First Aid and Emergencies Flashcards
What are the 3 aims of first aid?
- To prevent the animal’s conditioning deteriorating
- To reduce suffering
- To preserve life
What are inside crash carts?
- ET tubes and ties
- Laryngoscope
- Tracheostomy tubes
- Ambubag
- Syringes and needles
- I/V cannulas and tape
- Drugs
What are the 3 groups of emergencies?
- Life threatening emergencies
- Emergencies requiring immediate attention
- Minor emergencies
What does AMPLE mean and when would you use it?
- A: allergies
- M: medications
- P: past history
- L: lasts (meal, medication, defecation and urination)
E: events - On an emergency telephone call
What is a triage?
The art of assigning priority to emergency patients through a primary survey and a secondary survey
What is a primary survey?
- Takes 30-60 seconds
- ABC
- Level of consciousness using AVPU
- Vital signs
What does ABC mean?
- A: airway
- B: breathing
- C: circulation
What does AVPU mean?
- A: alert
- V: verbally responsive
- P: responsive to painful stimuli
- U: unresponsive
What is a secondary survey?
Systemic examination from nose to tail
What does DRABC mean for a patient assessment?
- D: danger (Ensure you own safety first)
- R: response (Check if the animal is conscious
- A: airway (Check airway is clear)
- B: breathing (Check breathing is normal
- C: circulation (Check pulse, MM colour, CRT)
What should you be thinking about when checking airway and breathing in emergencies?
- Can the patient maintain an airway?
- Is a tracheostomy needed?
- Is airway clearance needed?
- Is the animal breathing normally?
- Is an endotracheol intubation needed?
Describe the recovery position
- Lie animal in lateral recumbency
- Check airway (pull tongue to side and extend head back slightly)
- Stretch out legs
Describe venous bleeding
- Less serious
- Flowing action
- Blood deeper red in colour
Describe arterial bleeding
- Most serious
- Blood is forceful
- Blood is bright red in colour
Describe capillary bleeding
- Always involved in haemorrhage
- On surface of body
- General ooze of blood
- Blood is pink/red in colour
What are the 3 ways natural control of bleeding occurs?
- Retraction of blood vessels
- Blood pressure decreases
- Clotting
How does clotting work?
- Wound occurs and blood cells release thromboplastin
- Thromboplastin convert prothrombin to thrombin
- Thrombin converts fibrinogen to fibrin
- Fibrin forms a mesh, which traps RBCs
What are 2 methods of first aid for haemorrhages?
- Direct pressure for 5 minutes
- Pressure bandage
Why are tourniquets not recommended?
- Limited use
- Can damage tissue
- Have to reapply frequently
- Permanent circulatory damage
What is cardiopulmonary arrest (CPA)?
The cessation of spontaneous ventilation and systemic perfusion, which can lead to hypoxia and death
What are the clinical signs of Cardiopulmonary arrest (CPA)?
- Gasping or absence of respiration
- Agonal bleeding
- Absence of heartbeat
- Lack of femoral pulse
- Loss of consciousness
- Dilated pupils
How is Cardiopulmonary arrest (CPA) reversed?
Cardiopulmonary cerebral resuscitation (CPCR)
What is a Cardiopulmonary cerebral resuscitation (CPCR)?
Technique employed to reverse CPA, which provides artificial support for circulation and breathing until restored; ABC is used here
What do you do for the airway during a cardiopulmonary cerebral resuscitation (CPCR)?
ET tube placed, but if an obstruction present then an emergency tracheostomy is needed
What do you do for the breathing during a cardiopulmonary cerebral resuscitation (CPCR)?
Ventilate with anaesthetic circuit or ambubag; 1 breath every 10 seconds and volume is judged by chest movement
What do you do for circulation during a cardiopulmonary cerebral resuscitation (CPCR)?
Maintained by chest compressions
What are the two types of compressions?
- Chest compressions
- Abdominal counter pressure
How do you do chest compressions?
