First Aid Flashcards
define first aid
provision of initial care for illness/injury that is usually performed by a non-expert
what does first aid consist of?
a series of simple, sometime life saving techniques that an individual can be trained to perform with minimal equipment
what does the veterinary surgeons act of 1966 state about first aid?
anyone can perform first aid on an animal provided it is to preserve life, prevent suffering, prevent the deterioration of the patients condition
how does the RCVS define the limits of first aid?
provided what is done is done to save life, stop pain and suffering and is done as an interim measure before seeking veterinary assistance, it is unlikely that what has been done has gone beyond first aid
what can VN perform under schedule 3?
assist vet and carry out certain procedures under guidance and not in a body cavity
what are the 9 key rules for telephone conversations about potential emergencies?
introduce yourself (by name)
be polite and calm
ascertain nature of problem asap
establish who the caller is and whether or not they are registered with the practice or not
obtain owners details including mobile number they will be using during transport
quote for emergency costs
clear directions to practice (postcode and parking)
taxi or animal ambulance information for alternative transport
gain ETA and advise staff
what is the main purpose of the phone conversation?
to decide if the condition is life threatening or not
how should a distressed/hysterical client be dealt with?
remain calm, sympathetic and patient
reassure them of the relevance of questions
what should happen if the condition is life threatening?
animal is brought to the practice immediately
what should be asked to ascertain how urgent a problem is?
known or suspected toxin ingestion onset of signs (gradual or rapid) current medical conditions current medication breathing - normal, easy? responsive able to walk normally recent trauma
what are 11 examples of life threatening emergencies?
respiratory distress severe bleeding collapse/unconsciousness rapid abdominal distention inability to urinate sudden onset neurological signs severe vomiting and hemorrhagic diarrhoea extreme pain witnessed ingestion of toxin bone fracture dystocia
what advice should be given over the phone to foreign objects patients?
don’t remove
keep animal calm and still
bring to vets asap
what advice should be given over the phone for uncontrollably bleeding patients?
a calm owner leads to a calm dog, leading to reduced HR and so blood loss,
apply pressure through a clean towel
tourniquet if bleeding cannot be slowed with pressure and only if <20 mins from practice
what are 5 examples of non life-threatening conditions?
mild/moderate vomiting non-hemorrhagic diarrhoea small wound with minimal blood loss polyuria/polydipsia weight bearing lameness a short single seizure
how should small emergency patients be transported?
in baskets (cats and small dogs)
how should large emergency patients be transported?
on a blanket or board, should be made secure in boot of the car
how should broken bones and dislocations be managed/
keep patient confined. Small cage of collapsible kennel is ideal, if not use a large blanket/towel to support patient and prevent further movement
what is different about first aid away from the practice?
same principles apply, encourage owner to assist - extreme caution to keep yourself safe, particularly with wild animals
what is the purpose of an emergency/crash box?
gives immediate access to drugs and equipment
where should the crash/emergency box be kept?
in the same place at all times so everyone knows where it is
what items should be found in an emergency/crash box/
ET tubes laryngoscope O2 supply anesthetic circuits IV catheters in various sizes clippers scissors tapes and bandages to secure IV ECG machine Syringes and needles suction machine/bulb syringe Dog urinary catheters (different sizes) good light source drug dosage charts drugs used in cardiac resus anti convulsant drugs steroids anaesthetic drugs analgesics fluids
define polydipsia
drinking lots
define polyuria
urinating lots
what are common symptoms of an epileptic seizure?
dog appears to not be responding and is shaking uncontrollably and has passed urine/faeces
define triage
process of organising patients according to the severity of their condition and getting treatment within an appropriate length of time
what are the key parts of information gathering?
preparing all consent forms
prepare critical care monitoring sheet
pre-populate all patient information fields and highlight fields to be gathered
write down the history gathered on the telephone
write down all information as you get it or assign a scribe
what 9 parameters should be recorded in the primary survey?
heart rate pulse rate mucous membrane colour capillary refill time respiratory rate respiratory effort gait mentation temperature
what parameter should be measured before the patient is handled?
respiratory rate and effort
how long should the primary survey take?
30 seconds
what makes up the primary survey?
