Ch. 6 - Er & Triage

Front 1

Name 4 important factors to consider when creating a crash cart:

Back 1

1. transportation (easily transportable)

2. organized (labeled drawers, etc.)

3. re-stocked (check daily/weekly for expired drugs and supplies)

4. Accessories (calculator, dose charts for CPR in 5 lb increments, etc.)

Front 2

A Basic Crash Cart should contain items in these 4 categories:

Back 2

1. airway / breathing

2. circulation

3. drugs

4. basic supplies

Front 3

A Crash Cart should contain at least these 5 items related to air way / breathing:

Back 3

1. endotracheal tubes

2. Ambu bag

3. laryngoscope

4. stylets

5. anesthesia / O2 mask

Front 4

A Crash Cart should contain at least these 9 items related to

Back 4

1. stethoscope

2. IV catheters

3. butterfly catheters

4. tape

5. fluid administration sets

6. fluid bags: crystalloids & colloids

7. clippers

8. surgical scrub

9. infuser bag (fluids)

Front 5

A Crash Cart should contain the following 7 drugs plus what accessory supplies?

Back 5

1. Atropine

2. Epinephrine

3. Coricosteroids (dexamethasone, Prednisolone, methylprednisolone)

4. 2% Lidocaine (w/o epi)

5. Sodium bicarbonate

6. Calcium chloride

7. Mannitol

+ various size syringes and needles

Front 6

Atropine: name 4 effects

Back 6

1. prevent bradycardia

2. reduce respiratory / salivary secretions

3. pre-anesthetic

4. organophosphate toxicity

Front 7

Epinephrine:

1. Should be _________________.

2. Used in cases of _______________________ and ___________________.

3. Function (How it works) ________________________.

Back 7

1. refrigerated

2. anaphylaxis and cardiac resuscitation

3. bronchoconstrictor

Front 8

Corticosteroids:

dexamethasone:

1. Is used in cases of _______________ and __________.

2. Functions as an ________________.

Back 8

1. shock, CNS trauma

2. antiinflammatory

Front 9

Corticosteroids:

Solu-delta (Prednisolone Na succinate)

1. Is used in the following 4 situations:

2. Functions as an ________________.

Back 9

1. lameness, snakebite, toxemia, stressful conditions

2. antiinflammatory

Front 10

Corticosteroids:

solumedrol (methylprednisolone):

1. Functions as an ________________.

Back 10

antiinflammatory

Front 11

What basic supplies should be on a crash cart?

(11)

Back 11

1. various sized needles & syringes

2. tape in various sizes

3. roll gauze

4. tourniquet

5. sample collection tubes (purple top, marble, etc.)

6. PCV tubes

7. minor surgical pack

8. sterile gloves

9. scalpel blades

10. sterile drapes

11. wide ace bandages

Front 12

Name 2 types of specialty crash carts:

Back 12

1. GVD (bloat) (Gastric dilatation and volvulus syndrome)

2. toxicosis

Front 13

In an ER situation, what is the first thing that is treated?

Back 13

The life-threatening condition

Front 14

Crash Plan - what does it stand for?

Back 14

C - circulation

R - respiratory

A - abdomen

S - Spine

H - head

P - pelvix

L - limbs

A - arteries & veins

N - nerves

Front 15

Crash Plan / CPR:

What does ABC stand for?

Back 15

A - air way (establish one)

B - breathing

C - circulation

Front 16

When it comes to Breathing, what are 3 ER options you can use?

Back 16

1. Ambu bag

2. O2

3. CPR

Front 17

ER: Always treat the _____________, not the _______________.

The goal is to _____________ the ______________ first.

Back 17

PATIENT, not the problem

stabilize the patient first

Front 18

Recognizing impending arrest...

4 signs:

Back 18

1. decreased mentation

2. change / decrease in RR, depth, & pattern

3. change / decrease in PR, rhythm, quality

4. abnormal ECG rhythm

Front 19

Recognizing the arrest...

5 signs:

Back 19

1. loss of consciousness

2. apnea or agonal breathing

3. no palpable pulse

4. no heart beat

5. dilated pupils (occurs quickly after arrest)

Front 20

A - establishing an AIRWAY:

First 4 steps:

Back 20

1. extend head and neck

2. remove any mechanical obstruction (bone, ball, stick, etc.)

