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What is Triage ?
The process of assessing urgency of a medical situation and prioritizing treatment (if more than one patient exists) according to that urgency.
What are the 3 classifications that we deal with ?
Explaing Critical condition.
- Treatment must begin within minutes.
- Respiratory &/or cardiac arrest
- Major arterial bleeding
- Sudden collapse and non-responsive
- Hit by car (HBC)
Explain Urgent condition.
- Treatment must begin within one hour.
- repeated or continuous seizure activity
- Anti- freeze ingestion
- Chocolate ingestion
- Rat poison in gestion
Explain Pressing condition
- Treatment must begin within several hours.
- continuous/repeated vomiting &/or diarrhea
What makes a situation critical as opposed to urgent?
Determined by the things which we require moment to moment to live. . Oxygen and a Heatbeat
What are the CAB's of Cardiopulmonary Resuscitation ?
- Circulatory - check for any pulsating bleeding and apply pressure to help control it. If heart is not beating perform compressions
- Airway - must be unobsturcted. If it is blocked, carefully remove the obstruction if visible. If not visible perform Heimlich
- Breathing - the animal must be breathing. If not, mouth to nose respiration is performed.
How are animals placed before starting compressions ?
How many compression should you perform per minute ?
What is the hand placements for a Large/giant breed dog for compressions?
Have hands placed over the widest portion of the chest.
What is the hand placement for dogs that have a keel-chest during compressions?
Should have the hands placed directly over the heart.
What are the hand placements for small dogs and cars during compressions?
Require compressions from both sides of the chest wall.
How should rescure breathing be performed ?
Mouth to nse, by closing the mouth, or if you are in the clinic you could use an Ambu-bag.
What is the CPR equipment ?
- Endotracheal tubes
- Droppler blood pressure Moniter
What is an Ambu-bag ?
Designed to be used in conjunction with an endo-tracheal tube to provide assisted ventilation.
What is an Endotracheal Tube ?
They allow a clear airway into the trachea. Most common with an inflatable cuff to create an air-tight seal within the trachea
What is an Anaesthetic Machine ?
The oxygen source. Connected to ambu-bag or rebreathing bag.
What is an ECG ?
Electrocardiograph. An instrument that provides a record of the electrical activity of the heart
What is a Doppler Blood Pressure Monitor ?
Gives a continuous audible record of the peripheral blood pressure and heart rate
What is an emergency crash kit ?
It contains necessary drugs and equipment that are useful or needed when an emergency arrives.
What are some common drugs in a emergency crash kit ?
- Sodium bicarbonate
What are some equipment in a emergency crash kit ?
- Ambu bag
- Endotracheal tubes
- oxygen mask
- intravenous catheteres
What can you use for a muzzle ? (improvise)
- belt, either leather or from a robe
What can you use for a improvised splint ?
- magazine or newspaper
- heavy towel
What can you use for a absorptive or pressure bandage ? improvise
- clean washcloth, tea towel, hand towel
- feminine hygiene pad
What can you use for a improvised bandage ?
tear wide strips of old tea-towels, sheet, t-shirt
What are the different forms of outer wrap or covering ?
- plastiv tubing or plastic pouches
Choice depends on the size of item and type of sterilization
What are the types of sterile instrument packs ?
- spay pack
- castration pack
- abdominal pack
- suture pack
- dental pack
- Double Wrapped
What are the types of sterile Drape packs ?
- 4 corner drape pack
- extra drape pack
- laparotomy sheet/drape
- hand towel pack
- Single Wrapped
What is a Non- sterile surgery ?
They are NOT performed in the surgical suite. They are approachinga non sterile body area that is considered contaminated or dirty, and should not be done in a sterile environment.
What are some examples of a NON-sterile surgery ?
- abscess repair
- skin surgeries
- dental cleanings and teeth extractions
- relieve urinary obstructions
- cat neuters and declawing
What are some surgical instruments ?
- Scalpel handle - blades
- Scissors - blunt-blunt, sharp-sharp, sharp-blunt
- Tissue forceps - rat tooth, adson tissue
- Carmalt forceps
- Hemostat forceps - kelly, mosquito
- Needle holder/driver
- Towel clamp
- Spay hook
What is a autoclave ?
Most common method of sterilization, moist heat with steam under pressure.
What is Anprolene?
Ethylene oxide is the gas most commonly used. Used on items that are not suitable for the autoclave.
What is a Cold Sterile tray ?
Sterilization done by a liquid chemical. most useful on hard, smooth surfaces that are ok to be immersed in liquid.
What can failure in sterilization result from ?
- packs are too tight
- improperly loaded it in the autoclave
- inssufficient temperature, pressure, exposure time
What is Suturing ?
- use of suture material to tie tissues together.
- May be used to apposed tissue layers (skin, muscle), stop bleeding (ligation) or used as a temporary means of holding onto an organ
What are the 2 types of suture material ?
