First Aid Flashcards
What is the law in terms of first aid?
Under the VSA 1966, unqualified members of the public can perform first aid ONLY as an interim measure to:
- preserve life and
- alleviate suffering
RVNs may administer first to prevent deterioration and alleviate suffering
What should you do in a first aid situation?
Don’t panic
ABC! Airway Breathing Circulation
Maintain airway
-check for obstructions, extend neck, pull out tongue, remove collar and harness
Check Breathing
- palpate and observe chest
- hold something light in front of nose to see
- if not breathing, start artificial respiration
Control haemorrhage and check circulation
- palpate heartbeat on lateral chest wall caudal to elbow between ribs 3-7 (easier on LHS).
-check pulses, MM and CRT
- If no pulse, start CPR
Contact VS asap!
What Is triage?
Prioritising cases into :
- Those that are likely to live, regardless of treatment
- Those that are likely to die, regardless of treatment
- Those for whom immediate care may result in a positive outcome.
When arriving at the scene of an emergency, what should you do?
- Assess the situation - what are the risks to you and the casualty?
- Assess the casualty
- is it conscious? ABCs. CPR or recovery position - Contact vet ASAP
- Assess the injuries
Give some examples of a life-threatening emergency
Cardiac Arrest Airway obstruction Severe haemorrhage Collapse with dyspnoea Severe burns, dehydration GDV(gastric dilation and volvulus) Sudden onset neurological problems
Give some examples of a serious or urgent emergency
Unconscious Fractures Bleeding (mild) Wounds Spinal injury Eye injuries
Give some examples of minor emergencies
Minor burns, stings FBs (e.g. in paw) diarrhoea lameness skin reaction
What should your conversation with an owner include when receiving a phone call about a potential emergency?
Introduce yourself and practise
ASAP confirm if life threatening
Provide clear directions to the practise and alternative transport methods
Obtain ETA and owners contact info
If not an emergency, obtain:
- patient details
- nature of problem
- first noticed
- on any meds
- previous history of anything similar?
- any other changes
- demeanour of patient
What should the nurse do during resuscitation in the vet practise?
Liase with the vet RE cardiac compression and artificial respiration
Monitor and record throughout emergency and stabilisation.
What is your crash plan?
A - airway
C - circulation R - respiration A - abdomen - signs of internal bleeding, pain S - spine - stable? limbs functioning? H - head - bleeding/ trauma?
P - pelvis - stability, fractures?
L - limbs - fractures? Bleeding?
A - arteries and veins -bleeding elsewhere?
N - nerves - signs of control problems
If you don’t have access to equipment, what 2 methods can be used to oxygenate a patient in respiratory distress?
- Chest compressions
- only to be used when no injury to chest wall.
- lateral recumbency, extend head and neck and pull tongue and front legs forward.
- palm at middle point of chest (top of chest dome)
- compress about 1/3rd way down and try to get chest to spring back.
- compress chest and release every 0.5-1 second - Mouth to Nose
- use face mask
- pull tongue forward and close jaw
- place hands around mouth, support head and seal lips
- place mouth over patients nostrils and blow, inflating the lungs do not overinflate- stop when feel tension
- respire patient every 1 second
What is the procedure for oxygenating a patient in respiratory distress in practise?
Intubate using ET tube (can use a very small one to by pass an obstruction - may need to use tracheostomy) Attach to anaesthetic circuit to provide 100% O2 IPPV bagging (Intermittent Positive Pressure Ventilation) - every 5 seconds until spontaneous ventilation occurs. \+/- respiratory stimulant drugs e.g. doxapram
Describe the method for cardiac compressions
Place in right lateral recumbency
Support lower chest with padding - allows u to apply more force.
Place hands over lower 1/3rd of the chest, just caudal to the elbow (flat part of the chest).
Compress at 0.5-1 second intervals
In small species use fingertips
What is CPR?
How do you carry it out (not in practise)?
Cardiopulmonary resuscitation
- carrying out cardiac massage and artificial respiration simultaneously
- ideal to have 2 people doing 5 compressions to 3 breaths
If on own, cardiac compressions for 15 and then inflate chest twice.
Check HR & RR every 2 cycles
Continue for at least 20-30 minutes or until help arrives
Maintain observations and keep patient warm
Describe how you would carry out CPR in practise?
