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107 Cards in this Set

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What is critical care?
Critical care is the care of a patient in an unstable condition.
What is triage?
Triage is the act of sorting cases according to status.
What should be communicated to a distraught owner who calls the clinic with an emergency situation?
In an emergency situation, the owner should be counselled to bring in animal immediately, advised that animal may bite if in pain, to not use muzzle if in respiratory distress, to bring in suspected toxins if probable poisoning, or keep cool if heat stroke.
What is the most important first step to take upon arrival of an emergency case at the clinic?
Upon arrival of an emergency case, the first determination needs to be made as to how and to what level of restraint needs to be accomplished to keep pet, handler, and treatment team safe without overly stressing animal.
What are the 8 initial patient assessments performed upon an emergency patient?
Patient assessments performed are: mental state, mucous membranes, CRT, palpebral reflex, pupils, heart rate, respiratory rate, and pulse.
What are the 7 steps to be initiated immediately if the animal crashes?
If an animal crashes, the following steps must be taken: call for help, assess airway,assess rate and condition of breathing or supplement, assess HR and pulse and MM and CRT, administer drugs for resuscitation, monitor on EKG, then handle fractures.
What should be assessed in the airway before moving on to the next step of emergency care?
The airway should be checked to ensure that it is free of obstructions, then establish a supplemented airway which is usually done using an endotracheal tube.
What is done when assessing breathing status?
Breathing status must be assessed by rate and condition, then supplemented if breathing is not occurring.
How is breathing initially supplemented in an emergency?
Breathing is initially supplemented in an emergency with 20 breaths per minute using bagging or anesthesia machine.
What is the next step to take if the heart is not beating?
If heart is not beating, chest compressions should be initiated at a rate of 80 to 100 compressions per minute.
What is the difference in chest compression rate between small and large dogs?
Chest compression rate should be higher for small dogs as they have a normally higher heart rate.
What is a possible issue if heart beat is normal but pulse is thready?
If heart beat is normal but pulse is thready, it could be an indicator of internal bleeding.
What is the major reason for administering fluids to an emergency patient?
The most important reason for administering fluids to an emergency patient is to keep blood pressure up in order to maintain periphery circulation and avoid damage to tissues.
What are 4 body systems that are critical to assess post resuscitation?
Post resuscitation assessments are: brain, kidneys, heart, and lungs.
What are some of the more frequently seen emergencies?
Frequently seen emergencies are: cardiac, shock, seizures, trauma, respiratory, central nervous system, abdominal, musculoskeletal injuries, soft tissue injuries, firm tissue injuries, ear, ocular, and poisonings.
What are 5 steps to take to ensure preparedness for cardiac emergencies?
Preparedness for cardiac emergencies includes: maintaining crash cart, maintaining adequate and maintained supplies, ability to administer external cardiac massage, ability to read and record EKG monitor, and team practice drills for efficiency.
How soon does irreversible brain damage occur after cardiac arrest?
Irreversible brain damage occurs 3.5 to 4 minutes after cardiac arrest.
What are the characteristics of acute congestive heart failure?
Acute congestive heart failure is sudden in onset in which heart is not pumping enough blood to supply body with enough oxygen.
What is the treatment for acute congestive heart failure?
Treatment for ACHF is use of oxygen cage to help supplement low levels and drug support, keeping in mind that intubation should not be performed because it requires sedation which would further reduce heart rate.
What are two critical factors in providing the best chance of recovery from shock?
To help an animal recover from shock, it is vital that it is carefully monitored and provided fluid therapy.
What are 2 common types of shock?
Two common types of shock are hypovolemic and anaphylactic.
What is hypovolemic shock?
Hypovolemic shock results in low blood pressure caused by low blood volume, and is associated with traumas but not main reason for presentation of case.
What is anaphylactic shock?
Anaphylactic shock results from a sever hypersensitivity, and due to the amount of cardiac and respiratory distress it causes to animal, death can occur rapidly.
