Emergency and critical care vet medicine

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Allgemeine Hochschulreife smallies and equine Fichas sobre Emergency and critical care vet medicine, creado por Hayley Pfeffer el 24/04/2016.
Hayley Pfeffer
Fichas por Hayley Pfeffer, actualizado hace más de 1 año
Hayley Pfeffer
Creado por Hayley Pfeffer hace más de 8 años
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Resumen del Recurso

Pregunta Respuesta
Triage Sorting patients according to their need of medical care
What are two types of triage? phone triage disaster triage
What does the primary and secondary survey involve? primary - initial assessment performed immediately only looking at crucial things- A,B, C, D secondary- performed later. complete full PE
What does A, B, C, D stand for in the primary survey? airway breathing circulation disability
What do you do if the patient isn't breathing and if it is? isn't- ventilate is- perform rest of respiratory system evaluation
How do you assess circulation? HR PR CRT MM mentation extremity temp vs core temp
What does disability evaluate? level of conciousness and cns state pain toxin exposure
Name the triage levels level1: immediate level 2: very urgent level 3: urgent level 4: standard level 5: non urgent
Give some examples of immediate triage? apnea CPA seizure
give some examples of triage level very urgent acute abdomen shock dypnoea posion ingestion
Give some examples of urgent level triage trauma without shock or respiratory distress
Give some examples of standard triage level minor trauma laceration anorexia abscess lethargy
give some examples of non urgent triage level lameness dermatological condition coughing without distress
name 8 causes of respiratory distress and give examples of specific dz 1. upper airway disease-laryngeal paralysis, FB 2. lower airway disease-asthma, bronchitis 3. parenchymal lung disease-pneumonia, pulmonary odema 4. pleural space dz- pneumothorax, DH 5. Structural rib/intercostal musculature conditions- rib fractures 6. neurological conditions 7. vascular pulmonary dz- pulmonary thromboembolism 8. abdominal distension- organomegaly
Normal RR cats: dogs: 15-30 15-40
Is open mouth breathing normal in cats? dogs? no yes
To what % of Sp02 does the mm colour remain pink? 86%
What Spo2 is considered hypoxaemic? <90%
At what % spO2 does mm colour go cyanotic? <85%
Name 5 diagnostics in respiratory distress 1. pulse oximetry 2. blood gases 3. thoracic radiographs 4. thoracic US 5. Thoracentesis
What are some ways oxygen can be delivered to an animal in respiratory distress? flow by oxygen mask oxygen hood oxygen cage nasal oxygen intubation
Whats an advantage and disadvantage of an oxygen mask? immediate and can achieve high Fi02 may not tolerate
Whats an advantage and disadvantage of an oxygen hood? Can easily achieve high Fi02 possible rebreathing of Co2 or overheating
Whats an advantage and disadvantage of nasal oxygen? can achieve high Fi02 may not tolerate placemnet-can be stressfull
Whats an advantage and disadvantage of an oxygen cage? quiet environment, well tolerated. can achieve high Fi02 expensive limited access to patient- if open cage will have sudden decrease of Fi02
What is an advantage and disadvantage of intubation? can ventilate if needed and achieve high Fi02 Invasive-requires anaesthesia
What is the TV of a dog? 10-20 L
When is positive pressure ventilation indicated? Hypoxaemia sp02 < 95% Hypoventilation increase pCo2 >60 Increased work of breathing- exhaustion
What are the 3 types of shock? Cardiogenic hypovolaemic vasodilatory
What is the mechanism of cardiogenic shock? Example? Low CO not due to hypovolaemia DCM, HCM
What is the mechanism of hypovolaemic shock? example? low intravascular volume Fluid loss, haemorrhage
What is the mechanism of vasodilatory shock? mechanism? Systemic vasodilation, mitochondrial dysfunction SIRS, sepsis, anaphylaxis
What determines CO? SV + HR
How do you tell if a patient is in shock? -list the parameters you look at 1. mentation 2. CRT 3. MM colour 4. HR and PR 5. pulse quality 6. extreme temp vs core temp
What is something else we can test to see if there is sufficient 02 or not? lactate level will be increased if there is a lack of o2
Why do we see an increase in lactate with reduced o2? The glucose pathway ends with either making ATP which requires oxygen or lactate- when there is no 02 more lactate is made
can you monitor shock by measuring Bp? why? No not soley. If shock is compensated then Bp will be normal. If uncompensated Bp will be low
How do you treat hypovolaemic shock? fluids -isotonic crystalloids -hypertonic crystalloids -colloids
What dose of isotonic crystalloid would you administer to a dog? cat? over what time period? 80-90ml/kg 40-50ml/kg 5-15 mins Start with 1/4 of shock dose
What are some advantages and disadvantages of isotonic crystalloids? ad- cheap, balanced electrolytes, treats dehydration dis- large volumes, oedema, haemodilution
How would you dose a cat and dog with colloid fluids? dog- 10-20ml/kg cat- 5-10ml/kg Over 5-20 mins start with 1/4 shock dose
What are some advantages and disadvantages of colloids? ad- small volume, intravsacular, increases COP dis- expensive, fluid overload, coagulopathy
What dose of 7.5% hypertonic solution would you treat shock with? 4-6ml/kg start with half dose rate. Give over 10-15 mins
What are some advantages and disadvantages of hypertonic solution? ad- V small volume, rapid increase in intravascular volume dis- rapid redistribution, arrhythmia, dehydration
Why may you give blood products? anaemia coagulopathies thrombocytopenias VWF
How do you diagnose and treat pneumothorax Muffled lung sounds dorsally thoracocentesis
How do you diagnose and treat hemothorax? Muffled lung sounds ventrally- side they are lying on Thoracocentesis
How do you diagnose and treat pulmonary contusions? increased lung sounds oxygen possibly IPPV
How do you treat rib fractures/flail chest? analgesia +/- stabilisation with bandaging or surgery
How do you treat DH? oxygen therapy can shake animal to try get organ back in place surgery
How do you treat myocardial contusions? antiarrhythmias
What diagnostics can you use in thoracic trauma? Thoracentesis thoracostomy Radiographs US
Therapy in thoracic trauma always give O2 IPPV Surgery- DH, unresolving pneumothorax, penetrating rib fractures
What do you do with a haemoabdomen patient? symptomatic and supportive care isotonic crystalloids IV- hypotensive fluid resuscitation surgeyr if doesn't resolve in next 12-24 hours or can't control internal haemorrhage
What do you do with a patient with septic abdominal trauma? surgical emergency
What diagnostics can you do with abdominal trauma? US radiographs abdominocentesis
How do you manage a patient with traumatic head injury? neurological exam stabilise Resp and CV systems mannitol oxygen therapy IPPV if needed
What do you do with a patient wit spinal trauma? immobilize radiographs surgery if indicated
Fracture management? stabilise radiographs bandage/splint surgery if indicated
Wound management? Prevent further contamination- cover with non adhesive sterile pad and bandage sedate and debride wound
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