Vet logic - outcome 1 Flashcards
What is the primary survey?
Rapid, immediate assessment to identify whether or not there are life threatening conditions. ABC, consciousness and neurological status.
with ABC what does A stand for and what are you checking?
Airway - that it is clear and free from obstruction
with ABC what does B stand for and what are you checking?
Breathing - checking for chest movements, rate and effort
with ABC what does C stand for and what are you checking?
Circulation - assess central and peripheral pulses. pulse and heart rate and rhythms should be obtained at the same time. check MM’s and CRT
What are you looking for when checking neurological status?
Conscious/unconscious
mentation
demeanour
neurological signs such as tremors, seizures etc
What is secondary survey
Once you have done primary survery and establish no threat to life the secounardy survery checks Nose Mouth and teeth eyes ears face and head thorax abdomen limbs tail
What might swelling or discharge from the nose indicate?
bruising or underlying disease depending on whether the discharge is blood, serous or purulent.
when checking mouth and teeth in secondary assessment what are you looking/checking for?
MM's CRT trauma - broken teeth/jaw/etc harmorrhage hard palate is intact check the open and closing of the mouth for signs of fracture
with secondary survey what are you checking for with the eyes?
Pupil - size - light reaction - palpebral reflexes
trauma
FB
discharge
with secondary survey what are you checking for with the ears?
Pinnae checked for trauma and haemorrhage
signs of discharge
with secondary survey what are you checking for with the face and head?
general appearance
aysmmetry or swelling can indicate face or skull fratures
with secondary survey what are you checking for with the abdomen?
external wounds
swelling
penetration of FBs
if possible palpation of bladder - checking for rupture but distended bladder should be handled with care
with secondary survey what are you checking for with the limbs?
appearance - swelling/deformity?
check movement as long as no obvious fracture signs
pinch between toes to assess neurological function - no pain perception can indicate presence of spinal damage
If you pinch between patients toes and they don’t pull back or don’t feel pain in the limbs what can this indicate?
spinal damage
with secondary survey what are you checking for with the external genitalia?
discharge or damage
with secondary survey what are you checking for with the tail?
appearance
way it is held or moved - can indicate fracture or dislocation
When is CPR preformed and what is the aim?
when breathing has stopped and/or no pulse. 7
the aim is to keep the vital organs supplied with blood through chest compression and to oxygenate the blood by ventilating the lungs.
What does RECOVER stand for and what do they do?
the Reassessment Campaign on Veterinary Resuscitation. they produced the first evidence bases recommendations to resuscitate dogs and cats in cardiac arrest.
Explain how best to do CPR according to RECOVER guidelines
100-120 chest compression per minute - one-third to one-half of the chest width with the animal lying on its side.
ventilate intubated dogs and cats at rate of 10-30bpm or if compression being done 2 breaths every 30 compression
switch the person compressing every 2 minutes
administer vasopressors every 3-5 minutes
When should you not do CPR?
When something is obstructing the airway.
Theobromine toxicity?
What is it found in?
Signs?
Treatment?
Theobromine is the active ingredient in chocolate.
Signs of toxicity include panting, vomiting, tachycardia and in severe cases, cardiac arrhythmias.
Treatment includes inducing emesis, which is always best done in the practice setting, where there is a controlled environment, using apomorphine under the veterinary surgeon’s direction. Activated charcoal should be given, and this may need to be repeated every 4-6 hours due to enterohepatic recirculation of the toxin. Intravenous fluid therapy should also be instigated and cardiac arrhythmias treated as necessary.
Warfain toxicity?
What is it found in?
Signs?
Treatment?
Warfarin is found in rodenticides such as rat bait.
causes haemorrhage which is seen around 5 to 7 days after ingestion. Petechiae - pin-point haemorrhages of the gums - together with pale mucous membranes, can indicate warfarin poisoning.
If ingestion is recent, emesis should be induced and activated charcoal administered. However, if absorption has already occurred, vitamin K to aid blood clotting will be needed and a blood transfusion may be necessary
Metaldehyde toxicity?
found in?
signs?
Treatment?
Metaldehyde is found in slug bait
causes seizures and other neurological signs. Vomiting and diarrhoea may occur. Hyperthermia is likely, due to seizure activity, and metabolic acidosis ensues.
Treatment includes control of seizures, keeping the animal cool if it is hyperthermic, and intravenous fluid therapy administration
Ethylene glycol toxicity?
Found in?
signs?
treatment?
The active ingredient of antifreeze,
Vomiting, ataxia, dehydration and renal failure can occur quickly.
Immediate treatment is by inducing emesis and administering intravenous fluid therapy. Other treatment options include the administration of ethanol (alcohol) and in extreme cases, peritoneal dialysis may be attempted. Mortality rate is high following ingestion of ethylene glycol
What should induction emesis be used for?
Emesis should be induced for non-corrosive and non-narcotic poisons, as long as patient is not seziuring
When might gastric lavage be used with poisonings?
