Triage Disease Flashcards
What is triage?
- Prioritisation of needs with cases coming in
- Working out which of your patients is likely to decompensate/die first, and see those animals above others that arrive at the same time
What factors can be implemented in a practice to ensure success in the emergency patient?
- Need dedicated area with equipment that may be required for these challenging patients
- Appropriately trained staff and someone to take charge (you as the vet)
- Appropriate equipment and pharmacological agents
What is the immediate treatment focus of all severely poly-traumatised or critically ill patients?
- recognise and treat life-threatening problems
- reduce global and local hypoxia and hypercarbia
- only when the animal is stable do we need to do a head-toe examination
- if things are deteriorating then fix these first
What secondary survey diagnostics might be used in emergency and critical patients?
- Stabilise first
- Ultrasound (major body systems assessment)
- 2 view radiographic study of the entire body in animals with multiple injuries (only if animal is stable)
- Baseline and serial blood samples
- Clipping thoracic, flank and abdominal hair to detect bruises
What is the goal with secondary survey diagnostics in emergency and critical patients?
Detect all injuries that will lead to life-threatening consequences early enough to prevent serious complications and death
What signs should be evaluated to assess if a patient is in shock?
- Mentation
- Mucous membrane colour -
- Capillary refill time (CRT)
- Pulse evaluation
- Core-extremity temperature difference
Why can mentation be used to indicate levels of shock?
The brain is an obligate user of oxygen and glucose and has few energy stores. Inadequate delivery of oxygen and glucose to the brain results in loss of the normal mental state in seconds
What scale of mentation can be used to assess blood supply to the brain and shock?
- alert and normally responsive
- depressed or obtunded (inadequate blood supply)
- stuporous or semicomatose (suggests functional brain disease)
- comatose (suggests functional brain disease)
What causes pale to white mucous membrane?
A pale to white colour is caused by depletion of volume or of haemoglobin.
What causes red mucous membrane?
A red colour suggests poor perfusion and vasodilatation (blood trapped within the capillary beds) as in sepsis.
What causes blue-purple mucous membrane?
Cyanosis, which is represented by a blue-purple discolouration, is caused by the presence of >5g/dl deoxygenated haemoglobin. Severe hypoxaemia can occur without cyanosis
What causes muddy/brown mucous membranes?
Methaemoglobinaemia, associated with paracetamol toxicity in cats, can cause mucous membranes to be pale, cyanotic, and muddy or brown in colour.
What causes yellow mucous membranes?
Icterus is indicative of bilirubin, suggesting haemolysis, hepatocellular disease or extrahepatic/intrahepatic biliary tract disease
Which emergency patients are likely to be hypovolaemic and which are likely to be dehydrated?
- Majority of our emergency and critically ill patients are HYPOVOLAEMIC
- In longstanding disease animals may be both HYPOVOLAEMIC AND DEHYDRATED
- Dogs left in hot cars and those animals’ with severe burns, DEHYDRATION is likely to be the primary fluid loss
Define dehydration.
Describe a loss of electrolytes and water from the interstitial and intracellular spaces
