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What are the different triage systems? (3)
- MBSA- CRAN: Major Body Systems Assessment- Cardiovascular, Respiratory, Abdominal, Neurological
- ABCDE: Airway, Breathing, Circulation, Disability, External assessment
- CRASH PLAN S: Cardiovascular, Respiratory, Abdomen, Spine, Head, Pelvis, Limbs, Arteries, Nerves, Skin
What are the 6 overarching questions to address during triage?
- Is the patient in shock?
- Is the patient dyspneic?
- Is it an acute abdomen?
- What is the patient's neurologic status?
- Is it messy?
- Is there a specific circumstance? (pain? allergic reaction? cat? acute toxicity?)
What are the 6 perfusion parameters to assess if a patient is in shock?
- pulse quality
- temperature of extremities
What are the 6 dyspnea parameters?
- respiratory rate
- elbow abduction
- neck extension
- open mouth breathing
- nasal flaring
Where do you assess pulse quality in small animals?
What are some audible and some auscutable sounds to assess for dyspnea?
- Audible: stridor, stertor
- Auscultation: crackles, wheezes, increased/ harsh sounds, decreased lung sounds
What are 3 respiratory patterns that are associate with respiratory distress?
inspiratory, expiratory, and restrictive
What are 3 respiratory patterns that are NOT associated with respiratory disease?
apneustic breathing, cheyne-stokes breathing, kussmaul breathing
Describe an inspiratory breathing pattern and the lesion localization of this.
- deep, noisy w/ increased effort on inspiration (stertor versus stridor)
- upper airway, extrathoracic trachea obstruction
Describe an expiratory breathing pattern and the lesion localization of this.
- increased effort on expiration with some degree of abdominal effort
- lower airway disease
Describe an restrictive breathing pattern and the lesion localization of this.
- short, shallow, rapid breaths
- pleural space disease, pulmonary parenchymal disease
Describe an apneustic breathing pattern and the lesion localization of this.
- deep inspiration followed by breath hold prior to exhalation
- increased ICP, damage to pons or medulla
Describe an cheyne-stokes breathing pattern and the lesion localization of this.
- alternating pattern of tachypnea followed by bradypnea
- medullary disease
Describe an kussmaul breathing pattern and the lesion localization of this.
- hyerventilation characterized by slow and deep breaths with regular rhythm
- ketoacidosis, medulla receiving inputs from central and peripheral chemoreceptors (acidosis)
When assessing the abdomen, what 4 things do you look at?
- tympanism ("ping")
- ballottement/ fluid wave
If there is suspected fluid in the abdomen on triage,the next steps are... (3)
- abdominal FAST (US)
- analysis of belly tap fluid
How do you assess neurological status? (4)
- level of consciousness
- pupil size and CN deficits
- seizures or post-ictal
- ambulation/ posture
What are the 4 levels of consciousness and define each?
- Obtunded/ dull: responsive to normal stimuli, like touch and sound
- Stuporous: not responsive to normal stimuli but responsive to noxious stimuli
- Comatose: not responsive to any stimuli
What do you assess on the skin? (2)
- wounds, especially degloving injuries
- potential sources of infection
What is the shock panel we do with trauma triage? (8)
- BP (compensated or decompensated shock?)
- abdominal and thoracic FAST (cavitary bleeding, heart function)
- place IV cath
- Blood gas analysis
- Lactate (shock assessment)