Triage

Question 1

What 3 body systems should be assessed during a triage exam?

Answer 1

1. Cardiovascular
2. Respiratory
3. Neurologic

not necessarily in that order

Question 2

What 2 general things are you assessing in a triage neurologic exam?

Answer 2

1. Mentation
2. Is the patient actively seizuring?

Question 3

Describe normal mentation

Answer 3

Responds normally & appropriately to stimuli

Question 4

Describe dull mentation

Answer 4

Responds to all stimuli but with less vigor than normal

Question 5

Describe stuporous mentation.

Answer 5

Only responds to noxious stimuli

Question 6

Describe comatose mentation

Answer 6

Doesn’t respond at all (even noxious/painful stimuli)

Question 7

Describe demented mentation.

Answer 7

Responds inappropriately to stimuli

Question 8

A patient presents to your ER for seizures. The patient is not actively seizuring at this time. Should you put this patient higher or lower on your triage list (in general)?

Answer 8

Can be put lower on list

Question 9

What 3 things should you assess during a triage respiratory exam?

Answer 9

1. Is the patient breathing?
2. What is the effort like? (i.e. labored, open -mouth (differentiate from panting), distressed (look at the eyes))
3. What is the respiratory rate?

Question 10

Engagement of abdominal muscles tells you what about a patient’s respiratory effort?

Answer 10

There is increased respiratory effort exhibited on expiration.

Question 11

A patient presents to your ER and is tachycardic with a RR of 72 bpm. The patient is also sticking out their neck when taking breaths. Are you concerned?

Answer 11

Yes! This patients RR is significantly higher than normal & is actively adjusting their body to make breathing easier

Question 12

Besides your hands/eyes/ears/nose/brain, what is the ONLY equipment you need to do a triage cardiovascular asssessment?

Answer 12

Thermometer

Question 13

For your cardiovascular assessment, what 6 things are you going to look at to assess perfusion?

Answer 13

1. Heart rate*
2. MM color
3. CRT
4. Mentation
5. Temperature
6. Pulse Quality

Heart rate probably the most important & easiest thing to assess perfusion

Question 14

In general, what is a normal heart rate for a dog of any size?

Answer 14

60-120bpm

Question 15

In general, what is a normal heart rate for a cat in hospital?

Answer 15

180-240bpm

Question 16

Tachycardia is a sign of poor perfusion, except in which species?

Answer 16

Cats - bradycardia more significant

Question 17

With poor perfusion, what is one of the first things the body will do to increase cardiac output?

Answer 17

Increase HR

Question 18

What does red gum color indicate?

Answer 18

A lot of oxyhemoglobin

Question 19

What does brown gum color indicate?

Answer 19

Methemoglobin (damaged hemoglobin)

Question 20

What does blue gum color indicate?

Answer 20

deoxyhemoglobin

Question 21

What does white gum color indicate?

Answer 21

No hemoglobin

Question 22

What does yellow gum color indicate?

Answer 22

Bilirubin (this is a byproduct of hemoglobin)

Question 23

What is a normal CRT?

Answer 23

1-2 seconds

Question 24

What is a CRT of >2 seconds indicative of?

Answer 24

Vasoconstriction

Question 25

What is a CRT of <1 second indicative of?

Answer 25

Vasodilation

Question 26

Poor mentation in the absence of other neurologic signs, or in the presence of other indicators of poor perfusion may indicate what?

Answer 26

The poor mentation is likely from poor perfusion

*Treat perfusion first, then reassess mentation/neurologic status

Question 27

Is hypothermia or hyperthermia indicative of poor perfusion?

Answer 27

Hypothermia

*When you’re cold, you vasoconstrict…when you vasoconstrict, you get cold

*Shunting blood away from periphery to maintain blood flow to the core (brain, heart, etc.)

Question 28

If a patient has bounding pulses, is the time spent in systole increased or decreased?

Answer 28

Decreased