- In lateral recumbency
- In cats and small dogs, heel of hand directly over heart
- In large dogs, apply pressure at the highest point of the thoracic wall
- Compression rate around 100-120 per minute
How do you do abdominal counter pressure and what does it improve?
- Pressure on abdomen between chest compression
- Improves venous return to the chest
Name 4 advanced life supports
- Fluids: initial bolus
- Adrenaline (epinephrine): peripheral vasoconstrictor
- Atropine: an anticholinergic drug
- Lidocaine: an antiarrhythmic drug
What are the clinical signs of death?
- Apnoea
- Absence of heartbeat for more than 3 minutes
- Loss of corneal reflex
- Loss of pupillary light reflex
- Glazing of the cornea
- Grey MMs
- Body cools and rigor mortis setting in
What are the clinical signs of a fracture?
- Swelling
- Crepitus
- Abnormal movement
- Pain
- Change in length of limbs
What are the 3 classifications of fractures?
- Position of fragments
- Incomplete versus complete
- Shape of the fracture line
What are 4 types of fractures regarding the position of the fragments?
- Avulsion (a fragment broken off)
- Impacted (bone impacted into another bone)
- Depressed (bone dinted)
- Overriding (bone overides another bone)
What are the two types of imcomplete fractures?
- Greenstick
- Fissure
What are the 4 types of complete fractures?
- Simple
- Multiple
- Comminuted
- Open/compound
What are the 3 types of fractures regarding the shape of the fracture line?
- Transverse
- Oblique
- Spiral
What can spinal fractures cause caudally?
- Paralysis
- Urinary/faecal incontinence
- Lack of sensation
What can cervical spinal fractures cause?
Death
How should you first aid spinal fractures?
- Maintain spinal alignment
- Use a stretcher
- Blankets used to restrict movement
What are the two types of neurological emergencies?
- Head trauma: assess level of consciousness
- Seizures: assess what stage they are in
What are 4 stages of seizures?
- Pre-ictal
- Ictal
- Post-ictal
- Status epilepticus
What is the pre-ictal stage of seizures and the clinical signs?
- Occurs a few minutes before the seizures starts
- Restlessness and excitability
What is the ictal stage of seizures and the clinical signs?
- The is the seizure
- Collapse, paddling, jerky movement, salivation, jaw champing, vocalisation, urination/defecation, loss of consciousness
What is the post-ictal stage of seizures and the clinical signs?
- The period following the seizure
- Disorientation, restlessness, dazed and exhausted (can last a few hours up to a week)
What is the status epilepticus stage of seizures?
The animal stays in the ictal stage or goes back into pre-ictal and then ictal repeatedly (known as cluster fits)
What is unconsciousness?
Collapse where the animals brain is affected, preventing them from responding to normal external stimuli
What is the first aid treatment for unconscious patients?
- ABC
- Resuscitate if needed
- Control any haemorrhages
- Conserve heat
- Treatment underlying cause
What is a cerebrovascular accident (CVA)?
- A true stroke, as there has been a rupture of a blood vessel in the brain
What are the urological emergencies?
- Urethral obstruction from calculi, plug, stricture or neoplasia
- Acute renal failure, which can be caused by shock, infection, toxins and drug therapy
What is the gastrointestinal emergency?
Gastric dilatation vovulus; stomach dilates and twists on its axis
What are the clinical signs of gastric dilatation volvulus?
- Collapse
- Severe hypovolaemic shock
- Retching
- Distended abdomen
What service is available regarding poison?
Veterinary Poisons Information Service (VPIS)
What are the 4 types of exposures to toxins?
- Topical
- Ingestion
- Respiration
- Systemic
What are the 6 categories of poisons?
- Pesticides (metaldehyde and warfarin)
- Fungicides
- Household chemicals
- Plants (Daffodil bulbs and lilies)
- Medicines (Aspirin and diazepam)
- Human food
What are three types of gastric decontamination?
- Emesis
- Gastric lavage
- Absorbents
What is gastric lavage?