Intubate patient on 100% o2 - 1 breath every 3-5s (10-12 breaths per minute)- Ambu bag if no anaesthetic machine available.
Cardiac compressions 1-2 compressions per second
Administer drugs under direction of vet
Defibrillator
What is shock?
Circulatory collapse causing inadequate tissue perfusion leading to inadequate supply of O2 to cells
What are the types of shock?
Hypovolaemic
Cardiogenic
Distributive (sepsis)
Obstructive
What can cause shock?
Severe haemorrhage, infection, dehydration, medical condition or some poisons
What are the signs of shock?
Pale MM Prolonged CRT Rapid, shallow respiration Rapid, weak pulse Cold extremities Dilated pupils Dull Depressed Convulsions/ collapse
What first aid can be given to a patient in shock?
Gently warm patient - environmental heat rather than direct - insulate
Control the haemorrhage
Reduce stress
Monitor vital signs - Constant observation
Get vet ASAP
IVFT -according to need (get IV access early as once in shock, its difficult to get a vein)
What are the signs of haemorrhage?
Pale MM Prolonged CRT Rapid, weak pulse Altered breathing pattern Subnormal body temperature Inability to stand/weakness
Describe the 5 types of haemorrhage?
Arterial - bright red oxygenated spurting blood in time with pulse rate
Venous - dark red/purple deoxygenated flowing blood
Capillary - red, oozing blood from pin points
External - outside bleeding from an orifice
Internal - in a body cavity
What does the body do to save itself from haemorrhage?
Elastic recoil
Reduced blood pressure
Back pressure
Blood clotting (needs platelets and clotting factors. Fibrin forms the mesh)
How can you control haemorrhage?
And In practise?
Direct Digital Pressure - your hand on it
Pressure Bandage - care if FB, can use belly bandage(temporary measure)
Pressure Points - on arteries
Arrest haemorrhage and notify VS Keep patient warm and quiet TPR and observe! May need IV access, blood replacement, prep theatre Tourniquet - VS only!
What are open and closed fractures?
Open is when there is a skin and tissue wound also
Closed when there is no open surface wound
What are simple and compound fractures?
No complications (e.g. soft tissue, nerves) = simple Compound = complications
What are overriding and avulsed fractures?
Overriding = body naturally splints the fracture, shrinks muscles and pulls the bones along side each other
Avulsed means there is a bit missing or broken off
What are a) transverse b) oblique c) spiral d) comminuted or multiple e) segmental f) impacted g) torus h) greenstick fractures?
a) straight across break
b) diagonal break
c) twisting round the bone
d) crushed and lots of little bits
e) floating bit
f) bone driven in to each other
g) damage to epiphysis
h) not complete - more of a bend
What first aid should you administer for a fracture? Limb fracture?
Minimise movement of the area and NEVER try and re-set a fracture.
A muzzle may be required
Control any bleeding without disturbing the fracture
Seek VS asap
Assess whole patient - ABCs. Fractures aren’t life threatening!
If a limb fracture, slide folded towel under fracture for support and cover any open fractures with gauze or clean tea towel. Let animal find comfortable position and support the site. Control any haemorrhage and wait for vet.
Check and treat for shock if Apt.
How should you treat a fracture in practise?
Immobilise the fracture site
May require a Robert Jones bandage (very thick) or splint - helps immobilize are, reduce swelling and inflammation.
Provision of analgesic under VS direction
Most patients will require sedation or GA if stable
Radiographs likely
Name the 4 types of open wound
Incised
Lacerated
Puncture
Abrasion
Describe an incised wound
a clean slice caused by sharp implement
- clean edges
- bleeds freely , no elastic recoil (blood vessels aren’t damaged so blood can still get to the area to promote healing)
- often deep, involves other structures
- heal well with little scarring
Describe a lacerated wound
A torn wound - caused by blunt object
e. g. bite or scratches
- Jagged edges
- doesn’t bleed much
- the deeper it is, the more severe
- high risk of infection
- slow healing and extensive scarring
The wound has been stretched, so blood vessels elastic recoiled and shrivelled. Tissues tend to die off because no active blood supply or nutrients
Describe a puncture wound
Deep, narrow wound caused by a sharp point
- small skin wound but deep track
- often infected
- skin heals, trapping the infection causing an abscess
Describe an abrasion wound
Dragging or friction injury causing removal of skin surface
- doesn’t penetrate skin thickness
- painful but rarely serious
- capillary ooze
What are the first aid aims with wounds?
