Triage and major body systems assess (Buckley) Flashcards
1
Q
Phone triage is almost always a…
A
trap
2
Q
Why triage
A
- allows you to set priorities
- resource allocation
- sickest patients first
3
Q
Triage question
A
- Does animal have a life threating problem?
- what is it?
4
Q
How long should triage take?
A
- < 1 min assessment
- brief reason why patient presented today
5
Q
Triage assessment
A
- Heart and perfusion
- Breathing
- Neuro status
- Abdomen
- Bleeding
- Male cats
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
7
Q
Inappropriate Loss of Conciousness
A
- cardiopulmonary arrest
- unconsciousness
- status epilepticus
8
Q
Respiratory problems
A
- Not breathing
- Respiratory distress
- open-mouthed breathing cats
9
Q
Abnormal gum color
A
- Extremely pale/white
- Blue/cyanotic
10
Q
Cardiac
A
- Severe arrhythmias
- Profound tachycardia
- Profound bradycardia
11
Q
Hemorrhage
A
- Uncontrolled bleeding
- Arterial bleeding
12
Q
Specific abnormalities
A
- Sucking chest wound
- Gun shot wound
- Visible internal organs
- Impalement injuries
- Large breed with abdominal distention
13
Q
Cat 1 ex
A
- GDV
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
15
Q
Cat 3 ex
A
- Minor allergic rxns: puffy face
- Lacerations without major bleeding
- Stable fractures
- Vomiting/diarrhea
- Cat bite abscess
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
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
18
Q
Major body system assessment
A
- Can be done while someone places cath
- Heart
- Brain
- Lungs
- Bladder of male cat
19
Q
Heart
Assess
A
- Heart rate and rhythm, murur
- Pulse quality-can be very helpful
- Mucous membrane color
- Capillary refill time
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
- Sinus tachycardia
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
- Crackles
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