- Used when not safe to induce vomiting
- Patient is lightly anaesthetised and a large gore stomach tube is placed in to drain the fluid out
How do absorbents work in gastric decontamination?
Activated charcoal delivered as a powder or slurry, which slows down GI transit time; not given to dehydrated patients
How is ocular decontamination carried out?
- Flush eye with saline or water for 10-15 minutes
- Stain corneal surface with fluorescein to check for ulcers
- Monitor alkaline exposure by using a urine dipstick; if greater than 7.5 pH, keep flushing
What are the clinical signs of poisoning?
- Vomiting
- Diarrhoea
- Depression
- Unconsciousness
- Convulsions
- Abdominal pain
- Muscle tremors
- Hypersalivation
- Panting
How is poison from lilies treated?
- Empty stomach and give activated charcoal
- Wash skin if pollen on it
- If renal impairment evident, aggressive fluid therapy needed
How is poison from daffodil bulbs treated?
- Empty stomach and ensure adequate hydration
- Anti-emetics may be required
How is chocolate toxicosis treated?
- Induce vomiting through emetics
- If over an hour, use absorbents
How is grape and raisin toxicity treated?
- Emesis
- Activated charcoal
- IV fluids
How is warfarin poisoning treated?
- Empty stomach and monitor clotting time
- Vitamin K s/c in numerous sites
How is acetaminophen (ingredient in paracetamol) poisoning treated?
- Gastric decontamination
- Supportive care
- Monitor liver enzymes
- Oxygen therapy
- Activated charcoal
How is metaldehyde (ingredient in molluscicides) poisoning treated?
- Gastric lavage with sodium bicarbonate or milk
- Activated charcoal
- Diazepam to reduce excitement and convulsions
How is ragwort (Alkaloid) poisoning in horses treated?
A high carbohydrate diet and supportive treatment
What is shock?
An acute circulatory collapse, due to a decrease in venous return to the heart, which leads to a decrease cardiac output
What are the 3 things shock leads too?
- Inadequate capillary perfusion
- Insufficient oxygen levels
- Inadequate removal of metabolic waste
How does a decrease in cardiac output lead to shock?
Pressure sensitive baroreceptors send info to the brain, which cause compensation mechanisms to kick in, so increased heart rate, cardiac contraction and peripheral vasoconstriction occur to increase cardiac output, which maintains vital organs
What can prolonged shock lead to?
- Organ failure
- Death
What are the 7 stages of prolonged vasoconstriction?
1: Prolonged vasoconstriction
2: Tissue death
3: Fluid leaves blood vessels
4: Cardiac output falls further
5: Blood becomes viscous, platelets aggregate and blood clots in blood vessels
6: Disseminated intravascular coagulopathy (DIC)
7: Death
What are the 4 classifications of shock?
- Hypovolaemic shock
- Distributive shock (vasculogenic)
- Cardiogenic shock
- Obstructive shock (e.g., blood clots)
What is hypovolaemic shock?
- Inadequate circulating blood volume in the blood vessels
- Caused by haemorrhage, severe vomiting and severe diarrhoea
What are the clinical signs of hypovolaemic shock?
- Tachycardia
- Increased CRT
- Pale MM
- Poor pulse quality
- Low blood pressure
How is hypovolaemic shock treated?
- Lost fluids are replaced
What is distributive shock?
Increased blood vessel capacity (Vasodilation), but normal blood volume
What are the 4 things that can cause distributive shock?
- Neurogenic shock
- Anaphylactic shock
- Endogenous vasoactive chemicals
- Endotoxic (septic) shock
What are the clinical signs of distributive shock?
- Hyperaemic MM
- Increased CRT then reduced
- Bounding pulse
- Warm extremities
- Blood volume is not decreased
How is distributive shock treated?
- Address underlying cause
- Care with fluid, as may cause oedema or effusions
What is cardiogenic shock?
Seen in conditions where heart cannot pump effectively e.g., dilated cardiomyopathy or severe arrhythmias
How is cardiogenic shock treated?
- Underlying heart disease treated
- Possible fluid therapy
