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Module 14 > Small Animal Emergencies: Triage & Stabilization > Flashcards

Small Animal Emergencies: Triage & Stabilization Flashcards

1
Q

what triage occurs in the waiting room

A

stable vs immediate care (CPA/shock)

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2
Q

what is triage in the waiting room primarily based on (2)

A
  1. vital signs
  2. ABC
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3
Q

what other information should you get in the waiting room (2)

A
  1. brief history (presenting complaint)
  2. focused physical exam
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4
Q

what is the traffic light system used in the waiting room triage

A

red: critical unstable
amber: urgent/potentially unstable
green: stable

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5
Q

what triage can be done on the phone

A
  1. background info
  2. main complaint
  3. specific questions –> ABC
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6
Q

what else can be communicated on the phone when triaging

A
  1. advice on first aid transport –> handling/mobilization, muzzle
  2. clear instructions/directions
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7
Q

what questions could you ask the owner when triaging on the phone

A

beginning of signs?

did signs become more severe?

is the pet standing?

responsive?

do you think the pet is in pain?

can you see the colour of the gums?

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8
Q

what is the primary survey of the patient

A

physical parameters in more detail

less than 2 mins

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9
Q

what is the goal of the primary survey

A

routine systematic approach to stabilize the patient

ABCDE

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10
Q

what is the secondary survey and when is it done

A

after life-saving procedures started

re-evaluation in detail of ABCDE

complete history

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11
Q

what is the goal of the secondary survey

A

full understanding of the patients condition

long term plans and therapeutics

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12
Q

fill out the diagram of ABCDE

A
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13
Q

what are the pathways to establish a plan with the airway

A
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14
Q

what is the difference between stridor and stertor and what do they indicate

A

Stridor/stretor = abnormal upper resp sounds
Strider: high pitch sound that is seen with laryngeal paralysis (narrowing)
Stertor: rough sound made after vibration of soft tissue with passage of air (BOAS the sound bulldogs make)
Can hear without stethoscope and always indicate abnormalities in upper airway

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15
Q

what observations should be made when observing the patient’s breathing

A

respiratory rate and effort

auscultate for increased/decreased/abnormal sounds

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16
Q

what other diagnostic tools can be used to assess breathing

A
  1. T-POCUS: thoracic point of care ultrasound
  2. SpO2
  3. EtCO2/PCO2
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17
Q

what can T-POCUS diagnose (4)

A
  1. pleural effusion
  2. pneumothorax
  3. B lines (pulmonary edema)
  4. consolidation
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18
Q

what is paradoxical breathihg

A

asynchrony between abdomen and chest when breathing

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19
Q

what are the types of O2 therapy

A
  1. flow by/O2 mask
  2. O2 hood
  3. O2 cage
  4. O2 prongs/nasopharyngeal cannula
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20
Q

what are the indications for O2 therapy (4)

A
  1. cyanosis hypoxemia
  2. dyspnea
  3. SpO2 < 93%
  4. PaO2 <70mmHg
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21
Q

what are the advantages of flow by

A

if the patient won’t tolerate a mask

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22
Q

what are the disadvantages of O2 masks

A

risks of CO2 rebreathing

patient won’t tolerate sometimes

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23
Q

what are the advantages of O2 cages

A

control of humidity and CO2

higher concentrations than masks

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24
Q

what are the disadvantages of O2 prongs

A

may require sedation to fit prongs

stress

patient discomfort

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25
Q

when is sedation required to address breathing issues

A
  1. distress/laboured breathing
26
Q

what sedation would be used to address breathing problems and why

A

butorphanol 0.2-0.3 mg/kg

or

ACP 0.005-0.02 mg/kg

both have minimal resp depression

27
Q

when is intubation/tracheostomy indicated during breathing issues

A
  1. laryngeal paralysis/obstruction

mechanical ventilation > 12 h

28
Q

when would a thoracocentesis be indicated to address breathing issues

A

pneumothorax or pleural effusion

therapeutic

29
Q

what are 6 tests that can be used to assess circulation

A
  1. perfusion parameters
  2. auscultation
  3. PCV/TS
  4. BP
  5. Lactate
  6. ECG
30
Q

what should BP and MAP be to indicate good perfusion

A

BP: sys <160 mmHg

MAP: >75 mmHg

31
Q

what should lactate be to indicate good perfusion

A

<2.5 mmol/L

32
Q

what are the physiological pathways that can help you interpret perfusion status (i.e start with pulse)

