

A

B type carry antibodies against type A

NEVER GIVE B TYPE a TYPE A TRANSFUSION

68
Q

What is oerythrolysis?

A

When a kitten (type a) suckles colostrum from a type b mother

Causing damage to its type a red blood cells

69
Q

What must be firstly carried out on a cat blood donor?

A

Perform infectious disease screen
Perform blood typing
Perform full haematology & biochemistry (PCV, total solids)

Must be a healthy cat aged 1-8years old weighing more than 4kg

70
Q

What size needle and blood bag should be used when taking a transfusion from a cat?

A

20G needle

250/450ml blood bag

71
Q

In cats what is the percentage of blood you can take for a transfusion?

A

No more than 20%

11-13ml/kg

72
Q

Describe taking blood for a transfusion.

A

Use jugular vein
Allow syringe to fill at 5ml/min (cats)
Allow syringe to fill 40-50ml/minute (dogs)

Apply pressure with swabs on site for 2 minutes

Wrap vetwrap/neck bandage over swabs and leave for 30-60 minutes.

73
Q

Ideally what temperature should blood products be at?

A

37 degrees C

74
Q

What should blood be administered through when carrying out a transfusion?

A

Through a fitter

Removes any blood clots and debris

75
Q

What is the infusions rate for a blood transfusion?

A

Initially 0.5 - 1 ml/kg/hour for 15-30 minutes

If no reactions the rest of the blood can be administered over 4 hours

76
Q

What fluids should never be given to patients receiving blood products?

A

Hartmanns

77
Q

What does a pulse oximetre measure

A

Saturation of oxygen in haemoglobin (SpO2)

78
Q

What should a healthy animal’s SpO2 be above ?

A

97%

79
Q

When should you provide O2 therapy to patients with low SpO2?

A

If it’s below 93%

80
Q

What is severe rib displacement repaired with?

A

K-wires or cerclage wires

81
Q

What is flail chest and how would you position the patient?

A

When section of rib cage is fractured and moves independently

Place animal in lateral recumbency with flail fracture underneath

82
Q

What damage does a ruptured diaphragm do?

A

Compresses vena cava causing a reduce in blood to the heart
Decreased cardiac output
Damage to abdominal organs

83
Q

What would you do to patient with a ruptured diaphragm?

A

Elevate head and chest

O2 therapy, analgesia, IVFR and treat for shock

84
Q

Explain care of a tracheostomy tube

A

Dressing changed daily
Flushed with 2-10ml of sterile saline
Apply auctions to remove this along with any secretions
Saline acts to humidify the tube

85
Q

Name 6 signs of laryngeal paralysis.

A 
Dyspnoea
Abdominal breathing
Exercise intolerance
Cyanosis
Hyperthermia
Change in bark
86
Q

What is the treatment for laryngeal paralysis?

A

O2 therapy
Sedation
Keep patient calm and cool
Maintain in sternal recumbency

Long term- surgery to tie back muscle folds

87
Q

What does BOAS stand for?

A

Brachycephalic obstructive airyway syndrome

Abnormal conformation of the animal causing airway obstruction - causes collapse and syncope

88
Q

How would you treat a patient with tracheal collapse?

A

Intubation can worse state
Signs include a goose-honk cough

Gain IV access 
Sternal recumbency 
Keep patient quiet, stress free
Sedative to calm dog 
Monitor with pulse ox

In emergency:
Tracheostomy tube, IPPV

89
Q

What is the treatment for feline asthma?

Name 3 signs of feline asthma

A

Treatment: use of inhaler, corticosteroids, bronchodilators

Signs: dyspnoea, abdominal breathing, wheezing

90
Q

What is parenchymal disease?

Name some causes

A

When the alveoli becomes filled with either fluid or tissue

Causes:
Heart failure
Neoplasia
Pneumonia
Pulmonary thromboembolism
91
Q

Describe triaging a chest trauma patient.

A

1st- maintain patent airway, control haemorrhage, o2 supplementation, stress free environment

2nd- TPR, MM- cyanosis?