What are the characteristics of seizures?
Seizures are a disturbance of brain function causing convulsions which are acute and spontaneous in nature, and they must be diagnosed correctly before any treatment can commence.
What is trauma?
Trauma is a physical injury caused by extreme force or violence, in which it is important to treat life threatening occurrences first and then secondary issues.
What are typical traumas seen?
Typical traumas are hit-by-car, dog fights, gunshots, and knife wounds.
What are 3 common respiratory emergencies?
Common respiratory emergencies are pneumothorax, hemothorax, diaphragmatic hernia, and flail chest.
What does "pneumo" mean?
"Pneumo" means air or lungs.
What is a pneumothorax?
Pneumothorax is air in chest cavity typically caused by trauma to chest, and the air in chest inhibits the expansion and contraction of lungs and heart.
What is the treatment for pneumothorax?
To provide normal negative pressure in thorax so that lungs and heart can expand and contract normally, a barrier or closure must be made over hole in chest.
What does "hemo" mean?
"Hemo" means blood.
What is a hemothorax?
Hemothorax is blood in chest.
What is the immediate treatment for hemothorax?
The first concern in treating hemothorax is to determine where blood is occurring, then to stop bleeding, removing excess blood, followed by fluid therapy.
What is a flail chest?
A flail chest injury caused by a broken rib, most of which are internal, and exhalation and inhalation causes intense pain.
What is a diaphragmatic hernia?
A diaphragmatic hernia is a protrusion of abdominal viscera through diaphragm usually caused by trauma that creates a hole in the diaphragm.
What is the treatment for a diaphragmatic hernia?
Treatment for a diaphragmatic hernia requires surgery, as well as breathing support, along with elevation of head to alleviate pressure on organs and chest.
What are 3 common central nervous system emergencies?
Common central nervous system emergencies are brain trauma, spinal cord injury, and peripheral nervous injuries.
What is a common cause of brain trauma?
Brain trauma is common in HBC occurrences or if animal is hit with extreme blunt froce to head.
What are the clinical signs for brain trauma?
Clinical signs for brain trauma vary from unconsciousness to coma or depression to seizures, delayed responses, and extremely dilated pupils.
What are the common causes of spinal cord injury?
Spinal cord injuries are usually associated with rupture of disks, fractures, or dislocations, and are more prevalent in long-bodied short-legged animals.
How should an animal with spinal cord injury be transported?
An animal with spinal cord injury should be transported on a board or blanket, or picked up with one arm under chest and one arm under rump while trying to keep spine in alignment.
What are characteristics of peripheral nervous injuries?
Peripheral nervous injuries result in loss of movement which causes atrophy of muscles.
What is an important part of nursing care for central nervous system patients?
It is important to reposition animals with central nervous system issues because of their lack of mobility which can cause decubital ulcers.
What are the characteristics of abdominal emergencies?
Many times patients will show no signs with abdominal emergencies and must be diagnosed by using bloodwork to check for problems, or by observing blood in urine for urinary traumas.
What are the 2 types of musculoskeletal injuries?
Two types of musculoskeletal injuries are soft tissue or firm tissue.
What are the 5 terms used to classify soft tissue injuries?
Soft tissue injuries are described as being open, closed, abrasions, punctures, or lacerations.
What is a closed soft tissue injury?
A closed soft tissue injury has no break in skin but is severe enough in impact to cause extensive bruising.
What is the outcome for untreated closed soft tissue injuries?
If supportive care is not provided adequately for closed soft tissue injuries, it can result in necrosis and sloughing of tissues due to damage of cell membranes.
What is an abrasion?
An abrasion, also called "road rash" is an injury where typically the first few layers of skin have been scraped off.
What is a puncture injury?
A puncture injury is caused by an object sharp enough to penetrate skin.
How are lacerations different than punctures?
Lacerations are different than punctures as they cause deeper damage to tissues, muscles, and arteries.
How are lacerations classified?