A

pulses –> HR –> RR –> CRT –> mentation –>

33
Q

what are the types of shock (6)

A
  1. hypovolemic
  2. cardiogenic
  3. distributive
  4. obstructive
  5. hypoxemic
  6. metabolic
34
Q

what are the causes of hypovolemic shock (3)

A
  1. hemorrhagic shock
  2. severe dehydration
  3. trauma
35
Q

what are the causes of cardiogenic shock (3)

A
  1. congestive heart failure (CHF)
  2. arrhythmia
  3. tamponade
36
Q

what are the causes of distributive shock

A
  1. SIRS/sepsis
  2. neurogenic
  3. anaphylaxis
    - insufficient supply of O2 despite blood volume
37
Q

what are the causes of obstructive shock

A
  1. pleural space diseases
  2. tamponade (fluid around heart builds up)
  3. GDV
    - circulatory flow is impeded
38
Q

what are the causes of hypoxemic shock (2)

A
  1. decreased PaO2
  2. decreased carrying O2 (Hb)

oxygen doesn’t reach tissue because of decrease O2 content or carrying capacity

39
Q

what are the causes of metabolic shock

A
  1. hypoglycemia
  2. mitochondrial dysfunction
40
Q

what are ways to get venous access (4)

A
  1. peripheral
  2. central venous catheter (CVC)
  3. peripherally inserted catheter (PICC)
  4. cut down
41
Q

what are ways to get fluids into the body

A
  1. venous
  2. intra-osseous
42
Q

what are ways to get circulation corrected

A
  1. pericardiocentesis if needed
  2. blood transfusion
  3. fluid resuscitation/therapy
43
Q

fill out this chart of the different types of fluid

A
44
Q

what is the shock does for a dog

A

60-90 ml/kg

45
Q

what is the shock dose for a cat

A

30-60 ml/kg

46
Q

what is the fluid challenge rate for a dog

A

10-20 ml/kg

47
Q

what is the fluid challenge dose for a cat

A

5-10 ml/kg

48
Q

what is the fluid rate of NaCl 7.5% for both dogs and cats

A

2-4 ml/kg

49
Q

what is the colloid dose for cats and dogs

A

10-20 ml/kg/24

50
Q

what is the colloid shock dose for cats and dogs

A

up to 50% daily dose

51
Q

how do you assess demeanour

A
  1. mentation
  2. increase ICP cushing’s reflect (increased BP and decreased HR)
  3. neurological exam
52
Q

what is Cushing’s reflex?

A

in response to increased ICP results in increased blood pressure, irregular breathing, and bradycardia

53
Q

how would you treat increased ICP with cushing’s reflex

A

NaCl 7.5% 2-4 ml/kg IV over 10-15 mins

mannitol 0.5-1 g/kg IV over 15-20 mins (decreases blood viscosity)

54
Q

what are the medications used to treat seizures (5)

A
  1. diazepam
  2. midazolam
  3. levetiracetam
  4. phenobarbitol
  5. propofol continuous rate infusion IV
55
Q

what effects demeanour (5)

A
  1. increased ICP
  2. seizures
  3. blood glucose
  4. electrolytes
  5. temperature
56
Q

how would you treat hypoglycemia

A

0.5-1ml/kg glucose 50% IV 1:4

57
Q

what electrolytes would affect demeanour (3)

A
  1. Na+: neurological (brain edema)
  2. K+: arrhythmias
  3. Ca2+: weakness, tremors, seizures
58
Q

how can heat stroke cause changes in demeanour

A

coma, coagulation abnormalities

59
Q

what does ABCDE stand for

A

A: airway

B: breathing

C: circulation

D: demeanour

E: entire body

60
Q

what parameters would you assess in the entire body (E) (4)

A
  1. biochemistry: BUN/Crea
  2. abdominal palpation: urinary bladder
  3. A-POCUS: effusion
  4. Coags
61
Q

what are other considerations when triaging emergencies

A
  1. preparedness: crash cart stocked, training, resources
  2. team work: cooperate, support, encourage

Module 14 (29 decks)

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