A -airway
B- breathing
C- circulation
what should be checked relating to the airway in the primary assessment?
patency -is the patient able to breathe
what should be checked relating to breathing in the primary assessment?
is the patient making good breathing efforts
what should be checked relating to the circulation in the primary assessment?
does the patient have spontaneous circulation (is there a pulse)
what must happen if the answer to any questions in the primary survey is no?
survey is stopped and patient receives CPR
what is being assessed during the major body system assessment of the cardiovascular system?
heart rate and pulses
what should be recorded during the major body system assessment of the cardiovascular system?
heart rate and pulse quality
mucous membrane colour
capillary refill time
blood pressure
how should the the heart rate and pulse be assessed?
digital pulses, osculation
what should be considered about pulse quality?
whether its bounding, strong or intermittent
if irregular is it regular! (sinus arrhythmia) or irregular
what HR is considered tachycardia in dogs?
120 BPM
what HR is considered tachycardia in cats?
180 BPM
what HR is considered bradycardia in dogs?
60 BPM (although consider dogs fitness)
what HR is considered bradycardia in cats?
120 BPM
what are icteric mucous membranes?
yellow/jaundiced
what pulse should be used to test peripheral circulation?
metatarsal
what should be assessed during the major body system assessment of the respiratory system?
rate, effort (does this differ on inhalation/exhalation) and any associated noise.
what respiration rate denotes tachyaponea in the dog and cat?
> 40 resps
what findings in the major body system assessment of the respiratory system would suggest respiratory distress?
cyanosis open mouth breathing abducted elbows extended neck paradoxical respiratory movement dilated pupils
what is paradoxical respiratory movement?
chest moves in on inspiration and out on expiration (flail chest)
chest moves out and abdomen moves in (ruptured diaphragm or pleural effusion)
what should be assessed during the major body system assessment of neurological signs?
non ambulatory patients - can they feel the limbs, do they respond to pain test
ambulatory patients - is gait normal
changes in mentation
any seizures
what can affect response to painful stimuli?
mentation of the patient (may feel the pain but disinterested in responding)
what changes of mentation should be noted?
whether patients are: alert/normally responsive, obtunded, stuperous, comatose
what does obtunded mentation mean?
rousable but quiet
what does stuperous mentation mean?
rousable with painful stimuli
what should be checked during major body system assessment of urinary systems?
palpation of bladder (size and feel)
ability to urinate
what is the final check of the primary survey?
rectal temperature
what should be checked while taking rectal temperature?
any blood, any faecal staining on perineum (indicates recent passing of faeces), anal tone (lack of tightening around thermometer indicates neurological damage)
what should be taken in a capsule history?
age/sex/breed presenting complaint last seen normal? last ate/drank/urinated vomiting/diarrhoea/coughing toxins/trauma is the condition static or progressive other conditions/medications
what is the purpose of a secondary survey?
identify problems that could rapidly become life threatening
what should be checked during the secondary survey?
head, chest, abdomen, limbs and tail
what areas of the head should be checked in the secondary survey?
nose - haemorrhage, swelling and discharge (bilateral or unilateral)
mouth - pectical haemorrhage, eccymosis, dry/excessive salivation
eye - reflexes, light response, nystagmus/strabismus, mucous membrane colour
ears - symmetry, discharge, head tilt
what can nystagmus/strabismus indicate?
head trauma or neurological condition
what should the chest should be checked for in the secondary survey?
dysponea, crepitus, wounds, swelling, auscultation
what is crepitus?
crackling under the skin which indicates presence of air
what should the abdomen should be checked for in the secondary survey?
swelling, bruising, painful bladder
what should the limbs and tail should be checked for in the secondary survey?
fractures, dislocations, neurological function (weakness, propreoception)
what is involved in general nursing care of first aid/emergency patients?
mental needs physical needs toileting needs dressings, catheter and tube sites nil by mouth/eating monitoring
what parameters should be regularly monitored in the emergency patient?
pulse rate and quality mm colour and crt respiratory rate and effort temperature demenour/mentation body weight (every 12 hours instead of 24)
how regularly should the the emergency patient be monitored?
every 15 minutes initially, increase interval as time passes/animal becomes more stable
what other parameters should be considered during monitoring of the emergency patient?
urine output and SG blood pressure ECG pulse ox CVP electrolyte and blood gases
what parameters may remain normal for a period of tme after cardiac arrest/cardiac contractions stop?
mucous membrane colour, capillary refill time and ECG
what is involved in basic life support?