Lacerations are classified by cleanliness.
What is a clean wound laceration?
A clean wound laceration is an opening created surgically.
What is a contaminated wound laceration?
A contaminated wound laceration is one in which bacterial growth is in place.
What is a clean/contaminated wound laceration?
A clean/contaminated wound laceration is one which was contaminated and then surgically cleaned up.
What is debridement?
Debridement is to surgically clean up a wound.
What is a dirty laceration?
A dirty laceration is infected.
What is the basic treatment of a laceration?
Basic treatment of a laceration starts with the hair being clipped from wound site, area cleaned, wound lavaged with sterile saline, and then application of bandages.
What is the most common firm tissue injury?
The most common firm tissue injury involve bones.
What is an important factor in treating firm tissue injuries?
An important factor in treating firm tissue injuries is to immobilize joint above and below fracture site.
What is the most common reason for ear emergencies?
The most common reason for ear emergencies is foreign bodies.
What is one of the most common foreign bodies in ear emergencies?
The most common foreign body in ear emergencies is the grassawn.
What is the outcome if a grassawn is not removed?
If not remedied, a grassawn will work thru drum into middle ear, which causes pressure on tissues around it resulting in inflammation and eventual necrosis.
What is a critical factor in treatment of ocular emergencies?
Ocular emergencies need to be treated within an hour to reduce extensive damage resulting in loss of vision.
What are the 2 most common ocular emergencies?
The most common ocular emergencies are due to foreign bodies or proptosis.
What is proptosis?
Proptosis is a condition in which the eyeball pops out of the socket, which is common in brachycephalic breeds.
What are 5 keys to communicating with a client about an emergency arising from a suspected poisoning?
Clients should be instructed to bring in suspected ingested or contacted substance or container, try to determine type and amount of toxin, induce vomiting if not caustic, bathe with mild detergent for dermal isues, and bring animal in as soon as possible.
What are the 3 main steps to properly evaluating a patient presenting with suspected poisoning?
Evaluation of a patient with suspected poisoning starts with evaluation of patient, followed by physical exam, and then toxin elimination.
What are the 5 most immediate questions to ask about patient history in a poison case?
The history to be obtained from a patient with suspected poisoning includes determining possible poisons, rate of onset, duration of signs, progression of symptoms, and status of eliminations.
What are the 5 steps of a physical exam for a poison case?
The physical exam that should be performed initially on a poison case should be assessment of appearance, TPR, skin exam, oral odor, and abdominal palpation.
How should skin be treated that has been in contact with a toxin?
Skin contact with a toxin should be washed with a mild detergent within 20 to 30 minutes of contact, preferrably shaved to remove hair retaining toxins and to provide for easier monitoring.
What are 5 drugs used as emetics?
Drugs used as emetics are apomorphine, xylazine, 3% hydrogen peroxide, table salt, and syrup of ipecac.
What is the dosage of hydrogen peroxide to use as an emetic in poison cases?
Dosage in poison cases is 1 teaspoon per 10 pounds of body weight using hydrogen peroxide.
What are supplies needed for gastric lavage?
Gastric lavage supplies include endotracheal tube, gauze, gastric tube, lubricant, warm water, funnel, mild suctioning device, dosing syringe, and an absorbent.
What are 3 absorbents used for gastric lavage?
Absorbents used for gastric lavage are activated charcoal, mineral oil, and antidotes.
Which antidote is used to treat organophosphates?
Organophosphates or insecticides are treated with atropine.
What antidote is used to treat ethylene glycol poisoning?
Ethanol is used to treat antifreeze or ethylene glycol poisoning.
What antidote is used to treat lead poisoning?
Pencillamine and EDTA are used to treat lead poisoning.
What antidote is used to treat acetaminophen toxicity?
Acetylcysteine and methylene blue are used to treat acetaminopen toxicity.
What antidote is used to treat poisoning from rodenticides?
Vitamin K is used as an antidote for rodenticide poisonings.
