Quiz 1

Question 1

allowable tasks for LVTs in an emergency

Answer 1

Tourniquet
Drugs
Fluids
Oxygen procedures
- flow by, nasal canulas
Establish open airways
- ET
External CPCR
Splints
Bandages
Wound dressings
Heartwarming
Cooling

Question 2

skills and characteristics of a competent ER LVT

Answer 2

Team leader/ player
Calm
Triage
- quick P/E
IVC
Meds IV, SQ, IM
ET
BP
BW
CPCR
Monitor vitals
Maintain patient records/ controlled drugs
TLC
Patience

Question 3

Oxygen cage (when we would use)

Answer 3

none invasive oxygen therapy with temp/humidity control. Small holes allow for patient handling without loosing too much 02
Used in cases of RRD/ CHF induced RRD

Question 4

Capnograph

Answer 4

measures end tidal carbon dioxide
For intubated patients
Better indicator of hypoventilation than pulse ox
35-45mmHg for ax, 35-55mmHg for awake

Question 5

Blood gas analyzer

Answer 5

Requires an arterial blood sample* (often found on the bottom of the foot)
• Provides rapid and accurate assessment of blood gases, which are important in respiratory or cardiac emergencies

Blood gas analysis provides information about the acid-base status as well as the oxygenation and ventilation status
Venous or arterial blood can be used for blood gas analysis, but only arterial samples give information about oxygenation.
Venous samples can be used to give information about acid-base status and ventilation.
PaO2 is the partial pressure of oxygen in the arterial blood. This
value indicates how well the blood is being oxygenated. This value also indicates how well the lungs and pulmonary circulation are functioning.
pH is a measure of the acidity or alkalinity of the blood. In general, pH measures the amount of hydrogen ions in the blood. The pH value has a narrow window of normalcy. If the value strays beyond normal, the buffering system is triggered to help compensate for the abnormal value. This value is affected by both metabolic and respiratory factors.
PaCO2 is the partial pressure of carbon dioxide (CO2) in the circu- lating arterial blood and is an indicator of ventilation. Because CO2 acts as an acid, excess CO2 may cause acidosis or the body may hy- poventilate to raise CO2 levels to compensate for alkalosis. PaCO2 is considered the respiratory component of a blood gas.
HCO3 − (or bicarbonate ion) is the major buffer in the body. The level of bicarbonate ion determines the “metabolic component” of a blood gas.
BE is the base excess (the amount of base above or below the normal buffer level). A base deficit is how far away from zero a patient is to the negative and describes how many units of base are needed to return the patient to neutral. A base excess describes how far from zero a patient is to the positive. A base excess or deficit indicates a metabolic disturbance or c

Question 6

Blood chem and cbc

Answer 6

Provides a baseline measurement of organ function; needs a cbc for a complete analysis. Provides information regarding kidney, liver, heart function. These are important in assessing hydration, hypovolemia, kidney/ liver failure, anemia.

Question 7

Electrolyte analyzer

Answer 7

Provides information about electrolyte balance; sodium, potassium, chloride, glucose. As well as overall organ function like blood urea nitrogen levels and Creatine levels. Dysfunction of these values could indicate cardiac arrhythmias that need to be treated right away. Like hyperkalemia which is often seen in urethral obstructions, acute renal failure.

Question 8

Crash cart should be equipped with?

Answer 8

Defibrillator on top as well as EKG
Airway establishing items such as laryngoscope, gauze, ties, and ET. Emergency drugs should be available and a cheat cheat should be readily accessible with pre determined weights and emergency drug doses. There should also be syringes, needles, flushes, fluids, intravenous catherer materials, as well as ambu bags and corresponding tubing, suction should be pre-set and ready to use. All drawers should be labeled for easy access and tape placed over the drawers to indicate readiness of materials needed.

Question 9

Defibrillators are used to?

