Week 1 - Triage and initial stabilization Flashcards
Bounding or “water hammer” pulses
Forceful, rapidly increasing
-Fever
-Sepsis
-PDA
-Anemia
Reasons for tachycardia
-Early shock
-Anemia
-Arrhythmia
-Hypoxemia
-Hypercapnia
-Excitement
Pale MM’s
(Muddy, grey, or white)
-Poor perfusion
-Vasoconstriction from shock
-Anemia
Red MM’s
-Vasodilation
-Sepsis
-Hyperthermia
-Anaphylaxis
-Carbon Monoxide toxicity (alarm)
Red = fire alarm
CRT <1
START method
RED - critical, needs life saving treatment immediately
YELLOW - can wait a few hours for treatment
GREEN - green = go, with or without treatment
BLACK - will die regardless of treatment
Brown MM’s
-Methemoglobinemia
-Acetaminophen toxicity in cats
Tylenol = Carprofen (brown pills)
Yellow MM’s
-Icterus
-Bile duct obstruction, liver disease
-Sepsis in cats (cats can have yellow eyes)
-Hemolysis
-Hyperbilirubinemia
Blue MM’s
-Hypoxia
5g/dL of hemoglobin to show blue
Blue = Blaine 2005
Fluid overload signs
-Serous nasal d/c
-Increased RR/RE
-Chemosis (3rd eyelid coming up)
-Increased skin turgor
-Increased weight
-Peripheral edema
ABCD’s
-Airway
-Breathing
-Circulation
-Disabilities
Hypoxemia
SPO2 <95% and PaO2 <80mmHg
Pulsus alternans
-Alternates between small and large volume pulses
-Can be seen on ECG, R wave amplitude = pericardial effusion
-L sided heart failure
-DCM
Pulsus paradoxus
-Pulse volume decreases on inspiration
-Pulse volume normal on expiration
-Can be seen on ECG
Cardiac tamponade
Decreased lung sounds
-Pleural effusion
-Pnemonthorax
-Pulmonary consolidation (pneumonia, pulmonary edema)
Crackles in lungs
-Pneumonia
-Pulmonary edema
-Pulmonary hemorrhage
Crackles = snap, crackle, pop (P)
3 P’s
Expiratory wheezing
-Bronchitis
-Small airway collapse
Stridor breathing
High pitched, upper airway partial obstruction
Stridor = high, upper
Laryngeal paralysis
Stertor breathing
Low pitched, lower airway partial obstruction
Stertor = stern voice = low
Primary assessment
-Visual
-TPR
-Owner history
Relative bradycardia
Unexpected Low HR despite the under condition
Relative = not related to symptoms
A dog with hypovolemic shock with HR of 100bpm (should be tachycardic)
Kussmaul breathing
Slow, deep breathing
-Severe Metabolic disease
-DKA
-Kidney disease
K’s
Pulse deficits
Difference between pulses felt and heart rate heard
= cardiac arrhythmias, VPC’s
Decreased blood flow
Muffled heart sounds
-Pericardial effusion
-Pleural effusion
Secondary assessment
-PE (ABCD’s)
-Cardiovascular
-Respiratory
-CNS, LOC
Paradoxical breathing
When chest and abdomen move in opposite directions during inhalation and expiration
Tx = thoracocentesis
X - in both paradoxical and tx
Level of consciousness (LOC)
-Obtunded: less responsive to visual or tactile stimuli, depressed
-Stupor: only responsive to painful or vigorous stimuli (toe pinch)
-Coma: non-responsive
YELLOW (START method)
Will survive with treatment within a few hours
-Mild respiratory distress
-Uncontrolled, mild hemorrhage
-History of unconsciousness
-Fractures
-V/D
-Ophthalmology injuries
GREEN (START method)
Will survive with or without treatment
Green = Go
RED (START method)
Critical condition and needing life saving treatment immediately
-Severe decompensatory shock
-Exsanguinating hemorrhage
-Severe respiratory distress
-Active seizures
-GDV
-Acute poisoning
Reasons for bradycardia
-Shock in cats
-Athleticism
-Cushing’s disease
-Medication (opioid, alpha-2 agonist)
-Electrolyte imbalance (hyperkalemia)
Neonates
-Hypothermia: lack of insulating fat
-Hypoglycemia: demand for glucose, poor liver and muscle glycogen reserves
-Dehydration
Inspiration:Expiration Ratio
I:E is 1:2