CPR
what is the aim of basic life support?
keep blood flowing and oxygen delivery to tissues through external support to the body
what is involved in advanced life support?
administration of drugs and other treatments to restart spontaneous circulation
how many people should be involved in administration of CPR?
minimum of 3
which staff within the practice should be trained in CPR?
all, including receptionists and managers
what is the name of the detailed veterinary CPR guidelines?
RECOVER
what are the 5 main signs of actual or impending arrest?
agonal gasping
absence of a heartbeat or weak and rapid pulses that slow quickly
loss of consciousness
fixed dilated pupils
loss of reflexes (e.g. corneal and palpebral)
what is agonal breathing?
short labored breaths, tends to be moaning on exhalation
what is the corneal reflex?
a blink in response to light tough on the cornea
what is the palpebral reflex?
a blink when light touch is run over the upper/lower eyelids
what are the 5 key roles of a CPR team?
cardiac compressor ventilation provider recorder monitor person to draw up medication, place ECG and catheter
when should the roles of the CPR team be assigned?
as soon as everyone arrives on scene, usually by team leader (senior nurse/vet)
what should you do if a patient has arrested or you think they are about to?
note the time
call for help
keep calm
assign roles (or ensure someone does) when help arrives
what is the first thing that you should do when starting CPR?
chest compressions should be started as soon as possible, even before help arrives
describe the process that should happen on discovering arrest or peri arrest?
start compressions
secure airway and provide oxygen
assign a recorder/leader to record all interventions, monitoring and time
monitor the patient for any pulses and spontaneous ventilation
place a catheter
connect an ECG
how often should the cardiac compressor be swapped?
every minute
what can pulses tell us about the quality of CPR?
a good pulse during CPR shows compressions are effective and working
describe cardiac pump compressions
compression of the chest directly over the heart. The hand is placed around the chest and squeezed
describe thoracic pump compressions
compressions over caudal thorax (with animal in lateral recumbancy) or xiphisteinum (when in dorsal recumbancy)
on what animals are cardiac pump compressions used?
cats and small dogs
on what animals are thoracic pump compressions used?
medium and large dogs
how many compressions should be given a minute?
100-120
what depth should compressions be?
1/2 to 2/3 thorax width
what pulse can be used to assess effectiveness of compressions?
femoral
what is a capnograph?
device which measures ventilation and shows CO2 levels leaving the patient
what can a capnograph show/
effectiveness of CPR by showing gaseous exchange is taking place
how many breaths per minute should be given during CPR?
~20
how much should the chest be inflated during CPR?
to normal levels
what does ET tube and either an ambubag or anesthetic circuit provide?
intermittent positive pressure ventilation
what equipment is needed for basic life support?
Ambu bag/anaesthetic machine and circuits face mask/endotracheal tubes laryngoscope IV catheters recording sheet pen 3 people (at least) Ideally: ECG and capnograph
describe the collapsed patient
one who can still respond to/is aware of external stimuli
describe the unconscious patient
one who is unaware of surroundings
describe the alert collapsed patient
normal mentation, can’t walk/move
describe the depressed collapsed patient
quiet, still responds to name/clapping
describe the obtunded collapsed patient
responds only to pain, decreased consciousness
describe the unconscious patient
not at all responsive to external stimuli but has a pulse and is breathing unaided
what does reduced consciousness usually mean for the severity of an injury?
usually more severe
what can the state of consciousness be used to determine?
the severity of a condition that can vary in level (e.g. shock)
what issues do alert patients commonly present with?
orthopaedic disease (fractures) peripheral neurological disease (e.g. disk disease)
what issues do depressed patients commonly present with?
mild/moderate shock and pain
what issues do obtunded patients commonly present with?
moderate to severe shock, neurological disease and metabolic disease (e.g. renal failure)
what issues do unconscious patients with normal heart rates commonly present with?
neurological disease and metabolic disease (e.g. diabetic coma)
what issues do unconscious patients with a high or low heart rate commonly present with?
severe shock or imminent arrest
what is the most important nursing consideration of the unconscious patient?
they are unable to protect their airway and so the airway must be positioned so it can be kept clear
how should a patient be positioned in order to keep the airway clear?
lateral recumbancy, neck extended gently and head slightly upwards. Mouth opened with tongue out through the gap between canine and premolar teeth
what is the essential equipment for collapsed/unconscious patients?