Answer 9

“Restart the heart”
Only 305% of cpr is successful and less than 10% of patients fully recover.

Question 10

Fluid pumps and syringe pumps are used for?

Answer 10

Delivering a predetermined amount of fluids to patients. Fluid pumps are set to mls/ hr. If a continue drug infusion is needed then we could use a syringe pump which can deliver rates in mcgs/sec and mls/hr. Continuous rate infusions are indicated in patients experiencing severe pain in which case a strong opiod like fentanyl would be prescribed by the dvm for analgesia. Fentanyl has a short duration of action but is extremely effective in controlling pain therefor we could use a syringe pump to provide the patient with a controlled level of analgesic therapy.

Question 11

Blood pressure can be monitored?

Answer 11

Directly using an arterial catherer which provides an accurate measure of blood pressure as well as a central venous pressure monitoring catherer which is placed in the jugular vein, the tip should sit at the level of the right atrium. This type of monitoring device requires a 3 way stop clock, fluids and a manometer. This method accurately monitors blood pressure and hydration status; it is recommended for patients who are predisposed to hypo/hypertension.

Question 12

Triage phone calls; you should?

Answer 12

Ask the owner for their information as well as their pets information; a presenting complaint, brief medical hx as well as any drugs the patient might be currently taking. The level of consciousness and respiratory function should be assessed as well while communicating with the owner. All information should be recorded on a call log. It is important to keep calm, be patient and never diagnose over the phone. You could provide a relative diagnosis/ prognosis after speaking with the dvm.

Question 13

For hospital triage you should?

Answer 13

Use a system which indicates the level of severity/ urgency in the patients health. Yellow, green red. Animal trauma triage scale is categorized by perfusion, cardiac, respiratory, skeletal, neurological etc. Patients should be assessed within one minute of arriving at the hospital. Primary assessments should always be done first and secondary assessments can follow after assessing the patients health.

Question 14

Primary vs secondary assessments

Answer 14

Primary includes vital signs; RR/E, HR, pulses, MM/CRT, menace/ LOC, brief hx from owner, chief complaint and current meds.
Once you bring the patient to the back you can take the weight and temp. The presenting complaint should always be asked prior to examining the patient.

Question 15

CPCR steps

Answer 15

Cardiopulmonary cerebral resuscitation is recognized by the loss of consciousness and collapses. If pulses are not felt and MM are cyanosis/ pale, RR commonly ceases to exist.

Airway should be established
Breathing should be intimated
Circulation should be initiated through chest compressions
Drugs should be administer with dvm orders

Question 16

Abcd stands for?

Answer 16

Airway
Breathing
Circulation
Drugs

Question 17

Arterial bleeding what is it and how do you treat it?

Answer 17

Arterial bleeding will squirt or gush out as opposed to venous bleeding which flows out. Pressure should be applied using a clean towel/ gauze and it should not be removed even after the clots form. Tourniquets should only be placed on limbs or tails not expected to be saved. You can elevate the limbs above the heart to reduce blood pressure and slow down bleeding. You can also bind the gauze or cloth with tape or bandage material.

Question 18

Respiratory distress looks like?

Answer 18

Panting, heaving, open mouth breathing, specially in cats. Discolored MM, cyanotic/ pale. These patients should not be forced to walk, they should be carried whenever possible. Collards should not be placed around their neck.

Question 19

Hbc and shock, what do you tell the owner?

Answer 19

To transport their pet on a firm flat surface like a board if possible and to avoid manipulating the head/ neck/ broken bones. Have at least 2 people to move the patients and to be careful because their pet could be extremely painful/ in shock and could bite them. They can place a towel or blanket over the patients head to prevent them from biting when transported.

Question 20

Heat exhaustion is different than heat stroke, how? How do you treat?

Answer 20

Heat exhaustion is categorized by excessive panting, vomiting, diarrhea while a heat stroke has the same symptoms but now there is central nervous system depression, lethargy, ataxia, stupor, blindness and seizures. Anti nausea medications can be prescribed by the dvm to be given to the patient as well as IVF and active cooling devices.