3rd- any external wounds - if penetration to chest needs to be covered by a sterile dressing

92
Q

What is percussion massage?

A

When hands strike chest wall alternatively during inspiration and expiration - moving along chest wall

93
Q

What is the treatment for a dislocation?

A

Reduction performed under GA

Immobilise Limb with sling to prevent re-luxation

Cage rest

94
Q

Where is a velpeau sling placed?

A

Shoulder

95
Q

Where is a Ehmer sling placed?

A

Hind limbs

96
Q

What is hypoglycaemia?

A

Low levels of blood sugar

Can occur in neonate and those with underlying conditions

97
Q

Name 4 causes of hypoglycaemia?

Name 5 signs of hypoglycaemia?

A 
Causes: 
Insulin overdose
Insulinoma
Addisons
Liver failure
Signs:
Weakness
Collapse
Ataxia
Tremors/seizures
Unconsciousness
98
Q

What is the treatment for hypoglycaemia?

A 
Monitor blood glucose levels
Rub sugar solution on gums if conscious 
Offer food
Maintain body temp
Monitor TPR

If vet present:
Administer I/v glucose
Place IV catheter
IVFT

99
Q

What is Hyperkalaemia?

A

An increase in blood potassium level

It’s usually eliminated in the kidneys. It’s acidity can impact on the hearts ability to function
8.0mmol/l = death

100
Q

Name 3 causes of hyperkalaemia?

Name 3 signs also

A

Causes:
Urethral obstruction
Acute renal failure
Addisons

Signs:
Bradycardia
Poor pulse
Depression, lethargy

101
Q

What is the treatment for hyperkalaemia?

A

IVFT if vet present - CARE 0.9% NaCL to increase renal excretion
Monitor TPR, electrolytes, blood gases
IV calcium, insulin, dextrose - drives potassium intracellular - if vet present

102
Q

What is Hypercalcaemia?

A

An increased level of blood calcium

103
Q

What are 3 causes of hypercalcaemia?

What are 3 signs?

A

Neoplasia
Toxicity
Addisons

Signs:
PUPD
v+
D+
Renal failure
104
Q

What is the treatment for Hypercalcaemia?

A

IV Catheter and IVFT - under vet direction
Monitor for neurological signs
Encourage eating

105
Q

What is Diabetic Ketoacidosis?

A

A complication of diabetes mellitus, results of excessive fat breakdown - causing large quantities of acidic blood

Potential for hypokalaemia

106
Q

Name signs of Diabetic Ketoacidosis.

A

Anorexia, V+, PUPD, dehydration, shock, ketone breath, tachypnoea, collapse

107
Q

What is the treatment for Diabetic Ketoacidosis?

A

IVFT - supplementing electrolytes

Insulin therapy - short acting I/V

108
Q

What is the treatment for addisons?

A

Can be life threatening
Aggressive IVFT - don’t use hartmanns - contains K

Monitoring vitals + electrolytes
IV Corticosteroids
Treat hyperkalaemia

109
Q

What is DIC?

What is the treatment?

A

Disseminated Intravascular Coagulation

When the bodies clotting system becomes overactivated leading to consumption of clotting factors

Treatment:
Blood transfusion

110
Q

What is the treatment for megaoesophagus?

A

Placement of gastronomy tube for feeding to bipass pocketing

Feed from a height
Animal should remain elevated 15-20minutes after meals
Water food down into a milkshake consistency
Feed little and often

Only maintenance - no immediate treatment

111
Q

What is the treatment for GDV?

A

Gastric decompression - stomach tube/gastrocentesis
Rapid IVFT - line in each forelimb
Monitor vitals
Surgery to de-rotate stomach and suture to abdominal wall

112
Q

What is treatment for pancreatitis?

A

Nil by mouth until vomiting stops
Analgesia
Antibiotics
Low fat diet

113
Q

What is treatment for proptosis of globe?