3. finger sweep for mucous, vomit (or use suction if patient is conscious)

4. mouth-to-snout rescue breathing or place endotrach tube

Front 21

If airway cannot be unblocked, what procedure may be necessary?

Back 21

Tracheostomy

Front 22

What can you also try on an animal to unblock the airway (we do it on people too)

Back 22

Heimlich maneuver

Front 23

Breathing:

If patient does not resume breathing when the airway is cleared, administer ____________ ______________ breaths and check for breathing.

__________% O2 is desirable

Back 23

2 long breaths

100% O2

Front 24

Circulation:

In the absence of a detectable heartbeat / pulse, circulation is achieved by ______________ _____________________.

Back 24

cardiac compresssions

Front 25

CPR Team Approach:

1. team of _____________ people is best.

Back 25

3 - 5 people

Front 26

CPR Team Approach:

Team duties: ( 6)

Back 26

1. airway management

2. cardiac compressions

3. venous access

4. monitoring vitals / recording events

5. drug administration

6. coordination by team leader

Front 27

Performing CPR:

Cardiac Compressions - 3 types:

Back 27

1. cardiac pump

2. thoracic pump

3. abdominal pump

Front 28

Which type of cardiac compression should be used on small animals with a narrow chest?

Where should your hands be?

Back 28

cardiac pump

hands right over heart

Front 29

Which type of cardiac compression should be used on LARGE animals with a DEEP/BARREL chest?

Where should your hands be?

What do you need for leverage?

Back 29

thoracic pump

hands placed at widest part of chest

HEIGHT needed for leverage

Front 30

Abdominal compressions direct blood from the _____________ half of the body back toward the ________.

Back 30

lower

heart

Front 31

Thoracic compressions result in __________ blood flow from the _____________.

Back 31

forward

heart

Front 32

TRUE or FALSE:

ER Medicine can be used as a substitute for ER medical treatment.

Back 32

False - use only until medical treatment is available.

Front 33

Burns - what should be applied until treatment can begin?

Back 33

Cool, wet cloth

Front 34

Choking - / upper airway obstruction:

Heimlich maneuver:

1. Small animal is held ___________.

2. Large dog is positioned _________________.

3. Apply force with fist just below ___________ in an ____________ motion (toward the _________)

4. Apply force ______________ for __________ times.

Back 34

1. upright

2. on its side

3. sternum, upward, head

4. quickly, 5 times

Front 35

If Heimlich maneuver fails, animal may need a _________.

Back 35

Tracheostomy

Front 36

TRUE or FALSE:

If animal is conscious and awake, it is okay to perform a finger sweep to clear airway.

Back 36

FALSE - use suction, but do no reach into the mouth of an awake animal.

Front 37

Airway obstruction:

If you can see the object, remove it only when patient is ________________

Back 37

unconscious

Front 38

List 3 ways to attempt to remove obstruction from airway (besides using hands or suction)

Back 38

1. Heimlich

2. 5 thrusts between shoulder blades

3. Lift animal by hind legs and shake

Front 39

Drowning:

Carefully approach animal with ______________________________.

Back 39

An object it can hold onto

Front 40

Drowning:

After removed from water, hold animal's head in a ____________ position to allow water to drain from airways.

Back 40

down

Front 41

Drowning:

May need to perform

Back 41

CPCR

Front 42

Drowning:

other concerns? What to monitor?

Back 42

hypothermia

temperature

Front 43

Eye injuries:

Two initial steps:

Back 43

1. keep animal from rubbing eye

2. rinse debris, foreign materials, chemicals with saline solution

Front 44

Eye injuries:

Should you attempt to remove objects penetrating the globe?

Back 44

NO

Front 45

If an animal's eye is proposed, what should you tell the owner to do on the way to vet?