Question 21

Stranguria, oliguria; what do you ask the owner?

Answer 21

If their pet is vocalizing when straining in the litter box, if they are noticing any urine being produced when they come out of the litter box, if they seem to have a painful or distended/ hard abdomen. Are they vomiting or experiencing lethargy? These symptoms could indicate complications like acute renal failure.

Question 22

Burns are classified by?

Answer 22

Partial thickness superficial which involves the epidermis only or deep which extends to the dermis. Full thickness involves the entire dermis, nerves and blood vessels/ extend into the SQ later, muscles, bones and therefor patients may not necessarily feel pain but are more likely going into shock in which case the owner can place a cold wet towel on the affected areas and wrap the patient in a blanket to prevent heat loss. Redness or blisters can indicate partial thickness, bleeding can indicate deep partial thickness or full thickness burns which destroy blood vessels. These cases are typically hospitalized and sedated for daily wound debridement until wound healing begins. Using sterile technique, bandages can be placed with silver sulfadiazine ointment. Burn patients are more susceptible to infections therefor sterile technique is mandatory.

Question 23

What kind of penetrating wounds are considered an emergency?

Answer 23

Wounds into the eye, thorax, abdomen or those with exposed bones either from fractures or devolving injuries. Owners can place splits at home using newspapers or wood to immobilize the limbs but they should not move the limbs unnecessarily.

Question 24

Snake bites, what do you look for?

Answer 24

Snake venom is Nemo toxic and depending on where the animal was bit and how long its been will determine the severity of the case. Pain, swelling, redness are typically noted as well as signs of v/d weakness, tachycardia, hypersalivation, convulsions, shallow breathing.

Question 25

Dystocia

Answer 25

Ask if the patient has recieved an abdominal ultrasound or radiographs to confirm pregnancy. Dystocia is common in big headed breeds like bulldogs and chihuahuas. Typical signs of Dystocia include green discharge without production of offspring, foul odor, crying or biting at vulva, profuse hemorrhage. Indications for Dystocia include being more than 1 week overdue, no fetus production within 4 hours of labor, strong abdominal contractions for more than 50-60 minutes, more than 3 hours between births or failure to deliver all offspring within 18-24 hours.

Question 26

Gdv

Answer 26

Risk factors include large breed dogs with deep narrow chested conformation. Common breeds include GSD, GD, ROTT, ST.B, LABS, MALAMUTES, DOBB, IRISH SETTERS. Characterized by abdominal pain/ bloat, dry heaving/ trying to vomit without production.

Question 27

Contraindications for inducing emesis include

Answer 27

Respiratory distress
Ingestion of caustic materials
Seizures
Extreme weakness
CNS depression
Bradycardia

Question 28

Restraining/Transporting

Answer 28

• without a suspected spinal injury
  Small dogs and cats are best wrapped in a large towel/blanket
  Large dogs can be transported the same way or use the blanket as a sling
• animal with a spinal injury or suspected of
  Small dogs and cats- pick-up in the axillary region with the legs facing away from the handler. The bottom of the animal is allowed to “dangle” but this keeps the Spinal Cord from suffering any further compression. This method is not ideal if they are struggling with restraint. Wrapping them “burrito style” in a thick towel or blanket will work to hold the entire patient still.
  Large dogs or animals that won’t allow you to pick them up to be placed on a flat surface for transport (board, a firm piece of cardboard, or an ironing board). The dog can be moved onto the board by grasping the skin of the scruff and over the back and gently sliding/shimmying the animal onto the board, trying to keep the back and neck straight. The dog can then by tied or taped to the board.

Question 29

Fractured Leg

Answer 29

Fractures of the femur and humerus cannot be splinted and the animal should just be handled gently and transported

Question 30

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