Small animal first aid Flashcards
What are the aims of first aid?
Preserve life
Prevent suffering
Prevent deterioration
Promote recovery
What are the 5 rules of first aid?
Safety Airway Breathing CPR Help - can start with this
Emergency telephone call?
Nurse may be first point of contact, especially if OOH
Listen to owner - be patient and try to calm them "Best understand to best help" - get client and patient details (call back) - get brief history - what? when? how?
Advice owner
- care required by owner
- coming to practice - when?
- ensure understanding (eg may be in holiday and nit sure where to go)
- ask for ETA
Inform team and prep for arrival
Who may carry out first aid?
Anyone
Providing they understand and reach the aims of first-aid
Preparation conisderations?
Number of staff required - who? At least 1 VS ans 1 VN - depends on situation and size of patient Suitable kennel and/or location Equipment needed Consumables (eg needs, syringes) Restraint, handling, transport equipment Paperwork - admit/triage/CPR forms
primary vs secondary survey?
primary
- main/first focus
- ABCs
secondary
- later focus
- full body examination
Airway and breathing
why first?
breathing = heart beating
heart beating ≠ breathing
airway and breathing
considerations?
is there a patent (open) airway
- any abnormal chest sounds?
- blockage?
- gulping?
- if able to open can you see a foreign body?
is the patient breathing?
- chest movement
- nose/mouth movements
laboured breathing?
- struggling
with shallow breathing?
- likely collapsed/recumbent
is the patient conscious?
- if not act now
- may be struggling to breathe
what to do if struggling to breathe or not breathing?
struggling:
suction
- remove fluid from airways
oxygen
not breathing: intubation - tube down the trachea tracheostomy - if obstruction in upper airway - incision into trachea IPPV (intermittent positive pressure ventilation) - breathing for patient
circulation assessment?
mucous membrane colour capillary refill time heart rate and rhythm - normal? pulse pressure - strong or weak? pulse deficit - heart rate without a pulse temperature sock symptoms haemorrhaging
circulation assistance?
defibrillation
haemorrhage control
IV access
emergency IVFT (intravenous fluid therapy)
causes and control of haemhorrage?
trauma clotting problem - eg bleeding from nose internal bleeding - requires checks to realise - checks suggest haemorrhage but nothing external to see
direct digital pressure
pressure bandage
indirect pressure
tourniquet
haemorrhage control methods?
direct digital pressure
pressing fingers direct onto wounds
- apply pressure
- use sterile swab or bandage material
risks
- pushing any protruding objects further in
- eg FB, bacteria or broken bone
advantages?
- quick and effective
disadvantages
- temporary
- lose use of a hand so harder to perform more checks
haemorrhage control methods?
pressure bandage
place bandage around wound
- adds pressure
- don’t need hand
risks
- pushing any protruding objects further in
- eg FB, bacteria or broken bone
advantages
- easy to apply
- can be left in place
- hands-free to carry on monitoring patient
disadvantages
- depends on wound and where wound is
- no easy on large wounds or head wounds
- easy on limbs
patient is bleeding through current pressure bandage?
don’t remove
add more
need current pressure to reduce blood lose
if remove bandage that had dried onto wound
- disrupt clotting that has started
- so has to start again
haemorrhage control methods?
indirect pressure
if bleeding quite a lot
applying pressure further up artery that is supplying that area
- stopping blood getting to wounds point
- specific pressure points
only used for legs and tail - cant restrict blood to organs
risks
- difficult to locate pressure points
- wasting time so continue bleeding
advantages
- hands-free so can continue monitoring
- equipment always available
- no pressure on protruding objects
disadvantages
- has a delayed response due to remaining blood below pressure to be removed
- checking on point - waiting for response - may not be at right spot
pressure points for indirect pressure?
brachial artery
- medual aspect of distal humerus
- reduce blood flow to lower forelimb
femoral artery
- medial aspect of femur
- reduce blood flow to lower hind limb
coccygeal artery
- ventral aspect of tail
- reduce blood flow to lower tail
haemorrhage control methods?