Back 45

use a wet washcloth and place over eye

Front 46

Fading puppy / kitten:

What should you do (3 things)

Back 46

1. keep them warm

2. keep them dry

3. rub Karo syrup on gums

Front 47

Heat exhaustion / stroke:

2 things you should do:

1 thing you should NOT do:

Back 47

DO:

1. cover w/cool, wet towels for transport or bathe in tepid water

2. rubbing alcohol to footpads

DON'T:

Do not douse with cold water

Front 48

Hypothermia / Frostbite:

How to warm animal's body? (2)

How to warm frostbitten areas?

Back 48

rub vigorously and wrap in warm blanket.

Feet, ear tips - gently warmed in warm water

Front 49

Snake bite:

DOs & DON'Ts

Back 49

DO: seek vet treatment immediately

DO NOT:

• use a tourniquet
• apply ice
• incise bite wound
• suck out venom

Front 50

Seizures:

DOs & DON'Ts

Back 50

DO:

move objects that may harm animal out of way

place something soft under head

have animal examined, obtain history

DO NOT:

reach into or near mouth

Front 51

Handling an injured animal:

2 things to do

how to handle cats

how to handle dogs

Back 51

1. ensure accident scene is safe for animal and handlers so additional trauma doesn't occur (ex. remove HBC animal from road)

2. approach gently & quietly

3. Cats - toss a blanket or large towel over them and scoop up

4. Dogs - muzzle before handling (rope, shoelace, tie, belt, cloth, etc.)

Front 52

Handling injured animals when spinal injury is suspected:

Back 52

dogs can be taped or tied to a piece of stiff cardboard and carried (if they can't stand or walk)

Front 53

Never force an injured animal to lie down...why?

Back 53

It may have trouble breathing when on its side.

Front 54

Penetrating wound to chest or abdomen:

(2)

Back 54

1. Do not remove the object

2. wrap area with towel / sheet and transport immediately

Front 55

Fractured limb:

What should you / owner do prior to transporting animal?

Back 55

Create a splint

(use rolled newspaper, magazine, tongue depressor, etc.)

Front 56

Bleeding wounds:

(2)

Back 56

1. apply and hold pressure (use towel, sheet, gauze pad, etc.)

2. DO NOT REMOVE whatever you are using to apply pressure - ALWAYS ADD A LAYER TOO IT, NEVER TAKE IT AWAY (you will tear off the platelets)

Front 57

Toxicities:

Call the...

Back 57

Animal Poison Control Center

www.ASPCA.org

Treat toxicity ASAP, according to book / chart

Front 58

Triage: define

Back 58

Classifying patients and their medical problems according to the urgency of their situation

Continually re-evaluating their status

Front 59

What are the Triage Classifications?

Back 59

First priority

Second priority

Third priority

Fourth Priority

Front 60

Define First Priority Triage:

Examples (6)

Back 60

• Patient is critical
• Treatment must be initiated within seconds - minutes
• Bring to treatment room immediately

1. major bleeding

2. breathing difficulty

3. altered mentation

4. shock

5. toxicosis

6. dystocia

Front 61

Define Second Priority Triage:

Examples (5)

Back 61

• Patient is urgent
• Currently stable but may become 1st priority
• Need to be re-assessed or have treatment initiated within minutes to hours

1. Hx of major trauma

2. Hx of unsuccessful urination / blockage

3. vomiting

4. diarrhea

5. severe dehydration

Front 62

Define Third Priority Triage:

Examples (4)

Back 62

• Patient is stable
• Pressing problem is NOT critical
• Treatment needed within hours

1. fever

2. lacerations

3. vomiting

4. diarrhea

Front 63

Define Fourth Priority Triage

Back 63

Patient is completely stable

Needs evaluation but not urgently

Front 64

Initial contact with client:

Be able to recognize an ______________.

Give advice re: ________ and ___________.

Back 64

emergency

first aid & transport

Front 65

Triage: Primary survey -

1. Who determines degree of urgency?

2. Use the _____________'s of emergencies

3. Include _______________ team

Back 65

1. Triage team

2. ABC's

3. neurologic

Front 66

Triage:

Check everything: (6)

Back 66

1. RR

2. HR

3. Pulse

4. temp

5. CRT

6. MMs

Front 67

Colors of triage:

Green =

Yellow =

Red =

Black =

Back 67

Green = minor injuries

Yellow = delayed, non-life threatening injuries

Red = critical, life-threatening injuries

Black = deceased