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Why is it beneficial to LVTs to know CPCR and first aid?
- to assist in life-saving procedures if in contact with a vet
- client education
- anesthetic emergencies
What do the different mucous membrane colors mean? pink, white, blue, red, yellow
- pink: normal
- white: shock, anemia, or blood loss
- blue: hypoxia
- red: sepsis
- yellow: liver disease
Where can we evaluate mucous membrane color?
What effects mucous membrane color?
- peripheral capillary blood flow
- hemoglobin concentration
- tissue oxygenation
How do you administer O2 therapy if a patient appears hypoxic?
- attach an O2 tube to the gas source
- turn flow to 6L/min and hold tube 6 inches from patient's mouth and nose
What kind of history do we need to obtain in an emergency (with a stable patient)?
What does AMPLE stand for?
- A: allergies
- M: medications
- P: past history
- L: lasts (urinate, vomited, pooped)
- E: events
What is a normal CRT?
1 - 2 seconds
What does a prolonged CRT mean?
- late stage of shock
- heart failure
- severe vasodilation or vasoconstriction
- pericardial effusion
What does a shortened CRT mean?
indicator of compensatory shock, fever, pain or anxiety
How do we assess skin tugor?
pinch a fold of skin and assess the time for the skin to return to its normal position
What does a slight delay in the skin tugor returning to normal mean?
5 - 6% dehydrated
What does pronounced tenting mean?
10 - 12% dehydrated
How can skin tenting be misleading in obese animals?
adipose tissue replaces interstitial water and maintains elasticity
How does the skin tenting in older/cachectic patients be misleading?
lose skin resiliency, mistaken for marked dehydration
What causes crackles when auscultating the lungs? What does it sound like?
- pneumonia, atelectasis, pulmonary fibrosis, acute bronchitis
- opening of airways, explosive sounds, nonmusical
What causes pleural friction rub when ausculting the lungs? What does it sound like?
- patients with pleural effusion/pleuritis
- abnormally lound but focal sounds - heard during inspiration and expiration
What causes wheezing when ausculting the lungs? What does it sound like?
- constricted airway
- continuous, nonexplosive, muscial sounds
What causes stridor when ausculting the lungs? What does it sound like?
- upper airway obstruction
- intense, monophonic, continuous wheeze
Where can we check for the pulse?
- femoral artery
- palmar aspect of carpus
What could it mean if there is a pulse deficit?
What does a bounding pulse pressure mean?
early compensatory stages of shock
What does a weak pulse pressure mean?
How do we take care of a laceration?
- lubricate wound with sterile lumb
- shave around wound site
- flush with dilute chlorhexidine/betadine with 35cc syringe and 18g needle
- sterile dressing
- keep dry
What is the goal for applying a splint?
stabilizing the joint above and below the fracture site
If there is a stinger from an insect bite still in the patient should w squeeze it to get it out?
no, because it can release more toxins
If a mother can not clean their baby, how should we do it?
- remove baby from sac
- wipe with clean cloth
- rub gently to stimulate breathing
What could cause a patient to become hypoglycemic?
- overdose of insulin in diabetic patients
- poor nutrition
- vomiting a meal after receiving insulin injection
- insulinoma are all causes
How do we care for a patient who is hypoglycemic?
- rub corn syrup on gums or glucose paste can be applied
- sugar water works in a pinch (owner can do before arriving at the hospital)
What does applying ice to an injury do?
- decreased blood flow
- pain and spasming
- trauma-induced edema
- decreased sensory and motor nerve conduction velocity
What does applying heat to an injury do?
- promotes circulation
- joint stiffness
- muscle relaxation
- increased nerve conduction velocity
If we are unsure whether we should apply heat or ice, what should we do?
ice if ever in doubt
How long and how often should we apply ice?
- 15 - 20 minutes at a time
- as often as every 45 minutes
How do we make ice packs?
When should we apply heat?
after inflammatory phase
How long and how often should we apply heat?
every 5 minutes up to 30 minutes
If the tissue feels warm should we use heat?
Should we use heating pads to apply heat?
