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
2
Q
What year is the veterinary surgeon act made?
A
1966
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.
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
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
6
Q
What would you provide in cases of hypovolaemic shock?
A
IVFT
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.
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?
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
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
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
12
Q
Name two disadvantages of an oxygen tank.
A
CO2 build up
Patient can become hot
13
Q
Name an advantage and a disadvantage of an oxygen tent.
A
Advantage- minimal stress, allows 90% O2 delivery
Disadvantage- expensive
14
Q
What is a disadvantage of flow-by oxygen?
A
Doesn’t allow high concentration of oxygen
15
Q
Name some disadvantages of nasal prongs
A
Not tolerated well
Fall out frequently
Cause sneezing
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
17
Q
What is paresis?
A
Weakness
18
Q
What is plegia?
A
Paralysis (unable to move)
19
Q
What is quadriplegia?
A
Paralysis of all 4 limbs
20
Q
What is paraplegia?
A
Paralysis of 2 limbs
21
Q
What does hemiplegia mean?
A
Paralysis of one side of the body
22
Q
What does hypermetria mean?
A
Exaggerated Limb movement
23
Q
What does obtunded mean?
A
Mentally dull
24
Q
What does stuporous mean?
A
Semi-conscious
Only roused by painful stimulus
25
Define a patient in a coma
Unconscious, unable to be roused
26
Name 4 things CPR helps the body to do.
Ventilates the lungs & pumps blood around body
Allows blood to become oxygenated
Oxygenated blood flows through the body to the brain
Prevents tissue death
27
How many people are required to perform CPR?
2
28
When carrying out IPPV, how many breaths should be given In a minute and what care should be taken?
6-12 breaths per minute
Care taken not to overinflate the lungs
29
Explain how to carry out CPR.
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
30
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?
Blood pressure monitor
Stop every 30 seconds to check
31
Describe a simple fracture?
Bone broken with only one fracture line
32
Describe a comminuted fracture?
Broken bone with more than one fracture line
33
Describe a green stick fracture?
When the bone is not completely broken in two, break in cortex of bone (common in young animals)
34
Describe the term Arulsion
When a broken bone comes away from an area of break
35
What is a compound fracture?
An open fracture - punctured through the skin
36
Name the 4 steps of first aid for fractures.
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)
37
What is the service available for help with poisons?
VPIS
| veterinary poisons informations service
38
Name the 4 steps of first aid for poisons.
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)
39
What is the antidote for warfarin poisoning?
Vitamin K
40
Other than inducing vomiting - what else can be done to treat poisons?
Gastric lavage- stomach tube to wash out the Poison
Absorbative agent - charcoal can be fed to absorb poison
41
Name the 6 steps of treating burns and scalds.
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
42
What are signs of cardiac arrest?
```
Agonal breathing pattern
Absence of breathing
Absence of pulse or heart beat
Loss of consciousness
Fixed, dilated pupils
Lack of reflexes
```
43
What are the 3 steps for tracheostomy placement ?
Dorsal recumbency
Hyper extensions of the neck
Mid- cervical region clipped and prepped
44
Name 5 drugs it is important to have in a crash kit/box
```
Adrenaline
Atropine
Lidocaine
Diazepam
Analgesics
```
45
What is hypvolaemic shock and name 3 causes?
It is deceased circulating blood volume
Causes:
Haemorrhage
Severe vomiting and diarrhoea
Loss of fluid into body cavities
46
What is distributive shock? And name 3 causes.
It is abnormal distribution of body fluids - dilation of all blood vessels
Causes:
Sepsis
Systemic inflammatory response (severe pancreatitis)
Severe allergic reaction
47
What is cardiogenic shock? And name 2 causes
Failure of heart to act as an effective pump.
Causes:
Dilated cardiomyopathy
Severe arrhythmias
48
What is obstructive shock? And name 3 causes
Physical obstruction to blood flow within the vascular system
Causes:
Pulmonary
Thromboembolism
Pericardial effusion
49
Describe central venous catheters. Where are they placed? And why are they used?
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
50
What is phlebitis and name 4 signs
Inflammation of the vessel wall in reaction to a catheter
```
Signs:
Erythema (red skin)
Swelling
Pain
Heat
```
51
What is thrombosis
Formation of a blood clot within a vessel
52
What is the correct terminology for when fluids/drugs enter tissues around a vein?
Extravasation
53
What species would you use a 24G catheter?
Rabbits or very small cats
54
When would you use a 18G catheter
In large or giant dogs
55
What catheter care should be provided every 4 hours?