torniquet
commercial or made one (eg bandage or ties)
pressure above wound
- stop blood getting to wound itself
risks
- cutting off blood supply to limbs
- so should never be placed for longer than 15 mins
- lack of o2 causes damage
advantages
- quick and easy
- most crash boxes have one
disadvantages
- blood supply is cut off
- easily damage tissues
shock?
definition? types?
a state resulting from inadequate blood prefusion to tissues
- not getting enough oxygen
- tissues damage and die
- may cause death
hypovolaemic chock
distributive shock
cardiogenic shock
obstructive shock
hypovolaemic shock?
most common
caused by reduced circulating blood volume
- lost blood from haemorrhage
- or lost fluid portion of blood (eg from vomiting or diarrhoea)
body responds through vasoconstriction
distributive shock?
inflammatory mediators cause blood vessels to dilate
cause increase in circulation system size so not enough blood to fill
subtypes:
- neurogenic shock - eg head trauma
- anaphylactic sock - allergic reaction
- endotoxic/septic shock - reaction to toxins
cardiogenic shock?
impaired heart function
- not pumping well
- so not enough oxygen reaching tissues
hypotension - low blood pressure
obstructive stock?
something preventing return of blood to heart
- either within or outside of circulation
- eg blood clot
clincal signs of shock?
pale/dry mucous membrane - bright read with distributive shock because of vasodilation slow CRT - fast in distributive weak or rapid pulse - depending on severity - will start fast to counteract shock - as continued and not treated heart will deteriorate so rate will slow down cold extremities - warm for distributive rapid, shallow respiation - attempt to take in my oxygen poor skin turgor - dry, no elastcity - dehydrated decreased urine output - little fluid
later stages of shock : reduced level of consciousness collapse convulsions - seizering - not enough oxygen to brain
shock treatment?
dicover cause and treat that
- eg haemorrhage control (cardiogenic)
- eg antibiotics or antihistamines (distributive)
keep warm and comfortable
IVFT
- not best for cardiogenic as adds more pressure to heart
observations
- TPR, CRT, MM
- pupillary reflex (pupil reflex with light)
- palpebral reflex (blink when touching inside of eye)
TLC
- keep aware of surroundings (stocking and talking) to keep in consciousness
can deteriorate quickly
- record continuously
I relatively stable
- record every 5-10 mins
common first aid emergencies?
wounds burns and scolds poisons - eg insect stings unconsciousness/collapse seizures/epilepsy fractures and luxation (dislocation) sensory organ damage - eyes, ears tongue major organ damage - heart, spleen, kidneys
wounds considerations?
open or closed?
- open - broken skin surface
- closed - internal bleeding
may or may not be appropriate to ask owner to apply pressure
- depend on situation
- no if fractured leg - more pain
- yes if easily accessible with no protruding objects
bring down asap
- regardless of info given
- can over or under exaggerate - perception
how to treat open wounds?
haemorrhage control - and assess for shock remove foreign bodies - eg bacteria clip and clean dress and re-dress surgery - may need sutures
how to treat closed wounds?
cold compress - for vasoconstriction drain - needle and syringe dressing/bandage - compresses - protect from any further damage (padding) surgery - if internal bleed
burns vs scold?
causes?
both types of wounds
burn - dry heat - eg. fire/electricity
scold - moist heat - eg. boiling water or hot oil
burn/scold considerations?
size - small or majority of skin? depth - superficial? (surface) - deep? (penetrating into tissues underneath) danger to yourself - if electricity burns make sure off before handling - if chemical/hot water burn wear gloves and try to remove first poisoning of patient - could lick chemical burns - try and wash off as fast as possible infections - there is a break in skin so is common
burn/scold treatment?
bring to practice asap COOL running water warm the patient - lose lot of heat through burns - blanket, rugs etc dress the wound - reduce fluid loss from weeping - keeps heat in and bacteria out - use cling film at home - specific dressing given in practice replace fluid loss - vet prescribes fluid analgesia assess for shock - hypovolaemic
types of poisons?
can be oral or via skin
antifreeze - cause kidney failure pesticides - rat bait and slug bait fungicides - often on grass or in streams insecticides - eg dog flee treatment toxic to cats household chemicals - bleach/white spirit inhalants - smoke/carbon monoxide plants - lillies/ragwort/daffodiles medicines - paracetamol foods - mouldy food - grapes, chocolate, mushrooms
poison considerations?
what is the poison?
