Term
|
Definition
| a list of 20 critical parameters to check at least daily in a critically ill patient |
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|
Term
| LOC stands for? Definition? |
|
Definition
| level of consciousness; how easily can an animal be aroused? |
|
|
Term
| What are the 4 different LOCs? |
|
Definition
lethargic: mildly decreased
obtunded: cannot be fully aroused; may react momentarily to loud noises
stuporous: sleeplike state, only aroused with painful stimuli
comatose: cannot be aroused, no response to any stimuli |
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Term
|
Definition
| initial assessment to categorize and prioritize an animal's medical status and risk |
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Term
| Triage can be used in both ___ and ___ situations. |
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Definition
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|
Term
| How can triage be used in routine situations? |
|
Definition
| -scheduling surgeries, appointments |
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Term
| What are the 4 classifications of triage patients? Describe each. |
|
Definition
immediate: airway obstruction, cardiac/resp. arrest, DOA
critical: resp/cardiac distress, shock, active bleeding, seizuring
serious: large wounds/fxs, bloat, toxins, blocked tomcat, puppy/kitten sick
less serious: other less severe situations |
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Term
| A patient experiencing laryngeal paralysis would fall under what category of triage? |
|
Definition
| immediate (airway obstruction) |
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Term
| A patient with a tennis ball stuck in its mouth would fall under what category of triage? |
|
Definition
| immediate (airway obstruction) |
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|
Term
| A patient with pneumothorax would fall under what category of triage? |
|
Definition
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|
Term
| A patient that is seizuring as it comes into the clinic would fall under what category of triage? |
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Definition
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|
Term
| A patient with a broken leg would fall under what category of triage? |
|
Definition
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|
Term
| GDV and blocked male cats would fall under what category of triage? |
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Definition
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|
Term
| Sick puppies and kittens would fall under what category of triage? |
|
Definition
|
|
Term
| A patient with a superficial skin laceration would fall under what category of triage? |
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Definition
|
|
Term
| What are the ABC's of critical care? Other letters? |
|
Definition
Airway, Breath, Circulation
Drugs, Electric defibrillation / examine patient, Follow-up once resusitated |
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|
Term
| What is the best drug a critical patient can be given? |
|
Definition
|
|
Term
| When an animal is in shock, the body will circulate blood primarily to the.... |
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Definition
|
|
Term
| How to get a patent airway? |
|
Definition
-extend head
-pull tongue or obstructions out
-place ETT tube (usu. inflate cuff)
-Heimlich maneuver if needed
-tracheostomy if needed |
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|
Term
| Are you supplying O2 during the Airway portion of critical care? |
|
Definition
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|
Term
| How to perform the Heimlich maneuver? |
|
Definition
-suspend patient by hind legs
-sharp pressure to diaphragm angled down
-if that doesn't work, place hands on sides of chest and deliver sharp compression |
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|
Term
| At what point of the critical care ABC's do you start supplying oxygen? |
|
Definition
|
|
Term
| How to establish breath in a critical patient? |
|
Definition
-oxygen supplementation
-ambu bag / reservoir bag
-mouth to snout |
|
|
Term
| How do you manually ventilate a patient? |
|
Definition
-ventilate every 2-3 seconds
-<20 cmH2O (14mmHg)
-or watch chest and try to provide a normal breath |
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|
Term
| What to do for the Circulation portion of critical care ABC's? |
|
Definition
-IV cath fluids
-perfusion assessment
-hemorrhage control
-compressions |
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|
Term
| The purpose of chest compressions is to maintain blood flow to the... |
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Definition
|
|
Term
| Position of patient for chest compressions? |
|
Definition
-right lateral, because you can hit the ventricle best
-dorsal if over 15kg |
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|
Term
| To what does "cardiac pump" refer? |
|
Definition
| cardiac compression technique |
|
|
Term
| How often to compress chest? |
|
Definition
| 80-100 times per minute (2-3 every second) |
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|
Term
| Where on the animal do you place your hands to do chest compressions in lateral recumbency? |
|
