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ECC > Triage and major body systems assess (Buckley) > Flashcards

Triage and major body systems assess (Buckley) Flashcards

1
Q

Phone triage is almost always a…

A

trap

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2
Q

Why triage

A
  • allows you to set priorities
  • resource allocation
  • sickest patients first
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3
Q

Triage question

A
  • Does animal have a life threating problem?
    • what is it?
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4
Q

How long should triage take?

A
  • < 1 min assessment
  • brief reason why patient presented today
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5
Q

Triage assessment

A
  • Heart and perfusion
  • Breathing
  • Neuro status
  • Abdomen
  • Bleeding
  • Male cats
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6
Q

Triage categories

A
  • Category 1: Will die without immediate intervention
  • Category 2: Critical, needs urgent attention w/in 30 min
  • Category 3: Sick, needs attention within hours
  • Category 4: Not true emergency, treat within 24 hours
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7
Q

Inappropriate Loss of Conciousness

A
  • cardiopulmonary arrest
  • unconsciousness
  • status epilepticus
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8
Q

Respiratory problems

A
  • Not breathing
  • Respiratory distress
    • open-mouthed breathing cats
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9
Q

Abnormal gum color

A
  • Extremely pale/white
  • Blue/cyanotic
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10
Q

Cardiac

A
  • Severe arrhythmias
  • Profound tachycardia
  • Profound bradycardia
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11
Q

Hemorrhage

A
  • Uncontrolled bleeding
  • Arterial bleeding
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12
Q

Specific abnormalities

A
  • Sucking chest wound
  • Gun shot wound
  • Visible internal organs
  • Impalement injuries
  • Large breed with abdominal distention
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13
Q

Cat 1 ex

A
  • GDV
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14
Q

Cat 2 ex

A
  • Pale mucus membranes
  • Severe fever
  • Dystocia
  • Toxicity patients
  • Possible lower urinary tract obstruction
  • Severe pain
  • Trauma
  • Severe dehydration: bad V/D, DKA
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15
Q

Cat 3 ex

A
  • Minor allergic rxns: puffy face
  • Lacerations without major bleeding
  • Stable fractures
  • Vomiting/diarrhea
  • Cat bite abscess
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16
Q

Cat 4 ex

A
  • Mild vomiting/diarrhea (1-2 episodes)
  • Mild-mod lameness
  • Mild cut/abrasion
  • Broken toe nail
  • Sneezing/ URT signs
  • Hematuria
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17
Q

After triage

cat 1, 2

A
  • Permission to do basic, life saving tx
    • bloodwork, IV cath, fluids, O2
  • Resuscitation code
  • Back to tx area
  • Major body syst assess
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18
Q

Major body system assessment

A
  • Can be done while someone places cath
  • Heart
  • Brain
  • Lungs
  • Bladder of male cat
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19
Q

Heart

Assess

A
  • Heart rate and rhythm, murur
  • Pulse quality-can be very helpful
  • Mucous membrane color
  • Capillary refill time
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20
Q

Tacycardia

Arrhythmia

A
  • Tachycardia
    • Sinus tachycardia
      • Hypovolemia-number 1 life threatening prob, give fluid
      • Anemia
      • Pain
      • Anxiety
    • Arrhythmia
      • ventricular tachycardia-know what this looks like
      • supraventricular tachycardia-atrium
      • atrial fibrillation-know what this looks like
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21
Q

HBC dog, high heart rate

A
  • tempting to bolus opiods
  • might actually need fluids
22
Q

Bradycardia

A
  • Sinus bradycardia
    • drug intoxication
    • anesthetic drugs
    • intracranial dz
  • AV block
    • cardiac disease
    • opioids
  • Atrial standstill
    • hyperkalemia
    • cardiac dz
    • hypothermia
23
Q

2 main causes of hyperkalemia

A
  • blocked cat
  • addisons
24
Q

Pulse quality

A
  • normal pulse doesn’t equal normal blood pressure
  • normal
  • weak
    • hypovolemia
    • poor cardiac output
      • heart failure
      • pericardial effusion
  • Tall and narrow ‘bounding’
    • compensated hypovolemia
    • anemia
25
Q