- package/samples?
when was the animal in contact with the poison/when did they digest it?
did they definitely eat the poison
- any other animals nearby?
how much was eaten?
- danger dose dependant
what is their species, breed, age?
- danger also species dependant
showing any symptoms?
- vomiting, diarrhoea, lethargy, seizures, tremors
- sample of vomit or diarrhoea
treatment of poisoning?
bring to practice asap if thought dangerous
prevent further exposure
- eg inhalant toxins = remove from the area and giving fresh air/oxygen
- eg toxin on skin = washing coat
identify poison
- use sample/packaging if given
- do know of any antidotes?
contact veterinary poisons information service
- helpline
- explain what patient has taken
- they will give advice on treatment/antidotes
- paid service but owners can also call
preventing absorption of poisons into bloodstream?
induce vomiting
- don’t if corrosive substances as will further damage oesophagus
- don’t if unconscious/convulsing
- don’t if had more than 4 hours ago - likely already ingested
give gastric lavage
- placing stomach tube and flushing out stomach
give charcoal
- lines coating of gastrointestinal tract
- stops absorption
- but hard to have patient take charcoal
how to wash coat with poisoning?
liquid oil substances
- use liquid paraffin
- rinse until cant smell any more substance
non-oily compounds
- use warm water
solid oily compounds
- clip clumped areas
- use veg oil/butter to soften and then able to wash off
insect stings?
type of poisoning
generally not severe
depends on site
- throat will cause swelling so make breathing difficult
- foot not as severe
can result in allergic reaction for some patients
- may provide antihistamines
how to treat a bee and wasp sting?
bee
- they are acidic
- bathe in something alkaline
- eg dilute bicarbonate of soda
wasps
- they are alkaline
- so bathe in something acidic
- eg dilute vinegar
adder bites?
often on nose or leg
cause rapid swelling and fang marks
may go into anaphylactic shock
practices may have antivenom to give
may just provide wound support and management
and let the patient rest
What is epilepsy?
A condition that causes waves of disorganised electrical activity within the brain resulting in frequent seizures
- often idiopathic (don’t know cause)
- can have from birth
- or caused by something (eg toxins)
Three stages of epilepsy?
Pre-ictal
- feel as if something is about to happen
- hyper/excited/anxious
Ictal
- actual seizure
- recumbent, tense, libs and extend and paddle
- drooling and lose baldder/rectal control
Post-ictal
- dazed and unsteady
- aggression is likely
- thirsty
Telephone advice for seizuring pet?
Do not touch patient Minimise people in the room but do not leave alone Remove objects that could injure the animal - eg table leg Reduce light and noise - can trigger seizures Allow to rest once subsided - let them move gradually on own Advise owner to take notes - how long? Triggers? How many? Bring to vet as soon as safe - Once through post-ictal phase
Seizure treatment/care?
Often don’t treat if one off seizure
- often not a risk
- if 2 or more then investigate
Take bloods to try and identify cause
If known cause (eg toxin) treat
Ictal phase should last around 2 minutes
- After 5 concerns won’t come round on own
- May need to give anti-seizure drugs
Status epilepticus
- can’t get get out stage
- even with meds
- put under anaesthetic and gradually wake
Types of fractures?
Simple/Transverse - straight break into two Oblique - diagonal break into two Spiral - broken bone spins Comminuted - multiple breaks - shattered bone Greenstick - incomplete break
Clinical signs of fractures?
Pain - May not be until moves Swelling - bruising around soft tissue Deformity - especially if complete break Loss of function - partial or complete - may damage ligaments/tendons Crepitus - bones rubbing/crunching Unnatural mobility - range of motion has increased
Treatment of fractures?
Take care to avoid causing more damage Provide support - supporting bandage or splint - to immobilise area Control any haemorrhage - may need internal - assess for shock Restrict movement - cage/box rest Keep spinal injuries flat and still Give analgesia Surgical correction - comminuted and major breaks - some left to heal on own (eg pelvis)
Dislocation?