- Absorbable: slowly degraded and absorbed by the body, used within the body
- Non-absorbable: inert, body cant absorb material, used for skin sutures where removal is necessary, may be used as a permanent ligament in knee
What are the 2 types of needles ?
- Cutting - have small hsarp blade near to the tip of the needle. Used for skin sutures
- Tapered - do not have a blade near the needle tip, used for soft tissue as will not traumatize. (intestine, urinary bladder, uterus)
There must be a hard copy record of what ? for surgical procedures ?
- Signed client consent of surgical procedure
- Fee estimate
- Anesthetic record
- Recovery record
What must a surgery log incorporate ?
- Date of surgery
- Patient identification
- Species + breed
- Pre-surgical assessment
- Preanesthetic used
- Induction + anesthetic used
- Time + length of surgery
- Recovery assessment
- Intitials of those administerin anesthetic
What are some examples of Sterile surgery ?
- Dog + cat spay
- Dog neuter
- Orthopedic surgery
- Urogenital surgery
What is Asepsis ?
A series of techniques and procedures that are aimed at excluding all pathogenic organism from the surgical site. Done by sterilization, disinfection, and antisepsis
What is Sterilization ?
A procedure by which ALL forms of life are destroyed.
What is considered to be sterile ?
- Instrument field
- Gown and linen field
- Surgical gown (neck to waste) and gloved hands
- Suture material and blades
- The insides of the animal
What is considered to be contaminated ?
- caps and masks
- gowns below the waist, back of gown
- outside of packs
- surgical light
What is Disinfectant ?
procedure in which by only SOME forms of life are destroyed. Surgery room floors, wall, ceiling.
What is considered to be dsinfected ?
items that have been in contact with some chemical disinfectant
What is Antisepsis ?
Similar to disinfection, chemical agents are used on the animals skin, and human ahnds. Only some forms of life are destroyed
What is considered to be antiseptic ?
- prepped animal skin
- scrubbed human skin
What is the X-Ray Tube ?
X-rays are generated in an x-ray tube. Purpose is to produce a controlled x-ray beam.
What is the x-ray Collimator ?
Located beneath the x-ray tube. Used to control the size of the x-ray beam. Collimating serves to prevent unnecessary radiation of the animal or the persons involved in restraining the animal.
What is the Voltage compensator?
The voltmeter provides manual adjustment of the transformer to allow for inconsisten electrical output from the main electrical line
What is Kilovoltage (kVp) ?
X-ray machines are calibrated so that the desired value of kilovoltage can be selected
What is Milliamperage (mA) ?
This compenent lets the radiographer choose the desired current to xray tube
What is the Timer ?
Allows the radiographer to select the time of each exposure
What is the Exposure button?
ON the face of the control panel or attached by a cable which is placed on the floor for foot control. Completes circuit for exposure when button is pressed.
What is the Warning light ?
Lights up when an exposure is made, and xrays are being emitted.
What is the xray table ?
Located beneath the xray tube, the collimator light source will view the beams path. Cassete will be loaded either table top, or under the table
What is the purpose of xray film?
To provide a permanent image record contaqining diagnostic information which can be used later evaluation.
A dark room must be ?
What are the 2 sides to the darkroom ?
- Dry side: where the cassettes are unloaded and reloaded usually on a countertop or table
- Wet side: where the chemical processing is performed by manual or automatic processing
What are the 5 basic step for manual and automatic processing ?
- 1. Developing
- 2. Rinsing or Stop bath
- 3. Fixing
- 4. Washing
- 5. Drying
What is the Somatic Effect ?
- Happens over the course of your time.
- Somatic cells are cells of the body, and when damaged can somtimes be repaired if it is not too extensive. Body cells Differ in their sensitivity
What is the Genetic effect ?
- Happens in your children's lifetime.
- Xray beam may or may not cause somatic damage to the gonads, however there may be inherited abnormalities in future generations
What are the most Sensitive cells in your body ?
- Those that multiply continuously:
- Immature blood cells
- Germinative layers of the skin
- Intestinal epithelium
What are the Least sensitive cells of your body?
- Those that do not reproduce in the adult state.
- Mature blood cells
- Muscle cells
- Connective tissue
What is Scatter Radiation?
The radiation which bounces off of the patient, the table top, or any ovject that is stuck by the primary beam, and delfected around the room.
What are the basic Radiation Safety rules ?
- Minimize time
- Maximize distance, minimize exposure
- Maximize shielding
- Never allow parts of the body in the primary beam
- Wear personnel radiation monitoring device
- Use mechanical restraint to hold patients
- Collimation of the beam
What are the 3 types of labeling methods ?
- X-rite tape: lead impregnated tape that when written on with a pen the pressure displaces the soft lead leaving and impression
- Lead block letters: are placed on the cassette in the field of view which can be used to spell out information
- EZ-Printer: imprints patient information permanently onto the film
What should the x-ray label include ?
- Indentification of the animal
- Log entry #
- Vet's name, clinic name
- 'R' or 'L' markers