A

Maintain airway, evaluate for shock
Control haemorrhage
Sedation/GA to replace
If optic nerve is stretched is can cause loss of vision

114
Q

What is Glaucoma?

A

A rise in ocular pressure exceeding 40mm.

115
Q

What is the treatment for Glaucoma?

A 
Measured with Tonometre or Tono-pen. 
Topical eye drops
Mannitol- to reduce ocular pressure
Buster collar
Analgesia
116
Q

How do you treat a corneal ulcer?

A

Treat underlying cause e.g entropion

Topical eye drops
Debridement
Grid keratotomy
Collagen contact lens

117
Q

What is Opisthotonus?

A

When the animal head and neck are arched

118
Q

What is the treatment for Opisthostanus?

A

Place in lateral recumbency with forelimbs and neck in rigid position

Elevate animals head at 30 degrees to improve arterial drainage to head
Avoid jugular venapuncture
Pulse ox
O2 therapy
Pain management
Adjust noise and lighting 
Turn patient every 30 minutes
Monitor excretions
Encourage to eat
Corticosteroids is contra-indicated in head trauma patients
119
Q

What is Status epilepticus?

A

When a seizure is prolonged (> 5 mins) of multiple seizures in short period of time without fully recovering between

An emergency
Can lead to brain damage

120
Q

Why must diazepam not be drawn up in advance?

A

As it doesn’t keep in plastic

121
Q

Name some treatment carried out on spinal trauma patients.

A

Turn every 4 hours if recumbent
Bladder may require manual expression
Physiotherapy (coupage, passive Limb exercises)
Aim not to worsen condition

Animals will often show aggression due to pain and distress

122
Q

What is dystocia?

A

Failure of the uterus to contract, may be primary uterine intertia due to large litter or secondary due to prolonged straining.

123
Q

When does a whelping bitch require a vet ?

A

Straining unproductively for > 1 hour

Straining longer than 30minutes between each pup

Green/black discharge present

Foetal fluids expressed and no pup within 2 hours

Bitch is unwell or depressed

Puppy stuck in birth canal

124
Q

What nursing care can be carried out for a caesarean?

A

Oxytocin may be administered to kick start contractions

Prepare theatre etc in advance

In surgery bitches chest should be elevated

Pups should be monitored closely and placed back with mother asap

125
Q

Explain neonatal resuscitation.

A

Clean foetal membranes from neck and head
Clear meconium + oral secretions
Check for cleft palate and abnormalities
Clamp and cut umbilical cord
Stimulate and dry neonate with a towel
Keep head lower than abdomen to allow draining of fluid
Use digital palpating to check for breathing and heart beat
O2 administration

Do not swing pups- can cause brain damage and cervical dislocation

126
Q

What treatment can be carried or for eclampsia?

A

Continuos monitoring of blood calcium levels
IVFT - infused with 10% calcium gluconate

TPR

Oral calcium supplementation
Wean pups if possible

127
Q

What is the treatment for paraphimosis? (Inability to retract penis)

A

Gently clean penis with warm water, saline, apply lubricant

Buster collar

Topical hyperosmolar solution to reduce swelling

Manually replace penis - requires sedation/GA

128
Q

What would you carry out after unblocking a urethral obstruction?

A

Urinalysis
Culture testing

Treat for hyperkalaemia
IVFT
analgesia

129
Q

What Nursing treatment can be provided for an animal with renal failure ?

A 
IVFT - diagnostic tests
Monitor for overperfusion
Diuretics - encourage urine production
Monitor urine production
Peritoneal dialysis
130
Q

How do you treat e.caniculi in a rabbit?

A

Fenbendazole

Quiet supportive treatment

131
Q

How would you care for a rabbit with gut stasis?

A 
Maintain body temp
Pro-biotics
High fibre diet
Analgesics
IVFT - 75-100ml/kg/day
Gut stimulants

Encourage to exercise
Always check teeth

132
Q

How often should animals with hyperthermia be monitored?

A

Above 41 degrees

Monitor every 5 minutes

Anatomy & Physiology (20 decks)

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