Joint not in correct place
Major force required to dislocate a normal joint - eg RTA or fall Some susceptible - eg dogs with hip dysplasia Often associated with pelvis fracture Dislocations may be reduced (put back into place) - use bandage to support joint - however likely to dislocate - may need surgery
Eye clinical signs?
Conjunctivitis - reddening/inflammation of conjunctiva Epiphora - increase tear production Photophobia - avoid bright light - close eyes or burry head Blepharospasm - excessive blinking
Eyelid injuries?
Foreign bodies - eg grass seeds under eyelids Wounds - don't use hibiscus as toxic - use iodine instead - suture under GA likely An inflammatory reaction - eg from allergic reaction of sting - use ice packs to soothe
Eyeball injuries?
Cornea injuries - penetrating wounds (eg scratches) - non-penetrating wounds (eg ulcers) Direct trauma to the eyeball - often cause heamorrhage Fractures to skill - along zygomatic arch - check for breaks or crepitus Prolapse of the eyeball - dislodge from socket - lubricate the eye (boil and cool water and hold over eye)
Eye treatments?
A prolapsed eye should be replaced ASAP - keep lubricated and prevent self trauma Flush with saline to clean - or iodine not hibiscub Sterile gauze taped over area - keeps eye moist Use buster collar Dark, warm area - reduce stress and further damage - increase pressure, HR and blood Monitor closely
Clinical signs of ears issues?
Usually damage to pinna
- scratch/bite
Or foreign body
Haemorrhage - lots of blood vessels so owner likely to panic - apply direct pressure - know not fracture Shaking of head - because of discomfort - cause aural haematoma Self trauma -irritated so rub on everything - makes hard to stop bleeding Swelling
Treatment for ears?
stop haemorrhages - provide direct pressure - know no fracture reduce pain - analgesia - remove blood-filled ear remove FBs - may require sedation surgery - tie off exposed blood vessel - only way to stop haemorrhages is to open and drain
nose considerations?
part of resp system - horses and rabbits only breathe through nose injuries can cause - dyspnoea - epitaxis (nose bleed) - discharge
potential causes of nose injuries?
direct trauma foreign bodies - eg grass seeds infection - discharge can cause blockage tumours
treatment for nose injuries
alleviate haemorrhage - cold compress to constrict blood vessels - don't put pressure - may be a fracture give oxygen if dyspnoea provide quiet area - decrease stress which decreases HR and blood avoid muzzling is safe observe for underlying issues - eg neurological damage - eg internal haemorrhage
potential causes of mouth injuries?
common injuries as patients use mouth for investigation
foreign bodies - eg fish hooks and sticks fractures - direct blows to the head (eg RTA) - mandibular symphysis is common in cats insect stings - eat wasps/bee
clinical signs of mouth injuries?
pain and swelling pawing/rubbing at face salivation/drooling dysphagia (difficulty eating) - off food or unable to eat presence of foreign body
treatment for mouth injuries?
remove foreign bodies if present - may need sedation/GA perform diagnostic tests - eg x-rays for fractures surgery - eg remove foreign bodies - eg wire jaw together give feeding tubes - insert during surgery - as unlikely to want when awake
what is GDV?
gastric dilation and volvulus serious and life threatening usually in deep chested breeds - eg greyhounds cause no always known
- usually after ingesting large amounts of food quickly followed by exercise
- gas then fills stomach which twists
- this stops gas from leaving
- this pushes on caudal vena cava and diaphragm causing obstructive shock
gas will continue to be made which will cause rupture if not treated
clinical signs of GDV?
distension of the stomach (large/swollen/bloated) discomfort and restlessness - stomach/abdomen hard to touch - sounds hollow from air dyspnoea trying to burp to release gas unproductive vomiting collapse - late stage obstructive shock signs - late stage
treatment for GDV?
genuine emergency IVFT - to increase blood pressure - but sudden relaxation on vena cava causes crash relieve pressure asap - needle to stomach and stomach tube surgery - gastropexy - suture stomach against body wall
causes of gastrointestinal obstruction/stasis?