Definition
LAT: where elbow meets costochondral junction
DORSAL: caudal end of sternum (at manubrium) |
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Term
| Depress the chest no more than ___. |
|
Definition
|
|
Term
| Do not stop chest compressions for longer than ___. |
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Definition
|
|
Term
| How can you supplement the cardiac pump? |
|
Definition
-thoracic pump
-abdominal compressions
-compression bandage
-open chest compressions |
|
|
Term
| What is the thoracic pump? |
|
Definition
| Coordinate chest compression with a breath. The air pressure in the lungs to help compress the heart. |
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|
Term
| Contraindications of open chest compressions: |
|
Definition
-rib Fx
-pleural effusion
-pneumothorax
-cardiac tamponade |
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|
Term
| How to administer drugs to critical patient? |
|
Definition
IV: bolus followed by 10-20cc saline to clear needle/line
IT: 2x IV dose, dilute with 5-10cc sterile water (absorbs better), usu. catheter inside ETT |
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|
Term
| Defibrillate a patient with what conditions? |
|
Definition
| V. tach or V. fib, not asystole |
|
|
Term
|
Definition
Ventricular Tachycardia
Ventricular Fibrillation |
|
|
Term
|
Definition
| "flat line," no cardiac contractions |
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|
Term
| What is the F part of the ABC's of critical care? |
|
Definition
| Follow-up with the patient once resuscitated, as many will arrest again. |
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|
Term
| What are the 3 stages of shock? (names only) |
|
Definition
-compensatory
-decompensatory
-terminal / irreversible |
|
|
Term
| Describe compensatory shock. |
|
Definition
-increased adrenaline
-hyperdynamic state
-snappy, bounding pulse
-increased HR, blood flow
-decreased pain
-animal still conscious, can seem totally okay |
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|
Term
| Describe decompensatory shock. |
|
Definition
-animal "crashes"
-blood circulates to brain and heart as priority |
|
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Term
|
Definition
-irreversible
-tx ceases to work |
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|
Term
| The first line of therapy for shock, regardless of the cause, is ___. |
|
Definition
|
|
Term
|
Definition
-decreased mental alertness
-cold, pale, clammy or dry MM
-prolonged CRT (>2sec)
-cyanosis or brick-red MM
-raised HR
-weak, thready, rapid pulse
-reduced urine output
-reduced RR |
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Term
|
Definition
| the loss of extravascular fluids |
|
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Term
|
Definition
| the apparent loss of intravascular fluid so that cardiac output (BP) is not normal |
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|
Term
| Signs of extravascular depletion (dehydration): |
|
Definition
-pale, dry MM
-poor skin elasticity
-reduced urine output
-microcardia (with comparison rad)
-sunken orbits (fat pad shrinks)
-cool distal extremities
-slow CRT
-weak, rapid pulse
-increased temp |
|
|
Term
|
Definition
-serous nasal discharge
-pitting edema
-increased urine output with normal kidneys
-ascites
-chemosis
-exophthalmos
-restless, won't lie down, coughing
-increased RR
-vomiting |
|
|
Term
| Look for pitting edema where? |
|
Definition
|
|
Term
| Monitor fluid rate by weight: |
|
Definition
|
|
Term
|
Definition
more osmotic pressure than plasma, brings fluids into vessels
eg: 7% NaCl |
|
|
Term
|
Definition
same osmotic pressure as plasma, used for maintenance
eg: LRS, 0.9% NaCl |
|
|
Term
|
Definition
less osmotic pressure than plasma, brings fluid out of vessels and into skin
eg: 5% dextrose |
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|
Term
| Emergency/shock fluid rates: |
|
Definition
Dog: 60-90mL/kg/hr
Cat: up to 60mL/kg/hr |
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|
Term
|
Definition
|
|
Term
| Electrolyte that is most abundant and the most influential on fluid distribution? |
|
Definition
|
|
Term
| Electrolyte that generates electrical activity for nerves and muscles? |
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Definition
|
|
Term
| Electrolyte that regulates pH? |
|
Definition
|
|
Term
| Hyperkalemia's effect on the body: |
|
Definition
| cardiac muscle "short circuit" aka cardiac arrest; can be used for euthanasia but not most humane way |
|
|
Term
| Hypokalemia's effect on the body: |
|
Definition
| muscle weakness, decreased nerve conductions |
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|
Term
| K+ administration should not exceed ___. |
|
Definition
|
|
Term
| All crystalloids contain the electrolyte ___, but most are __ deficient. |
|
Definition
| have Na, most deficient in K |
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|
Term
| Long-term use of crystalloids requires supplementation with __. |
|
Definition
|
|
Term
| When administering crystalloids, __% leaves the vessels for the ECS in __ min. |
|
Definition
| 75% leaves vessels in 30min |
|
|
Term
| What percentage of colloids remain in the vessels? |
|
Definition
|
|
Term
| For emergency fluid, start dogs at around ___. Start cats at around ___. |
|