Gastric lavage is sometimes necessary, to ‘wash’ the poison out of the stomach, in a bid to prevent absorption in the intestine. This will only work for recently ingested poisons, when the substance is still in the stomach.
Why is fluid therapy important following poisonings?
Intravenous fluid therapy is frequently needed, as many poisons affect renal function. In addition, fluid is lost after vomiting has occurred naturally or been induced, and this fluid should be replaced
Why is activated charcoal used?
Activated charcoal is often administered and may be given after vomiting has been induced or following gastric lavage. Activated charcoal adsorbs toxins and carries them to the outside, preventing their absorption in the intestine. It is important to be aware of the dose required, as activated charcoal is often given in inadequate quantities. The recommended dose for dogs and cats is 0.5-4 g/kg every 4-6 hours if enterohepatic recirculation of the toxin is possible, as metabolites are reabsorbed in the intestine. In severe cases, it may be necessary to administer the calculated dose of activated charcoal every 4 hours until symptoms subside
How should hypothermic patients be warmed following arrest?
Slowly 0.25c - 0.5c a hour
What monitoring equpiment is useful in CPR and what is the ideal reading?
capnography and 15mmHg indicates effective CPR
What will occur with ROSC (return of spontaneous circulation) becuase the carbon dioxide has built up in the tissue and is being taken to the lungs to be exhaled? what must be done ?
Hypercapnia - carry on IPPV to ensure normal carbon dioxide level
after arrrest IVFT and supplement of oxygen might be needed to prevent post cardiac arrest syndrome. How can hyperoxia be prevented?
Spo2 monitor - aim for reading of 94-98%
What is apomorphine given for?
To induce emesis for poisons cases/FBs
When should emesis not be induced?
emesis should be induced for non corrosive and non-narcotic poisonings
It should not be induced If the patient is not conscious or if the patient is seizuring
When is gastric lavage used?
When it is necessary to ‘wash the potion out of the stomach in a bid to prevent absorption in the intestine. Only works for recently ingested posions, when substance is still in the stomach
When might activated charcoal be administered and why?
Normally after emesis or gastric lavage. It absorbs toxins and carries them to the outside preventing their absorption in the intestine.
What is the recommended dose for activated charcoal? What is recommended if enteroheptic recirculation of the toxin is possible?
0.5g-4/kg every 4-6 hours.
If enteroheptic recirculation is possible then give required dose every 4 hours until symptoms subside.
What is enteroheptic circulation?
Involves a substance that is metabolised in the liver, excreted into the bile and passed into the intestinal lumen. There they are reabsorbed across the intestinal mucosa and returned to the liver via portal circulation
Why is IVFT important with poisons cases?
Many poisons affect the renal function and IVFT will help support the kidneys
Also fluids is lost after v+ and D+ and should be replaced
What is petechiae?
Pin-point haemorrhages of the gums
What end-tidal carbon dioxide reading indicates effective CPR?
15mmHg
Why does hypercapnia occur during CPR and what must be done?
Because carbon dioxide has built up in the tissues and is taken to the lungs to exhale.
IPPV must be continued even after spontaneous respiration has resumed to ensure normocapnia is maintained
Why should urine output be monitored post arrest?
Because renal perfusion during arrest causes cellular hypoxia, so return of urine is a good sign
How should patients be warmed post arrest?
Slowly aiming to increase 0.25 - 0.5 an hour
Define obtunded?
The patient is depressed; it is awake but not very responsive
Define stuporous?
The patient is semi-comatose and only response to vigorous or painful stimuli
Define comatose?
Patient is unconscious and does not respond to stimuli
What causes burns?
Dry heat I.e flames, hot surfaces
What causes scalds
Moist heat such as hot liquids, steam, fat or hot tar
What causes cold burns?
Metal, ice
Define burns 1st degree - 2nd degree- 3rd degree- 4th degree - 5th degree - 6th degree
1st degree burns are superficial - the outermost layers are affected
2nd degree burns are deep - partial skin thickness
3rd degree burns are also deep - full skin thickness
4th degree burns extend beyond skin thickness and include muscle and bone damage.
5th and 6th degree burns are only diagnosed on autopsy
Common complications of burns?
Shock due to fluid loss
Infection due to skin loss
Pain
If a client phones because a patient has a electric burn what should be advised?
Make sure the mains to the power supply is off as touching patient can lead to electrocution
Use a wooden pole to move patient out of way
What should be advised to client that has a patient with a chemical burns?
Full protective clothing , including eye protection must be warn
How should a heat induced burn be treated?
Area should be cooled with tepid water - not cold as can lead to shock
Area hair clipped
Area should be covered with steril non adherent dressing - alternative is cling film
Ivft and analgesia
Comfortable bedding and patient interference prevented.
What information will a vet need during a emergancy
nature of accident or illness time of event patients presenting symptoms treatment given response to treatment contact details