ET tubes conforming bandage (to hold mouth open oxygen supply laryngoscope dog catheters (airway access) mouth gag (or large vetwrap bandage) ECG Blood pressure monitor and capnograph
how quickly can occular emergencies deteriorate?
fast - should be seen urgently if onset of signs is rapid
what are 7 common occular emergencies?
traumatic proptosis occular foreign body corneal scratch/laceration corneal ulcer glaucoma hyphaema sudden onset blindness
what is traumatic proptosis?
forwards displacement of whole globe of eye
how do occular emergencies often present?
eye closed/half closed
depressed
unwilling to be touched
what is hyphaema?
bleeding into the anterior chamber of the eye turning it red colour
what are the main nursing considerations of an occular emergency?
assess entire patient (primary and secondary surveys) and deal with major body system abnormalities first
prevent self-trauma with Elizabethan collar
give analgesia
keep eye moist with false tear solution or sterile saline moistened swabs
keep the patient in a quiet dimly lit kennel
what are some common nasal emergencies?
epistaxis
nasal foreign body
how may a nasal foreign body present?
intense sneezing which may ease
what are the key nursing considerations of epistaxis?
keep calm elevate the nose and apply cold compress plug with an absorbent dressing monitor for hypovolaemia can use adrenaline on a moistened swab
what are the key nursing considerations of a nasal foreign body?
will require nasal examination and flush under GA
how should a patient be positioned for nasal flush under GA?
sternal recumbancy with rostral end downwards to avoid flush liquid entering trachea
what equipment is required for epistaxis?
surgical swabs
adrenaline
absorbent dressings
what equipment is required for nasal foreign body?
GA equipment (inc. cuffed ET tubes) otoscope and laryngoscope surgical swabs syringes sterile saline (1l for 25kg dog) bowl for catching flush solution
what size syringe should be used for nasal flush of cat and dog?
dog - 60ml
cat - 20ml
what side should the patient be laid on for CPR?
right
what is shock?
an acute state of circulatory collapse
define shock
it is defined as the inability of the circulation to transport enough oxygen to meet tissues needs
what are the 4 major types of shock?
hypovolaemic
distributive
cardiogenic
obstructive
what is the most common form of shock?
hypovolaemic
what causes hypovolaemic shock?
loss/reduced of circulating blood volume
blood loss
loss of fluids through diarrhoea/vomiting
what is the defining feature of distributive shock?
loss of peripheral resistance
what does the loss of total peripheral resistance in distributive shock cause?
allows blood to pool in the small blood vessels
what are the 4 main divisions of distributive shock?
septic shock
toxic shock
anaphylactic shock
neurogenic shock
what is cardiogenic shock caused by?
heart not working properly so there is inefficient oxygen/blood supply to the tissues
what is obstructive shock caused by?
obstruction
what are 3 common causes of obstructive shock?
pericardial effusion
pulmonary embolism
gastric dilation and voluvus
what are the general nursing considerations that need to be made when treating a patient with shock?
close monitoring as change can happen quickly
oxygen
slow warming after treatment has started
quiet environment to reduce stress and so oxygen consumption
what are nursing considerations that need to be made when treating a patient with hypovolaemic shock?
place an IV catheter
intravenous fluids
stop haemorrage
what are nursing considerations that need to be made when treating a patient with distributive shock?
find underlying cause ASAP through history and questioning
place IV catheter
IV fluids
what are the 3 first aid tests that can be used as markers of shock?
measure blood pressure
measure urine output
measure blood lactate
what does urine output during shock show?
whether the kidneys are retaining water and so illustrating reduced blood volume
what do lactate levels show?
amount of anaerobic respiration occurring in the tissues and producing lactate
what are 4 main cardiac emergencies?
acute congestive heart failure (CHF)
pericardial effusion
aortic thromboembolism
arrhythmias (irregular, tachycardia or bradycardia)
what are the key nursing considerations of cardiovascular emergencies?
oxygen place IV catheter ECG attached to patient analgesia to help with pain and to calm kept in a calm and quiet environment ultrasound ready prep for pleural or pericardial tap
what equipment is often used during cardiovascular emergencies?
