Introduction Module 1 Flashcards
What is assessed as part of the primary survey?
A - airway: is it patent?
B - breathing: is if effective?
C - circulation: is there a pulse? peripheral v. central apex
Major body systems
- Cardiovascular - HR, pulse quality, MM color, CRT, Auscultation
- Respiratory - RR, respiratory effort, auscultation
- Neurological - Mentation/consciousness, Gait/posture, deep pain
What makes up a capsule history?
SAMPLE
S - Signalment/signs
A - Allergies
M - Medications
P - Past illness
L - Last normal
E - Events leading up to illness/injury
What are the respiratory patterns and what are common differentials?
Inspiratory Pattern - Upper airway - polyps, neoplaisa/inflamm, servere URT, FB, LP
Obstructive Pattern - Lower airway - asthma
Restrictive Pattern -
Parenchymal disease: edema, haem, exudate, neoplasia, fibrosis
Pleural space disease: CHF, chylo, pneumo, pyo, FIP, haemo, neoplastic, diaphragmatic
Chest wall disease: trauma, abscess, neoplasia
What are trauma/severity scoring systems that can be used in general practice?
- Shock index - looks at HR, sys BP and measured against lactate
- Glasgow modified coma scale - head injury, 1-6 in motor activity, brainstem reflexes and level of consciousness, lower the score the worse the prognosis
- Animal trauma triage score - can be modified to use with perfusion, resp, neuro
What are the 4 sites of the AFAST
Looking for fluid - graded from 1-4 based on where fluid is found
- Diaphragmatic-hernia
- Spleno-renal view
- Reno-hepatic
- cystocolic
How do you identify a pneumothorax?
- TFAST: Chest tube site - highest point of the chest where the lung may be visualised against the thoracic wall
- Look for glide sign : decreasing gain can help
- M-mode: seashore - normal, barcode - abnormal
Wet lung v. Dry lungs
Dry Lungs: A-lines + glide signs
- not representative of all lung just that section
- feline asthma
- upper airway obstruction
- bronchial diesase
- PTE
Wet lungs: B-lines present
- if focal - pneumonia, contusions
- pulmonary edema - if 3 or more in 2 diff sites - CHF likely
What are the 5 criterion of B-lines?
- Vertical white lines
- Originate from lung surface
- Move with pleura
- Extends into far filed
- Obscures a-lines
Protocol for CPR
- Recognise arrest - absence of resp movements, pulses, consciouness
- Call for help - ideally 3 -
- 5 roles: leader, compressor, breather, drug pusher, recorder - BLS: ventilation and compressions
- 2 min cycles (takes 60s to get myocardial perfusion pressure to optimal level)
- 100-120/min 1/2-1/3 compressed with full recoil
- Cardiac, thoracic, sternal
- ventilation: 1 breathe every 6 secs - ALS
ECG - Fast >200 (v-fib, pulseless v-tach) defib/thump Slow <200 asystole, PEA (adrenaline/atropine)
Capnograph - Gold standard for checking return to spontaneous ventilation, over 15mmHg = good compressions
Drugs
IV access
How do you correct hypovolaemia without haem?
Isotonic fluids - crystalloids
- 10-20ml/kg (d), 5-10ml/kg (C) over 15mins and then reassess perfusion parameters
- If severe shock consider adding in colloids
- If brain trauma is present isotonic fluids and hypertonic saline
What are the end parameters of corrected shock?
HR 80-120/160-200
T 38-39.5
CRT/MM pink mm with <2 secs
BP sys 100-120mmHg
TS/PCV - >45/>25
UO - 1-2ml/kg/hr
What is dehydration?
Dehydration is a fluid deficit in the extracellular space and should be corrected slowly for 24-48hours
How is fluid deficit calculated?
% dehydration + maintenance + ongoing losses
% dehydration => BW x % x10 = ml
Basal fluid rate => RER = (30xBW) + 70
Ongoing losses can be weight or 4ml/kg per vomit/diarrhea