What do we use to apply heat?
fill tube sock with uncooked rice and warm for 30 - 45 seconds
When should we use both heat and cold therapy?
to reduce seromas, end of acute phase to flush debris
How do we use both heat and cold therapy?
- equal parts heat/cold (2 minutes ice then 2 minutes heat)
- always start with heat and end with ice
What should we tell owners to do for burns?
- apply cool water asap
- apply sterile nonstick pad over burned area and transport to the hospital
What should we do for chemical burns?
flush area well wtih water, saline is usually more comforting if available
What do we need to check the patient for when they are in hyperthermia?
- assess TPR in hospital
How do we treat an animal with hyperthermia?
- spray animal with cool water - spray pads with alcohol
- administer O2 therapy
What are different ways to treat an animal with hypothermia?
- wrap in blanket/towels that have been warmed in dryer
- bair hugger, hot dog warmer
- if tub table is present, can lie animal above grate, on top of towels - steam with water
- wrap feet in socks/foil/plastic wrap/bubble wrap
- rice socks
- warm water blanket
What should we tell owners to do if their animal is having GI problems?
- remove food for at least 24 hours and water for at least 4 hours
- then reintroduce water in small amounts or in ice cube form every 1 - 2 hours
- if patient does well with water for 12 hours, offer a small amount of bland diet every 3 - 4 hours
What should we tell the owners to do if their animals abdomens are distended?
come in to the hospital asap!
How do we do neuro monitoring?
- evaulate mentation: normal/alert, quiet, dull, stuporous, or comatose
- pupil size and responsiveness
What do we need to fully support during a neuro injury?
What should we do for "down dogs"?
reposition every 4 hours and provide sensory stimulation 3 - 4 x a day with light massage, brushing, visual stimulation
What are the three phases of CPR?
- basic life support
- advanced life support
- post arrest
What do we do for basic life support?
What do we do for advanced life support?
- IV cath and fluids
What do we do for post arrest?
treat for post CPCR complications such as hypoxemia, cerebral edema, acute renal failure and recurrent CPA
What are the different items to have on hand for CPCR?
- ET tubes
- sterile lube
- roll gauze
- IV catheters
- IV drip sets
- IO catheters
- syringes and needles
- adhesive tape
- surgical gloves
- scalpel blade
What do chest compressions actually help with?
blood circulation and brings air intot he lungs from the outside
How many chest compressions should we do per minute?
80 - 100
What happens if we stop doing chest compressions for too long?
increase intrathoracic pressure, intravascular pressure, and coronary perfusion pressure
Why are chest compressions important?
because they provide blood to vital organs and enhance venous return to chest
How should we have patients when doing chest compressions?
in right lateral recumbency and can do dorsal recumbency if lateral isn't working
How much should we compress the chest when doing chest compressions?
How often should you alternate people when doing chest compression?
every 2 minutes
How do we do chest compressions for an animal who is <15kg?
fingers on one side of chest, and thumb on the other - do not just use fingertips
When do we do internal cardiac massage?
penetrating chest wound, thoracic trauma with fractured ribs, pericardial effusion, pleural space disease, large dogs where external is less successful, intraop arrest, diaphragmatic hernia
What is the A portion of CAB?
- assess for any obstructions
What can we use to establish an airway?
ET tube or tracheotomy or red rubber cath/Foley urinary cath or face mask
What can happen if we excessively manipulate the epiglottis?
can cause vagal induced bradycardia
What does the B stand for in CAB?
How do we breath for the patient?
- give 2 breaths and evaluate for spontaneous ventilation - if not present, start PPV
- breathe every 5 - 6 secs (10 - 12 breaths/min)
- be careful not to bag/breathe for patiet at same rhythm as chest compressions
What can happen if we breath for the patient too frequently?
decreased coronary perfusion pressure, cardiac preload, cardiac output, right ventricular function, increased intrathoracic pressure, and decreased venous return to the heart
What do we need to check the ET tube for?
to make srue it is not clogged with vomit, exudate, or tracheal secretions if excursions aren't normal