Arrest the haemorrhage
- pressure bandage
Prevent shock
Prevent sepsis
- flush minor wounds with saline ‘dilution is the solution to pollution
- debriding (VS direction )
- appropriate dressing - Cling film can be used in an emergency
What promotes wound healing?
Good supply of nutrients and oxygen
Cleanliness and flushing
Humidity at wound surface
How would you nurse a patient with an open wound?
Maintenance of circulation and good nutrition
Excellent hygiene - PPE etc
Aseptic dressing changes and gentle lavage
Appropriate dressing and bandage selection
Prevent patient interference
Monitoring the patients stress and well-being
Name the 2 types of closed wounds
Contusion and Haemorrhage
Describe a contusion
a blow by a blunt instrument causing rupture of blood vessels in the skin and soft tissue (i.e. bruise) Initially red (inflammatory response), then purple, then fades to yellow/green.
Describe the first aid care for a contusion?
Cold compress - vasoconstricts so reduces severity of bruising
Firm bandage can help reduce swelling
Hot compress can be used a few days after which helps bring nutrients to the area and breakdown the blood clots
Describe a haematoma
Rupture of a blood vessel under the skin causing a pool of blood. Can be caused by self-trauma e.g. head-shaking, blunt trauma.
After the initial trauma, swelling is painless and cold. Over a few weeks, become contracted and hard.
What first aid should you carry out for a haematoma?
Cold compress
tight bandage
Surgery may be required at a later stage to remove clot and relieve pressure and prevent recurrence
What’s the difference between a burn and a scold?
Burn = destruction of tissue by extreme localisation
e.g. dry heat, excessive cold, chemicals, electrical current, radiation
Scalds = destruction of tissue by moist heat e.g. boiling water, steam, oil
How is the severity of a burn measured?
Depth and surface area (% of body surface) affected.
*very deep burns may not be painful as all the nerve endings have been burnt!
What is the first aid treatment for a burn?
Cool area immediately (can be luke warm as long as cooler than body temperature)
Careful in small animals not to cause hypothermia!
Keep the patient warm
Once cool, dress the wound with a non-stick sterile dressing (can use clingfilm)
Monitor patient for hyper/hypothermia and shock
Restrict patient’s movement
Do not leave patient unattended
Comfort them
IVFT may be indicate
plasma can ooze from a blister or burn - it may be this loss that kills the patient! SO monitor for shock!
How would you treat a burn from oil or fat?
Remove the oil or fat immediately to prevent the congealing of the skin.
Use paper towels to remove excess
Apply lukewarm water and detergent to remove the rest
Continue to cool and treat as any other burn
Describe an electrocution burn
What would be the signs in an animal who has had one of these?
creates a surface burn when a high voltage passes through the body. High risk of cardiac arrest
e.g. chewing cables
Patient would be collapsed, stiff or twitching/ spastic contractions of muscles, fur standing on end, short, sharp breathing. Entry and exit points - pale centre surrounded by redness.
What first aid would you carry out for an electrocution burn?
care not to stand in any liquid! Switch off the electricity supply
If cannot turn off, remove the patient with a dry insulator e.g. wooden pole.
Check ABCs
If no HR, start cardiac massage - may have to do CPR
Check burns and treat as any other
Monitor and get to vet ASAP
What are the signs of hyperthermia?
Distress Excessive panting restlessness Cyanosis (unable to respire properly) Hypersalivation Unsteady on feet Collapse and comatose
What first aid would you administer for hyperthermia?
What additional resources can you use in practise?
Remove from the hot environment
Run cool water over patient ( cold water can cause shock)
Soak the coat so that the water contacts the skin
Apply cold towels/ice packs to the heat (heat on the brain is very dangerous -can cause fitting)
Take temp very often until falls below 39 and then just keep an eye on it to ensure it keeps falling (stop cooling when 1 degree above normal)
In practise: un-warmed IV fluids sedation or GA Clipping off coat Cool water enema
Describe the signs of hypothermia
Everything slowly shuts down
sleepy and weak
Ears/paws cold
Slower HR, coma
What first aid should you administer for hypothermia?
In practise?