3 way tap - pericardial or pleural tap
ECG machine
Butterfly catheter (tap)
ECG trace
are aural emergencies usually life threatening?
no but can be distressing to owner and patient
what are 3 common aural emergencies?
aural foreign body
otitis externa and media
aural haematoma
what is otitis externa?
outer ear infection often leading to self trauma
what is otitis media?
middle ear infection
what are common signs of otitis media?
head tilt and altered walking pattern
what causes aural haematoma?
headshaking
fighting/paly
what is an aural haematoma?
collection of blood between skin and cartilage of ear
what equipment is required for aural emergencies?
Elizabethan collar
otoscope
analgesia (to prevent further self trauma)
what are the 2 main environmental emergencies?
hyperthermia
hypothermia
what can cause hyperthermia?
bracheocephallic breeds are prone due to altered respiration
heat stroke
over exercise
seizure
what can cause hypothermia?
sedation
anaesthesia
shock (particularly in cats)
what are other environmental emergencies?
burns
smoke inhalation
electrocution
what can smoke inhalation cause?
pulmonary oedema
what can electrocution cause?
burns and pulmonary oedema
at what temperature should cooling start for hyperthermia?
41.5 degrees
at what temperature should cooling end for hyperthermia?
39.5 degrees
why can active cooling end before the body temperature has returned to normal?
cooling continues within the body
what methods of active cooling are there?
fan
cool mat
cooling coats
what can be done to raise body temperature in hypothermic patients?
bubble wrapping limbs
warmed IV fluids (including fluid line)
Bair Hugger - warm air filled cover that can be laid over the patient and act as insulation
which patients are often hypothermic?
sick/sedated/anaesthetised
what methods of heating should not be used in hypothermic patients?
heat lamps or mats where the patient cannot move themselves away from the heat and may get burned
what are the main points when treating burns?
15 mins under running, cold water ASAP but at practise if owner is unable
analgesia
prevent interference and infection
treat shock
what are superficial burns?
involve only the epidermis
what are partial thickness burns?
involve the epidermis and dermis
what are full thickness burns?
involve destruction of the epidermis, dermis and any or all underlying structures (muscle, fat, bones, nerves)
are full thickness burns the most painful?
no as nerves are damaged so painful signal cannot reach the brain/be registered
what is the other way that burns can be described?
% of body burnt
what are the 3 main types of trauma?
haemorrhage
wounds
fractures
define haemorrhage
loss of blood from vessels
how is haemorrhage best assessed?
cardiovascular parameters - HR, MM, CRT
what are the 2 presentations of haemorrhage?
internal
external
how can you tell what vessel is loosing blood?
arteries spurt
veins and capillaries ooze darker blood
what may affect haemorrhage?
clotting disorders
what is the main first aid concern with haemorrhage?
apply pressure to wound with sterile dressing and complete primary and secondary survey
what may indicate internal haemorrhage?
breathing difficulties
swollen abdomen
melena
blood in urine
what can be done to try and slow bleeding in limbs?
partial occlusion of blood vessels above injury in order to reduce supply - only temporary
what are the 6 types of wound?
incised lacerated abrasion/grazes contusion puncture gunshot
describe incised wounds
clean cut, usually surgical or can be glass/metal
describe lacerated wounds
tearing of tissue with a less sharp/more jagged material. Always dirty (e.g. barbed wire)
describe abrasion/grazes
don’t penetrate skins full thickness and are often very dirty with embedded gravel/dirt
describe contusion
bruising- bleeding from capillaries under the skin surface. May indicate deeper injury and often accompanied by abrasion
describe puncture wounds
small external wound with massive internal/deep tissue damage. Will rapidly become infected and then liffe threatening
describe gunshot wounds
mixed - vary due to differing types of shot. A small entry wound often hides massive internal damage
how should a wound be treated on initial viewing?
cover to prevent contamination and complete primary and secondary survey
give analgesia ASAP
once/if patient is stable clip wide area around the wound
flush wound with warmed 0.9% NaCl
then approach vet about dressing/suture
what should the wound be covered with prior to clipping to prevent contamination from clipped hair?
sterile water soluble gel
what wounds should be flushed under GA and why?
bites/punctures to assess depth of injury
what is a fracture?
a break in the continuity of the bone
what is a complete fracture?
both sides of the bone are broken
what is an incomplete fracture?
only one side of the bone is broken
what is the difference between open and closed fractures?
open fractures have broken through the skin, closed have not
what is the difference between pathological and traumatic fractures?
pathological fractures are caused by disease rather than direct trauma
what are luxations?
dislocation
how should a patient with suspected fractures be transported?
