Triage and stabilisation Flashcards
How do you prioritise cases for triage?
Emergency - requiring immediate assessment
Potentially serious - triage when available
Give examples of cases which would fall into the emergency category
- Distended abdomen with non-productive retching
- Breathing difficulties
- Seizure lasting more than 5 minutes
- Collapsed animal
- Major trauma e.g. RTA
- Major bleeding
- Male cat unable to urinate
- Dystocia with pup/kitten stuck
- Toxic ingestion in the last 2 hours
Give exams of cases which would fall into the potentially serious category
- Persistent vomiting and diarrhoea with lethargy
- New onset of seizures less than 5 minutes long
- Wounds without major bleeding
- Acute lameness
- Acute onset of a painful eye
What are the initial steps involved in triage?
Aiming to get capsule history - Presenting signs - Current medical complaints/medications - Onset and duration - Consent for initial stabilisation* Sort your patients into order of priority and explain what is happening to their owners
What is the ABCD?
Alert – is the patient alert and awake
Breathing – can the patient breathe effectively
Circulation – is there a palpable pulse or heart beat. Is there major external haemorrhage
Disability – is there significant neurological concern
What are the major body systems?
Systems where acute failure leads to rapid death
- Cardiovascular
- Respiratory
- Neurological
What type of breathing is abnormal for cats?
Open mouth - immediately requires oxygen
What signs are being shown during triage require immediate stabilisation?
Any of the ABCD (Alert, breathing, circulation, disability)
Major body system concerns
What are the aims of stabilisation?
- Prevent current problems worsening
- Trying to find the cause of the problems
- Welfare: don’t forget about analgesia
What could be the possible causes of an unconscious pateint?
- Hypoglycaemia: check blood glucose and give IV if low
- Severe shock: check CV
- Seizing: IV diazepam
- Toxins
- Heatstroke: patient temp and then active cooling
- arrested: start CPR
What are the first aid steps when there is a patient struggling to breathe?
- Reduce stress and provide oxygen
- Consider sedation to minimise stress if needed – butorphanol
- Determine location e.g. obstruction, upper airway, lower airway, pleural space
How can you determine the location of a respiratory problem?
Upper = noise on inspiration
Lower = expiratory effort
Pleural space = paradoxical breathing pattern
What are the first aid steps when there is an external wound/haemorrhage?
- GLOVES
- Direct pressure on the wound with swabs
- Do not remove base layer of swabs, keep adding if soaking through
- Analgesia important
- Support CV system
- If not able to control bleeding with pressure aim to get BP normal and then surgical control of haemorrhage
What are the first aid steps when there is an internal haemorrhage?
- Pale collapsed patient with evidence of cardiovascular exam abnormalities
- Find source: POCUS of body cavities (ultrasonography)
- Stabilise cardiovascular system => fluids to normalise blood pressure
- Definitive control (usually surgery) once stable
How should the following neurological conditions be treated with first aid:
- Seizures
- Head trauma
- Treat with appropriate medications e.g. diazepam
2. fluids, analgesia, elevate head