Definition
dogs: start 80-90mL/kg/hr
cats: start 40mL/kg/hr and work up |
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|
Term
| In terms of electrolytes, where __ goes, __ will follow. |
|
Definition
| Where Na goes, H2O will follow. Na is responsible for fluid movement. |
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|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Also measure ___ before fluid therapy. |
|
Definition
|
|
Term
| Effect of low albumin on the body? |
|
Definition
| Pressure won't be maintained, shouldn't do surgery. |
|
|
Term
|
Definition
| poor liver function, which may mean decreased clotting factors and poor clearance of anesthetics |
|
|
Term
|
Definition
|
|
Term
| TPN contains what 3 things? In the form of what? |
|
Definition
| proteins (amino acids), fats (lipids), carbs (sugar) |
|
|
Term
|
Definition
| total parenteral nutrition |
|
|
Term
|
Definition
-great growth media because of lipids
-irritating to vein because it's hypertonic
-high maintenance |
|
|
Term
|
Definition
| partial parenteral nutrition |
|
|
Term
|
Definition
-no lipids, so can use peripheral vein
-less metabolic problems
-less monitoring
-can start earlier |
|
|
Term
|
Definition
| -not all metabolic needs met |
|
|
Term
|
Definition
| Clinimax, Quick Mix, ProcalAmine |
|
|
Term
| What to do if a patient has a foreign body e.g. arrow through its body? |
|
Definition
-don't remove it! doing so can cause pneumothorax/hemothorax, hemorrhage
-may cut off closer to the skin if necessary |
|
|
Term
| General trauma tip: even the nicest animal will... |
|
Definition
|
|
Term
| What sort of injury doesn't always show right away after blunt trauma? |
|
Definition
| diaphragmatic tears, rents, ruptures |
|
|
Term
| What is status epilepticus? |
|
Definition
| a state in which seizures continue for several minutes without any regaining of consciousness in between episodes |
|
|
Term
| Why is status epilepticus so dangerous? |
|
Definition
| increases body temp, O2 requirements |
|
|
Term
| Action plan to treat seizures: |
|
Definition
-establish clear airway
-place IV cath for fluids
-obtain blood samples
-anti-seizure meds
-measure rectal temp
-supplement O2
-once stable, place in dark, quiet, padded cage |
|
|
Term
| What to check for in blood samples of a seizuring patient? |
|
Definition
-toxins
-urea/ammonia
-glucose
-calcium |
|
|
Term
| Anti-seizure drugs from PP: |
|
Definition
-Valium
-phenobarb
-KBr
-primidone
-levetiracetam (Keppra) |
|
|
Term
| What is the different between "epilepsy" and "having seizures"? |
|
Definition
| Epilepsy means the patient is having seizures of an unknown cause. |
|
|
Term
| How often to check phenobarb levels? |
|
Definition
|
|
Term
|
Definition
| usually in conjunction with phenobarb, particularly if patient is becoming tolerant of phenobarb |
|
|
Term
|
Definition
| Anti-seizure med that breaks down to phenobarb in the body. |
|
|
Term
| Average age at which seizures start? |
|
Definition
|
|
Term
| __% of treated seizure patients are controlled. |
|
Definition
|
|
Term
| Three main goals of treating poison ingestion: |
|
Definition
1. emesis (if safe)
2. decrease absorption
3. increase elimination |
|
|
Term
| __% of cats will vomit when given xylazine. |
|
Definition
|
|
Term
| How to use H2O2 for emesis? |
|
Definition
1 tsp/5 lb every 15 min, up to 3 times
-not recommended in cats |
|
|
Term
| After giving a cat xylazine to induce emesis, what should you do? |
|
Definition
| can give Cerenia and activated charcoal |
|
|
Term
| Contraindications for emesis: |
|
Definition
| -suspect ingestion of caustic/corrosive agent (most cleaners) -unconscious patient (can aspirate) -symptomatic poisoned patient -brachycephalic (can aspirate) -ingestion >1hr -ingestion of salts, hydrocarbons -underlying conditions that increase likelihood of aspiration (megaesophagus, roaring, Hx of asp. pneumonia) |
|
|
Term
| After emesis, what can be given to prevent further absorption of poisons? |
|
Definition
| activated charcoal or kaolin |
|
|
Term
| Activated charcoal and kaolin ____ poisons so the body can't absorb them. |
|
Definition
|
|
Term
| SLUDDE describes the symptoms of ___. |
|
Definition
| organophosphate poisoning |
|
|
Term
|
Definition
| Blocks K, messes with clotting cascade; die 5d later |
|
|
Term
| How does ethylene glycol work? |
|
Definition
| breaks down and destroys kidneys, toxic in 30min |
|
|
Term
| Antidote for organophosphates? |
|
Definition
|
|
Term
| Antidote for ethylene glycol? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What amount of chocolate is concerning? |
|
Definition
|
|
Term
| Rat poison that causes hemorrhage for days or weeks? |
|
Definition
|
|
Term
| _# grape/raisin is enough to kill a dog. |
|
Definition
|
|
Term
| Ingestion of grapes/raisins causes... |
|
Definition
-vomiting within 6hrs
-anorexia, abdominal pain, diarrhea
-kidney damage
-death from ARF |
|
|
Term
| Ingestion of xylitol causes... |
|
Definition
-hypoglycemia
-seizures, liver Dz, and death |
|
|
Term
| What test should you run if an animal ingests xylitol? |
|
Definition
|
|
Term
| When monitoring RR during surgery, both __ and __ matter. |
|
Definition
|
|
Term
| Signs of respiratory distress in cats: |
|
Definition
-abducted elbows
-sphinx pose
-extended neck |
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