minimal movement
in a cage/box wherever possible
what must always be preformed on fracture patients?
primary and secondary surveys as fracture is often no the most life threatening problem
what is metabolism?
chemical reactions that occur within living organisms in order to maintain life
when do metabolic emergencies occur?
when homeostasis is not maintained by normal metabolic processes
what are 5 common metabolic emergencies?
hypoglycaemia hyperkalaemia hypocalcaemia hypoadrenocorticism (addisons disease) diabetic ketoacidosis
what is hypoglycaemia?
low blood sugar
how can an owner aid their hypoglycaemic patient?
smear honey on the gums
what are the main signs of hypoglycaemia?
weakness, collapse, seizures, coma
what is hyperkalaemia?
increase in blood K+ leading to cardiac issues
what can hyperkalaemia lead to?
bradycardia and asystole
how can hyperkalaemia be managed once in practice?
IV fluids and drugs to protect the heart and lower K+ concentration in the blood
what is hypocalcaemia?
low calcium
what is hypoadrenocorticism?
impaired secretion of adrenal hormones - leads to a multitude of issues including hypo/hyperkalaemia
what are the signs of hypoadrenocorticism?
vague - collapse, weakness, depression, acute vomiting or diarrhoea
what is diabetic ketoacidosis?
hyperglycaemia over a long period of time leading to cells breaking down proteins and lipids to gain energy as glucose is not being stored.
what are the signs of diabetic ketoacidosis?
vague - weight loss, collapse and excessive urination and drinking
what questions can be asked on the phone to aid identification of metabolic emergencies?
is the patient lactating (identify hypocalcaemia)
can the patient urinate normally
does the patient have diabetes
has the patient been polydipsic (prior to collapse)
does the patient smell of pear drops (not reliable as not all owners can smell this)
is there sudden diarrhoea/vomiting
are the mm normal and is CRT normal
what are 3 main urological emergencies?
urethral obstruction
uroabdomen
acute renal failure
what can urethral obstruction be caused by?
cellular debris
stones
cancer
stricture
within how many hours is urethral obstruction life threatening?
24 hours
what animal is urethral obstruction seen in?
male cats
what is uroabdomen?
urine leaking into abdomen due to hole on the urinary tract
why can uroabdomen and urethral obstruction lead to hyperkalaemia?
waste cannot be voided and so K+ builds up
what is acute renal failure?
sudden failure of kidneys
what causes acute renal failure?
blood clots, medication, toxins, end point of chronic renal failure
what are the main first aid considerations when nursing a urological emergency?
careful and extensive phone triage to discover signalment, drinking, urination and history of trauma careful handling pain relief ASAP place IV catheter consider whether PPE is needed
why may PPE be needed for urological emergencies?
some cases of acute renal failure are zoonotic
what equipment should be made ready when you know a urological emergency is on the way?
equipment for: monitoring urine output anaesthesia urinary catheters imaging of tract
on what animals may cystocytosis not be performed?
draining of urine from bladder via needle - not in cats as tissue is too friable
what is the main equipment needed in urological emergencies?
IV catheter
suture material
urinary catheter and suture device to hold it in place
IV fluids
name 5 common toxins of cats and dogs
cats: lilies anti-freeze advantix (spot on for dogs) paracetamol poison
dogs: raisins grapes chocolate paracetamol (overdose as dogs can metabolise it) poison
what are important questions to ask during telephone triage of a toxological emergency?
exactly what has been ingested how much how long ago how long exposed (level of absorption and will inform treatment) body weight of patient symptoms contact details
what should you advise the client when dealing with a toxological emergency?
consider own safety - bite risk and poisoning
safely - bring sample/package
prevent the patient licking dermal contamination
directions to practice
what are the 4 key aims of toxological first aid?
identify poison and amount ingested/exposed to
prevent further absorption of poison
treat any signs that develop symptomatically (e.g. ulceration, seizures, pain)
administer antidote (rare) or specific treatment
what is a toxbox?
access to common antidotes/poison treatments which are not often needed in practice and would be costly to buy in and often dispose of.
Many locations across the country - may have to drive to get it
where can you get more information about poisons?
VPIS - 24hr helpline for both vets and owners
BSAVA/VPIS guide
how much of gastric contents should be cleared by emesis?
