Trauma Flashcards
What is the classic triade of High Rise Syndrome?
- Epistaxis
- Hard palate fracture
- pneumothorax
Explain terminal velocity and how it is determined. What is the terminal velocity of an average 5kg cat?
- velocity of a falling body increases i.e., accelerates speed of fall that is pulled by gravity and determined by size and body surface area
- larger SA increases drag force which opposes velocity of the fall
- eventually velocity will reach point where gravitational forche equals drag force –> body stops accelerating = terminal velocity
5kg cat 60 mph - reached after 5 stories
What is the equation for the force with which the body hits the ground?
F = ma
F force
m mass of the body
a acceleration
How does a cat’s body position and therefore injury distributions change if falling from the second versus 6th floor?
2nd floor - likely landing on its limbs - most injuries to limbs
6th floow - high enoug to reach terminal velocity where vestibular system is no longer stimulated and cat will land flat, horizontal with injuries to thorax and abdomen
What are the most common abdominal injuries reported with high rise syndrome?
- hemoabdomen
- traumatic pancreatitis
- pancreatic rupture
- uroabdomen
How could you diagnose traumatic pancreatitis/pancreatic rupture on abdominal effusion?
intraabdominal lipase activity 22:1 compared to paired serum
In feline high rise syndrome which limb of the pancreas does usually rupture?
left pancreatic limb
What are the types of Trauma with the highest mortality rates in cats and dogs?
dogs
1. HBC
2. ballistic injury
3. injured inside vehicle
4. nonpenetrating bite wound
5. choking/pulling injury
cats
1. HBC
2. ejected from vehicle
3. nonpenetrating bite wound
4. ballistic injury
5. choking/pulling
What are the most common types of traumas in dogs versus cats?
dogs - penetrating
cats - blunt
Do dogs or cats have higher average ATT scores on presentation after trauma?
Cats (2 versus 1 in dogs)
How commonly do dogs and cats require surgery after trauma?
common
dogs 44%
cats 33%
How does the mortality rate from trauma compare between dogs and cats?
dogs have a higher survival to discahrge percentage (93%) versus cats (83%)
notes
* natural death the same but cats more commonly euthanized
* dogs were more commonly euthanized for financial reasons than cats (19% versus 16%)
What is the most common type of trauma in both dogs and cats?
bite wounds
What is included in the VetCOT score and how does it perform compared to the ATT score?
VetCOT score:
* Presence of spinal trauma
* Presence of head trauma
* Lactate
* iCa
compared to ATT:
* same AUROC (0.87)
* same disciminatory performance
* better callibration with VetCOT score - ATT overpredicts mortality at low scores
- vascular tone
- myocardial contraction
- coagulation
- neuronal signaling and conduction
- hormonal release/enzymatic function
what is the most common trauma type in toy versus giant breed dogs?
toy - blunt trauma (fall or HBC)
giant - penetrating
How does the survival from trauma compare between giant and toy breed dogs?
better survival percentage overall for toybreeds but patient size did not impact survival in a logistic regression model
How do ATT scores and mGCS compare between blunt and penetrating trauma in dogs?
highest ATT score if combination of both
blunt trauma with more cases with a lower mGCS score compared to penetrating
How does the occurence of abdominal free fluid, absence of glide sign, of pleural effusion compare between blunt and penetrating trauma in dogs?
all 3 most common in blunt trauma
What is the most commonly fractured bone in feline trauma patients?
mandibular fractures
How do mortality and ATT scores compare between sexes of dogs undergoing trauma?
neutered males/females better survival and lower ATT score compared to intact males/females
no difference between male and female
BUT: neutered males/females had less severe trauma
In Sepuya et al. how did WBCT compare to tranditional radiographs?
21 dogs
- 12 injuries missed on traditional xrays - including life-concerning e.g., bulla, pneumothorax, etc.
- only one on WBCT (distal metacarpal fx)
- traditional xrays misdiagnosed a DH and a ruptured urinary bladder which WBCT could rule out
- most dogs needed sedation only (76%) for WBCT (24% anesthesia)
For feline bite wounds, what has been shown to be associated with mortality
- higher ATT
- lower mGCS
- older age
- higher body weight