What antidote is used to treat heavy metal poisoning?
Penicillamine is used to treat heavy metal poisoning.
What are some of the supplies and equipment needed for a gastric lavage?
Equipment needed for a gastric lavage includes: endotracheal tube, gauze, gastric tubes, funnel, absorbent, suctioning device, and dosing syringe.
What are 3 rodenticides?
Rodenticides are strychnine, warfarin, and thallium.
What are the clinical signs of strychnine poisoning?
Clinical signs of strychnine poisoning are blue-green grains in vomit, seizure within minutes of ingestion, nervous and tense behavior, muscle stiffness, and sensitivity to noise.
What are the clinical signs of warfarin poisoning?
Clinical signs of warfarin poisoning are paleness, weakness, coughing, and hemorrhaging from ears, nose, or anus.
What are the clinical signs of thallium poisoning?
Clinical signs of thallium poisoning are vomiting, diarrhea, anorexia, hypersalivation, and abdominal pain.
What are 3 insecticides most commonly seen in poisonings?
Insecticides most commonly seen in poisonings are organophophates, pyrethrins, and d-limonene.
What are the typical sources for organophosphate poisonings?
Organophophate poisonings usually result from contact with flea powders, bug sprays, and dips.
What are the clinical signs of organophosphate poisoning?
Clinical signs of organophosphate poisoning are salivation, constricted pupils, muscle tremors, vomiting, and diarrhea, with further progression resulting in coma and death.
What is a common source for pyrethrins?
Pyrethrins are organic, most commonly coming from chrysanthemums.
What are the clinical signs of d-limonene poisoning?
Clinical signs of d-limonene poisoning include seizures and coma.
What are 3 heavy metal types of poisonings?
Heavy metal poisonings include arsenic, lead, and molluscides.
What are the common sources for arsenic poisonings?
Arsenic is typically found in ant, roach, and weed killers.
What are the clinical signs for arsenic poisoning?
Clinical signs for arsenic poisoning include vomiting and diarrhea, along with dehydration and pronounced restlessness.
What is the common source for molluscide poisonings?
Molluscides are found in snail and slug bait.
What are the clinical signs for molluscide poisonings?
Clinical signs for molluscides are incoordination, muscle tremors, salivation, anxiety, seizures, and diarrhea.
What are 4 types of plant poisonings?
Types of plant poisonings include cyanide, nitrates, oxalates, and glycosides.
What are common sources for cyanide plant poisonings?
Cyanide plant poisonings result from ingestion of hydrangea, and cherry, apricot, and peach pits.
What are common plant sources for nitrate poisoning?
Plant sources that result in nitrate poisoning are nightshade, jimson weed, sweet clover, and pigweed.
What are common plant sources for oxalate poisonings?
Oxalates are found in rhubarb leaves, calla lilies, easter lilies, and beet greens.
What are common plant sources for glycoside poisoning?
Glycosides are found in foxglove and oleander.
What are clinical signs for methylxanthine poisonings?
Clinical signs for methylxanthines are seizures and muscle tremors.
What are 5 types of miscellaneous poisonings?
Miscellaneous poisons include snake bites, acetylsalicylic, ethylene glycol, acetaminopen, and phenolic compound.
What are clinical signs for a snake bites?
Snake bites are typically found on face or appendages, and observed with puncture marks, associated pain in area, edema, redness, swelling, vomiting, diarrhea, rapid heartrate, wide pupils, seizures, disorientation, and weakness.
What are the clinical signs of ethylene glycol poisoning?
Ethylene glycol poisoning causes depression, darrhea, vomiting, colic, and kidney failure, and will result in high levels of blood and protein in urine.
What is the most common clinical sign of acetaminophen poisoning?
The most common clinical sign of acetaminophen poisoning is brown mucous membranes.
Where are phenolic compounds most commonly found?
Phenolic compounds are most commonly found in wood preservatives and household disinfectants.