Check bandage for dampness/ tightness
Check site for pain, swelling
Flush with heparinised saline to check patency and prevent clots forming
56
How long after placement of a catheter should it be removed?
3 days
57
How often should recumbent patients be turned?
Every 4 hours
Prevent decubitus ulcers and hypostatic pneumonia
58
With regards to patient handover, what does SOAP stand for?
Subjective -bright, flat etc
Objective - TPR etc
Assessment - appetite, neurological function
Plan - repeating care, time of feeds
59
What does an ECG measure and detect?
Measures electrical activity of the heart
Detects acid base balance
60
What does blood pressure measure?
Measurement of cardiac output and tissue flow
61
What is systolic blood pressure?
Maximum pressure in arteries when the heart contracts and pushers blood into the body
62
What is Diastolic blood pressure
Minimum pressure in the arteries between beats when the heart relaxes to fill with blood
63
In dogs What type of blood can patients that are DEA 1.1 receive?
Can receive 1.1 negative
| Or 1.1 positive blood
64
In dogs, what blood can patients that are DEA negative receive?
Can only receive DEA 1.1 negative
65
What is the most common blood type in cats?
Blood type A
66
Name the 3 blood types for cats.
A
B
AB
67
Why wouldn't you give a type B cat Type A blood transfusion?
B type carry antibodies against type A
NEVER GIVE B TYPE a TYPE A TRANSFUSION
68
What is oerythrolysis?
When a kitten (type a) suckles colostrum from a type b mother
Causing damage to its type a red blood cells
69
What must be firstly carried out on a cat blood donor?
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
What size needle and blood bag should be used when taking a transfusion from a cat?
20G needle
250/450ml blood bag
71
In cats what is the percentage of blood you can take for a transfusion?
No more than 20%
11-13ml/kg
72
Describe taking blood for a transfusion.
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
Ideally what temperature should blood products be at?
37 degrees C
74
What should blood be administered through when carrying out a transfusion?
Through a fitter
Removes any blood clots and debris
75
What is the infusions rate for a blood transfusion?
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
What fluids should never be given to patients receiving blood products?
Hartmanns
77
What does a pulse oximetre measure
Saturation of oxygen in haemoglobin (SpO2)
78
What should a healthy animal's SpO2 be above ?
97%
79
When should you provide O2 therapy to patients with low SpO2?
If it's below 93%
80
What is severe rib displacement repaired with?
K-wires or cerclage wires
81
What is flail chest and how would you position the patient?
When section of rib cage is fractured and moves independently
Place animal in lateral recumbency with flail fracture underneath
82
What damage does a ruptured diaphragm do?
Compresses vena cava causing a reduce in blood to the heart
Decreased cardiac output
Damage to abdominal organs
83
What would you do to patient with a ruptured diaphragm?
Elevate head and chest
| O2 therapy, analgesia, IVFR and treat for shock
84
Explain care of a tracheostomy tube
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
Name 6 signs of laryngeal paralysis.
```
Dyspnoea
Abdominal breathing
Exercise intolerance
Cyanosis
Hyperthermia
Change in bark
```
86
What is the treatment for laryngeal paralysis?
O2 therapy
Sedation
Keep patient calm and cool
Maintain in sternal recumbency
Long term- surgery to tie back muscle folds
87
What does BOAS stand for?
Brachycephalic obstructive airyway syndrome
Abnormal conformation of the animal causing airway obstruction - causes collapse and syncope
88
How would you treat a patient with tracheal collapse?
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
What is the treatment for feline asthma?
| Name 3 signs of feline asthma
Treatment: use of inhaler, corticosteroids, bronchodilators
Signs: dyspnoea, abdominal breathing, wheezing
90
What is parenchymal disease?
| Name some causes
When the alveoli becomes filled with either fluid or tissue
```
Causes:
Heart failure
Neoplasia
Pneumonia
Pulmonary thromboembolism
```
91
Describe triaging a chest trauma patient.
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
What is percussion massage?
When hands strike chest wall alternatively during inspiration and expiration - moving along chest wall
93
What is the treatment for a dislocation?
Reduction performed under GA
Immobilise Limb with sling to prevent re-luxation
Cage rest
94
Where is a velpeau sling placed?
Shoulder
95
Where is a Ehmer sling placed?
Hind limbs
96
What is hypoglycaemia?
Low levels of blood sugar
| Can occur in neonate and those with underlying conditions
97
Name 4 causes of hypoglycaemia?
Name 5 signs of hypoglycaemia?