Slowly warm environment Make sure animal is dry Insulate floor with blankets Cover patient with plenty of blankets Don't use direct heat
In practise:
- ABCs
- warm kennel in warmest room
- thick vet beds
- constant monitoring: TPR every 10 minutes
- Warmed IV fluids may be indicated
What is a poison?
Any substance which when enters the body is enough dose, has a harmful effect.
Who can you call to get a toxic dose?
VPIS
Veterinary Poisons Information Service
What is the role of the first aider or VN when coming across a patient suspected of lead poisoning (on phone)?
Find out:
- patient details
- how the animal is
- when was the substance ingested
- how much was ingested
- ensure animal is removed from source
- attempt to ID the poison
- reserve any faeces/vomit/urine for forensics
- may need to contact VPIS
What are some of the signs of poisoning in animals?
vomiting diarrhoea disorientation abnormal behaviour ataxia shock convulsions profuse salivation unconsciousness
What is it about chocolate that makes it toxic? How much is toxic?
Contains theobromine
milk choc = 9g/kg
dark choc = 1g/kg
What is the treatment for chocolate ingestion?
Activated charcoal
Fluids and monitoring
What are the signs of anti-freeze poison?
What are the treatments?
Acute kidney failure
Vomiting
Inappetant
Seizures
Tx:
- often unsuccessful
- supportive treatment, fluids (to dilute), can use pure ethanol within 24 hrs (reacts with ethylene glycol and converts into something safer)
What are the symptoms of lily poisoning?
Treatment?
Can die rapidly Kidney failure Inappetant Depressed Polydipsia
supportive treatment - often unsuccessful
- may washout stomach
Describe Permethrin poisoning and treatment
Permethrin is found in supermarket spot-ons and insecticides.
Cats are very sensitive (esp if put on a dog product)
Causes twitching, tremors, collapse, convulsions.
Can be fatal
Clip hair and bathe ASAP in lukewarm water
supportive treatment
drugs to control seizures
What is in slug bait that is poisonous? Signs and treatment
Metaldehyde
causes twitching, wobbliness and seizures
Tx:
- sedate or GA if fitting really bad. This gives the brain a rest and will hopefully pull them out of it.
Describe warfarin poisoning
Rat poison
blood thinning agent and prevents clotting
symptoms are just bleeding constantly - epistaxis, pinpoint bleeding, GI bleeding
Tx:
- Vit K - will help clotting
- supportive treatment
- possible a blood transfusion
What ingredient is in peanut butter that is toxic? Describe the treatment and symptoms
Xylitol
increases insulin which decreases blood sugar levels
hypoglycaemia can lead to collapse - fit- coma
Tx:
- manage blood sugar
- check liver
- supportive
- get them to eat
When should you not induce vomiting?
If the poison was corrosive
If the patient is unconscious
If the patient ingested the poison over 2hrs ago.
What should you do to treat topical poisoning?
Prevent the animal grooming or preening - collar, wrap in towel
Constantly supervise
Clean contaminated coat with appropriate substance:
- non-oily compound - disinfectants + water
- liquid, oily compound - Swarfega or cooking oil to work into coat and then wash off with detergent and water until no smell
- solid oily contamination - clip hair, then liquid paraffin or veg oil
What does successful treatment of a poison depend on?
Rapid ID of poison
Prevention of further absorption
Appropriate symptomatic treatment
Availability of an anecdote
What first aid should you do for a sting?
Remove sting if possible
Bee sting - bicarbonate solution
Wasp sting - vinegar solution
Apply ice pack
If animal collapses or swelling continues, animal should come to surgery
In case of anaphylaxis, institute treatment for shock ABCs O2 etc
What are some symptoms of snake bites?
Trembling Excitement Drooling Vomiting Collapse Dilated pupils Rapid pulse
What first aid should be carried out for a snake bite?
Treatment in practise?
Minimise movement (reduces circulation)
Wash bite thoroughly with cold water to remove venom
Keep affected area below heart (want to stop the poison from getting round the body)
Apply ice pack and bandage area
In practise:
- IV fluids
- antibiotics
- anti-inflammatories
- treatment for shock
- analgesics
- anti-venom
- o2
Name the 4 different layers of bandage
Dressing e.g. gauze swabs
Primary layer e.g. synthetic padding/cotton wool (softban)
Secondary layer e.g. conforming (knitfirm)
Tertiary layer e.g. cohesive conforming (petflex)
