Triage and Stabilization Flashcards
(T/F) Vets and rehabbers are often placed under a great deal of pressure to save the animal.
True
What is traige?
Injuries are prioritizing and treated according to severity
Most life threatening are attended to first
The decisions in triage about treatment and prioritization are base on _____ and ______.
Outcome and prognosis
How can an accurate triage help the vets in the long run?
Can save months of work, emotional energy and finite resources
Out of these, what can be a poor prognostic indicator?
a) Emeciated
b) Severe patagial wounds
c) Some parasites
d) Open old fractures
e) Damage to digit 3 and 4
f) Joint luxation and spinal fractures
A, B, D, F
C- heavy ectoparasites burden
E - Damage to hallux (1) and power tallon (2)
What are the 3 major problems that can happen with trauma that are part of the 3 strikes?
Wing fractures
Leg fractures
Severe ocular trauma
What is the most important thing to do during triage?
Do an initial brief assessment
(confirm species, note any obvious problems, evaluate aggressiveness)
What are the 4 compromising ABC or life threatening conditions that we should assess in our brief assessment that would make us want to act quickly?
Respiratory distress
Significant hemorrhage
Severe shock
Seizure
If the airway is compromised what should you do?
Use endotracheal tube or air sac cannula
What should you do if a patients breathing is compromised?
100% O2
Positive pressure ventilation
What should you do if circulation is compromised? (coloration of mucous membranes, body temperature, degree of hydration, CTR, pulse)
Heat source
Fluid therapy
What is the rate a bird should be intubated and have a positive pressure ventilation?
4-5 seconds
How many compressions over the sternum should be provided to an avian patient?
60-80/minute
What can you use to monitor heart beat in a cardiopulmonary arrest?
ECG and Doppler
If a patient is in respiratory distress what should you do?
Minimize handling
Get O2 (face mask or oxygen chamber)
Mild sedation (Butorphanol or midazolam)
What symptoms can you see with electrocution patients?
Acute respiratory distress (from neurogenic pulmonary edema)
Cardiac arrest, pericardial effusion, thermal burns
What is our top priority in hemorrhagic patients?
Homeostasis is top priority
How much blood can wild animals lose?
No more than 1% of BW
(in reptiles is 0.5%)
(T/F) Mammals will tolerate acute blood loss better than birds.
False - the other way around
When will we consider transfusions in birds and mammals?
Birds: <15% PCV
Mammals: <25% PCV
How do we define shock?
Poor tissue perfusion from either low blood flow or unevenly distributed flow
What kind of shock is the most common?
Hypovolemic shock
- Fluid therapy is critical
What is the only kind of seizure that is worth treating instead of euthanizing?
Seizures due to hypoglycemia
- babies
Everything else: trauma, infectious, toxins, parasites should be euthanized
What should be the amount you should be taking triaging your patient?
1 min (while transferring into incubator)
Raptors a little more in depth and we do diagnostics
What are the two blood tests performed on every raptor at entry?
HCT/TP
CBC/Chem can be done in the first week
What is the level for lead toxicity in blood work?
> 0.2 ppm
(it will vary depending on species on clinical signs)
Who is ok with one functional eye and who needs perfect vision?
One functional eye - owl
Perfect vision - accipiters (diurinal birds)
What are the signs of hyperthermia?
Severe exertion or excitement
Panting or red mucous membranes
Which patients do we see hypothermia the most?
Orphaned animals and wet animals
Which patients have hypoglycemia the most?
Orphaned wildlife
Will see - ataxia, seizures, loss of consciousness
What are the 3 things we should keep in mind while calculating fluids?
- % dehydration
- Maintenance fluid rate
- Estimate ongoing losses
What are crystalloids used for?
Replacement or maintenance of blood volume
Which routes can crystalloids be given?
PO, SQ, IV, IO
What compartment do colloid fluids replenish?
Intravascular (remains in blood stream)
What routes can colloids be given?
IV or IO
Which route of administration is best depending on the function of the GI?
With functional GIT - PO or SC
With diminished GIT - SC
What bones can we place IO catheters in birds? Which ones can we not?
Place - ulna or proximal tibiotarsus
Cannot place - humerus and femur
What bones can we place IO catheters in reptiles and mammals?
Proximal tibia
What should we give patients with head trauma within 24 hours of the event? How about after?
Within 24 hours - Mannitol or hypertonic saline
After 24 hours - NSAID therapy
What is the first diagnostic tool we use for avian spinal fractures?
Survey radiographs
What are the common sites of avian spinal trauma?
Caudal to the notarium
Cranial to the synscarum
In mammalian spinal trauma, what do you want to test for?
Test postural reactions (proprioception and withdrawal reflex)
If there is trauma to UMN above S1-S3 what will you see with the bladder?
Overdistended, difficult to express
If there is trauma to LMN within S1-S3 what will you see with the bladder?
Dribble urine, easily expressed
(T/F) UMN lesions usually have better prognosis for recovery than LMN lesions.
True
(T/F) You want to stabilize your patient first before going into surgery even though they have fractures because they are not fresh
True
Shells are made out of ____
Bone
If someone told you they picked up a bird and saw a cat pass by, should you provide antibiotics to the patient?
Yes - cat bites are notoriously infected (wild animals are often susceptible to P. multocida and sepsis from gram neg bacteria), assume they got bit if there is a cat around
What three drugs do we use for avian analgesia?
Tramadol, buprenorphine/butorphanol, gabapentin
What NSAID is used the most that is indicated for any type of trauma?
Meloxicam
What NSAID can be used for ocular trauma?
Flurbiprofen