40-60%
how many hours after ingestion of poison is emesis effective?
up to 3
when should emesis not be induced?
with caustic/acidic substances
volatile petroleum (or anything ending in ‘ol’)
patients with cardiac or laryngeal disease (vomiting will stress heart and patients with laryngeal disease cannot protect airway from vomit)
depressed or seizing patients
patients that can’t vomit (rabbits/horses)
what drugs are used to induce emesis in dogs and cats?
Apermorphine (Emedog) - dogs
Xylazine - cats
what are the main nursing considerations when performing dermal decontamination?
wear PPE including face mask
use warm water
clip hair where possible instead of washing
take care when drying not to increase skin temp
what effect can hot water have on dermal contamination?
increase speed of absorption through the skin
what are the main nursing considerations for occular decontamination?
contaminated eyes flushed with sterile 0.9% NaCl
after flushing cornea should be stained with fluorescein and examined for ulceration
check pH
what are the 4 most common GI first aid emergencies?
GI obstructions
vomiting
diarrhoea
gastric dilatation-volvulus
what is volvulus?
twisting
what are the important questions to ask in a telephone triage of GI emergencies?
history of ingestion
sudden unproductive retching, restless, salivation, hard bloated abdomen
vomiting and lethargy
diarrhoea and lethargy
what is an important consideration when discussing possible GI emergencies over the phone?
the breed of the dog - deep chested breeds need to have GDV considered
what are the main nursing considerations during GI emergencies?
PPE and consideration as to route through practice if infectious disease is possible
ABC’s
place a catheter
prepare a stomach tube
consider shock, hypothermia and hypoglycaemia
what are the 5 main reproductive emergencies?
dystocia neonatal resuscitation paediatric emergencies pyometra paraphimosis
define dystocia
difficulty giving birth or progressing with birth
what are some key paediatric emergencies?
hypothermia
hypoglycaemia
what is pyometra?
life threatening condition of uterus seen in entire bitches/queens
when is pyometra often seen?
4-6 weeks post season (can be up to 3-12)
what within a history may indicate pyometra?
vague history of polydipsea, inappetance and vulval discharge
what is paraphimosis?
penis extrudes and becomes stuck out of the prepuce
within what sort of animals is paraphimosis seen?
entire dogs
what indicates dystocia?
unproductive straining for over 1hr after start of stage 2
unproductive straining for over 30 minutes after last puppy
what RR is considered high in cats and dogs?
> 40
what are the signs of respiratory distress in cats?
hunched over hiding coughing (hacking sound) open mouth breathing (can also be seen in distress but only lasts a short term) blue tinged gums foam/froth from mouth
what are the signs of respiratory distress in dogs?
constant coughing (especially at night) exercise intolerance change in bark sounds/vocalisation anxious/restless/pacing panting stretching neck to make passage of air easier lack of lateral recumbancy (more sternal) tired abduction of elbows blue gums/foam from mouth paradoxical/abdominal breathing
what is sub-cutaneous crepitus?
air escapes from lung through hole and collects in sub-Q tissues
what can cause sub-Q crepitus?
break in pleural integrity
what happens during a pneumothorax?
pleural space fills with air due to breach in integrity of lung tissue
what is a tension pneumothorax?
large hole that becomes rapidly life threatening, the leak functions as the one way valve. Air enters on inspiration and doesn’t exit leading to increasing compression of the lung. The air must be drained
how should respiratory patients be nursed?
airway should be maintained in obtunded and unconscious patients (extend neck and pull tongue)
provide supplementary O2
restrict movement in small/comfortable space
management of ambient/patient temperature
reduction of stress leading to reduction of O2 need
what are the main causes of neurological emergencies?
head trauma
seizures
spinal cord disease
vestibular disease
define seizure
uncontrolled burst of electrical activity between brain cells. Causes temporary abnormalities in muscle tone/movement but doesn’t necessarily mean loss of consciousness
what are the main causes of spinal cord disease?
injuries infections compression by fractured bone loss of blood supply tumor
what are the signs of spinal cord disease?
weakness
paralysis
sensation is abnormal/lost
bladder/bowel functions are lost or different
what is required for seizure patients?
those in status epilepticus require immediate care, those who are no longer seizing may appreciate time in a quiet area to readjust
what are vestibular diseases?
group of diseases affecting balance systems
what are the main principles of neurological nursing?
ABCs immobilise suspected fractures head elevated 30 degrees in head trauma monitor temperature history of toxin exposure hypoglycaemia