means gut isn’t moving properly
obstruction - eg foreign body or mass - can cause gastric rupture - especially in animals that cant vomit not eating - either starved or health issues
use radiographs to diagnose
- show if any obstructions
clinical signs of gastrointestinal stasis?
anorexia (not eaating) discomfort and restlessness reduce gut sound sounds lack of feaces and diahorrea vomiting (if possible) colapse and shock - from rupture
treatment for gastrointestinal stasis?
geuine emergency - especially if chance of rupture monitor blood glucose assist in hand feeding - hand, syringe or tube - if no blockage treat for shock give analgesia and prokinetics - get system working again remove any obstructions
causes for spleen injuries?
blood filled organ so damage can lead to haemorrhage and death
trauma - eg RTA tumours - grown and ruptured torsion - twisting and turning - close connection with stomach (GDV)
clinical signs of spleen injuries?
sudden collapse hypovolaemic shock tachypnoea (fast breathing) pale MMs and weak pulse - so fast HR cold to touch if torsion then will be swollen, hard and very painful
treatment for spleen injuries?
if ruptured little can be done so PTS if not ruptured treat fr shock - blood transfusion or IVFT surgery - spenectomy - removal of spleen - don't need as other organs can take over
causes for kidney injury?
large blood supply so trauma can lead to haemorrhage and death
nephroliths - kidney stones
blunt force trauma - eg kick or RTA
clinical signs of kidney injury?
'hang dog' psoture - praying position - bottom up, shoulders down haematuria - blood in urine oliguria - recution in volume or frequency of urine
treatment for kidney injuries?
warm, dark, quiet kennel
- to reduce stress
treat for shock
have VS diagnose extent of damage
often heal well on own
- other one will take over
- will still need support
causes of bladder injuries?
uroliths - bladder stones - cause blockage in urethra - causes rupture bruising and displacement - from direct trauma
clinical signs of bladder injuries?
anuria/dysuria - true emergency as sign of rupture - rupture will cause crash = PTS haematuria - blood in urine oliguria - increased volume or frequency of urine
treatment for bladder injuries?
monitoring of urine production urine sample analysis imaging of bladder and kidneys - check for damaged further up remove eruthral blockage if any surgery - into bladder and remove large stones that won't pass
causes for pyometra?
pyometra = puss filled uterus
repeated cycles with no pregnancy causes cysts
these burst releasing puss
opening of cervix during oestrus causes bacteria to enter
there are low WBCs within uterus during osterus
so best conditions for bacteria
clinical signs of pyometra?
vomiting and diarrhorea anorexia uncomfortbale abdomen pyrexia (high temp) if open then purulent vaginal discharge if closed rupture is likely collapse - spetic shock
use ultrasound to diagnose
treatment for pyometra?
treat shock - IVFT IV antibiotics ovariohysterectomy - to remove puss
causes for ruptured diaphragm?
more common in cats than dogs
usually result of RTA
abdominal organs move into thoracic cavity
clinical signs of diaphragmatic rupture?
for some may be none varying degrees of dyspnoea - panting - gasping/struggling orthopneic position - sitting upright - extend head and neck with shoulders back - to increase air in lungs
treatment for diaphragmatic rupture?
keep warm and quiet oxygen supplementation monitor pulse and resps surgery - close rupture - stabilise and wait few days first
use radiographs to diagnose
heart failure considerations?
when heart is unable to pump blood around body - resulting in cardiogenic shock left sided heart failure - fluid accumulates in chest - pulmonary oedema/plural effusion ighted sided heart failure - fluid accumulates in body - especially abdomen (ascites)
clinical signs of heart failure?
signs of cardiogenic shock
- eg dysnpnoea, pale MM, weak pulse
treatment for heart failure?
diuretics - removes excess fluid - by increasing urination thoracentesis - needle in plural cvity to remove fluid oxygen therapy low stress handling keep warm
signs of unconsciousness?
heart beat present but slow respiration present muscles are flaccid body temperature is stable cornea are moist pupillary light response is present but may be sluggish fits may occur bladder control may be lost