Hyperemic CRT

< 1s

A
  • compensated hypovolemia
  • fever
26
Q

Pale prolonged CRT

> 2 s

A
  • Decompensated shock
27
Q

Pale, normal CRT

A
  • Anemia
28
Q

Pale, absent CRT

A
  • Severe anemia
  • Cardiovascular collapse
29
Q

cyanotic

A

hypoxia

30
Q

Lungs

Assess

A
  • Rate
  • Effort
  • Pattern
  • Sound
  • Auscultation
31
Q

Rate

descriptors

A
  • Rapid
    • Shallow
    • Gasping
  • Slow
    • sedation
    • airway obstruction
    • brain dz/herniation
  • Panting
    • dyspnea?!?
32
Q

Inspiratory effort

A
  • Upper airway obstruction
  • Abdominal distension
  • Pleural space dz
  • Diaphragmatic hernia
33
Q

Expiratory effort

A
  • Lower airway dz
    • feline asthma
    • severe bronchitis
34
Q

Inspiratory and expiratory effort

A
  • Parenchymal dz
35
Q

Non-specific dyspnea

A
  • PTE
  • Pain
  • Abdominal distention
36
Q

Short and shallow breathing

A
  • Parenchymal disease
  • Pleural space dz
37
Q

Paradoxical breathing

A
  • Pleural space disease
  • Diaphragmatic hernia
38
Q

Focal paradoxical breathing

A
  • Flail chest
39
Q

Stridor

A
  • Upper airway obstruction
    • lar par
    • laryngeal tumor
    • BOAS
    • Foriegn body
40
Q

Ascultation

Quiet

Loud

A
  • Quiet
    • pleural space dz
  • Loud
    • Crackles
      • pulmonary edema
      • pneumonia
      • pulmonary contusions
      • bronchitis
    • Wheeze
      • lower airway dz
41
Q

Summary

Parenchymal dz

A
  • Mixed inspiratory and expiratory dyspnea
  • Loud/Harsh lung sounds or crackles
  • short, shallow respirations
42
Q

Pleural space dz or diaphragmatic hernia summary

A
  • Inspiratory dyspnea
  • Short, shallow respirations
  • Sometimes paradoxical respiration
  • Quiet lung sounds on auscultation
43
Q

Summary of breathing patterns

A
  • Flail chest
    • focal paradoxical pattern
  • Lower airway dz
    • Expiratory dyspnea
    • Loud/harsh lung sounds or crackles
    • Wheezing
  • Upper airway obstruction
    • Inspiratory
    • Stridor
    • Referred upper airway noise on auscultation
44
Q

Brain

Assess

A
  • Mental status
  • Level of conciousness
  • Seizure activity
  • Ability to walk
45
Q

Level of concsiousness

A
  • Coma
  • Stupor
  • Obtunded
  • Dull
  • Quiet
  • Normal
46
Q

Aim of MBSA

A
  • Is patient
    • dying and in need of intervention right now
    • stable enough for diagnostics/tx
  • is life threatening problem primarily
    • cardiac
    • respiratory
    • neuro
47
Q

Minimum database laboratory values

A
  • PCV/TS
  • Glucose
  • Renal values
  • Electrolytes-esp K

*Try to take blood during catheter placement

48
Q

Emergency interventions

Cardiac/circulatory

Arrhythmias

A
  • Ventricular arrhythmia
    • lidocaine: 2mg/kg (1/10th the dose in cats)
  • Severe bradycardia
    • atropine
    • fix electrolytes
    • warm up
    • emergency pacing
49
Q

Emergency interventions

Cardiac/circulatory

Hypovolemia

A
  • Fluid therapy
  • Consider
    • crystalloids
    • colloids
    • hypertonic saline
    • blood products
50
Q

Emergency interventions

Cardiac/circulatory

Severe anemia

A
  • Blood transfusion
    • PRBCs, whole blood
    • Blood type cats
    • don’t need to blood type dogs first time
  • Oxyglobin
51
Q

Emergency interventions

Respiratory

A
  • Oxygen
    • flow by
    • oxygen cage (esp cats)
  • Intubation
    • upper airway obstruction
    • severe respiratory distress
    • respiratory failure
  • Ventilation
    • severe hypoxemia
    • hypoventilation

ECC (18 decks)

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