```
Causes:
Insulin overdose
Insulinoma
Addisons
Liver failure
```
```
Signs:
Weakness
Collapse
Ataxia
Tremors/seizures
Unconsciousness
```
98
What is the treatment for hypoglycaemia?
```
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
What is Hyperkalaemia?
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
Name 3 causes of hyperkalaemia?
Name 3 signs also
Causes:
Urethral obstruction
Acute renal failure
Addisons
Signs:
Bradycardia
Poor pulse
Depression, lethargy
101
What is the treatment for hyperkalaemia?
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
What is Hypercalcaemia?
An increased level of blood calcium
103
What are 3 causes of hypercalcaemia?
What are 3 signs?
Neoplasia
Toxicity
Addisons
```
Signs:
PUPD
v+
D+
Renal failure
```
104
What is the treatment for Hypercalcaemia?
IV Catheter and IVFT - under vet direction
Monitor for neurological signs
Encourage eating
105
What is Diabetic Ketoacidosis?
A complication of diabetes mellitus, results of excessive fat breakdown - causing large quantities of acidic blood
Potential for hypokalaemia
106
Name signs of Diabetic Ketoacidosis.
Anorexia, V+, PUPD, dehydration, shock, ketone breath, tachypnoea, collapse
107
What is the treatment for Diabetic Ketoacidosis?
IVFT - supplementing electrolytes
| Insulin therapy - short acting I/V
108
What is the treatment for addisons?
Can be life threatening
Aggressive IVFT - don't use hartmanns - contains K
Monitoring vitals + electrolytes
IV Corticosteroids
Treat hyperkalaemia
109
What is DIC?
What is the treatment?
Disseminated Intravascular Coagulation
When the bodies clotting system becomes overactivated leading to consumption of clotting factors
Treatment:
Blood transfusion
110
What is the treatment for megaoesophagus?
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
What is the treatment for GDV?
Gastric decompression - stomach tube/gastrocentesis
Rapid IVFT - line in each forelimb
Monitor vitals
Surgery to de-rotate stomach and suture to abdominal wall
112
What is treatment for pancreatitis?
Nil by mouth until vomiting stops
Analgesia
Antibiotics
Low fat diet
113
What is treatment for proptosis of globe?
Maintain airway, evaluate for shock
Control haemorrhage
Sedation/GA to replace
If optic nerve is stretched is can cause loss of vision
114
What is Glaucoma?
A rise in ocular pressure exceeding 40mm.
115
What is the treatment for Glaucoma?
```
Measured with Tonometre or Tono-pen.
Topical eye drops
Mannitol- to reduce ocular pressure
Buster collar
Analgesia
```
116
How do you treat a corneal ulcer?
Treat underlying cause e.g entropion
Topical eye drops
Debridement
Grid keratotomy
Collagen contact lens
117
What is Opisthotonus?
When the animal head and neck are arched
118
What is the treatment for Opisthostanus?
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
What is Status epilepticus?
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
Why must diazepam not be drawn up in advance?
As it doesn't keep in plastic
121
Name some treatment carried out on spinal trauma patients.
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
What is dystocia?
Failure of the uterus to contract, may be primary uterine intertia due to large litter or secondary due to prolonged straining.
123
When does a whelping bitch require a vet ?
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
What nursing care can be carried out for a caesarean?
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
Explain neonatal resuscitation.
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
What treatment can be carried or for eclampsia?
Continuos monitoring of blood calcium levels
IVFT - infused with 10% calcium gluconate
TPR
Oral calcium supplementation
Wean pups if possible
127
What is the treatment for paraphimosis? (Inability to retract penis)
Gently clean penis with warm water, saline, apply lubricant
Buster collar
Topical hyperosmolar solution to reduce swelling
Manually replace penis - requires sedation/GA
128
What would you carry out after unblocking a urethral obstruction?
Urinalysis
Culture testing
Treat for hyperkalaemia
IVFT
analgesia
129
What Nursing treatment can be provided for an animal with renal failure ?
```
IVFT - diagnostic tests
Monitor for overperfusion
Diuretics - encourage urine production
Monitor urine production
Peritoneal dialysis
```
130
How do you treat e.caniculi in a rabbit?
Fenbendazole
Quiet supportive treatment
131
How would you care for a rabbit with gut stasis?
```
Maintain body temp
Pro-biotics
High fibre diet
Analgesics
IVFT - 75-100ml/kg/day
Gut stimulants
```
Encourage to exercise
Always check teeth
132
How often should animals with hyperthermia be monitored?
Above 41 degrees
Monitor every 5 minutes
