Emergency Patient Examination (ASAN001/3) Flashcards
Emergency Patient Examination
(5)
A – Airway
B – Breathing
C – Circulation
D – Dysfunction / Disability
E – Evaluation / Examination
AIRWAY – Assess Ventilation
What do I need to check to assess if it is adequate? (7)
- Is the airway patent?
- Is dyspnoea present?
- Colour of MM’s – cyanosis?
- Facial injury affecting breathing?
- Injury to airway?
- Chest wall movement?
- Injury to chest wall?
BREATHING – Respiratory Rate & Effort
What are examples of abnormal RR & Efforts? (8)
- Panting
- Tachypnoea
- Bradypnoea
- Abdominal breathing
- Paradoxical respiration
- Cheyne–Stokes
- Hyperpnoea
- Dyspnoea
B – RR & Effort – Panting
Rapid, shallow breathing with mouth open.
Usually tounge protruding.
B – RR & Effort – Tachypnoea
Rapid, shallow breathing.
B – RR & Effort – Bradypnoea
Slow breathing.
B – RR & Effort – Laboured
Deep abdominal breathing.
B – RR & Effort – Abdominal Breathing (2)
Animal uses it’s abdo muscles to breathe.
Sign of respiratory distress.
B – RR & Effort – Cheyne–Stokes
Progressively deeper & sometimes faster breathing, followed by gradual decrease resulting in apnoea.
B – RR & Effort – Paradoxical Respiration
Instead of chest expanding during inspiration, an area of chest moves inwards
(ie. flail chest)
B – RR & Effort – Hyperpnoea
Rapid, deep breaths
B – RR & Effort – Dyspnoea
Difficulty breathing.
B – What is the normal range for RR of a Dog?
12 - 25 breaths p/min
B – What is the normal range for RR of a Cat?
20 – 30 breaths p/min
B – What is the normal range for RR of a Horse?
9 – 16 breaths p/min
B – What are the 5 main types of Respiratory Sounds?
Stridor
Stertor
Wheezing
Crackles
Dull
B – Respiratory Sounds – Stridor
High pitched inspiratory sounds generated from turbulent air flow in pharynx & trachea.
B – Respiratory Sounds – Stertor
Noise from nasal passages
eg. snoring / snuffling noises.
B – Respiratory Sounds – Wheezing
High pitched inspiratory or expiratory noise caused by narrowed airways.
B – Respiratory Sounds – Crackles (2)
High pitched inspiratory noise.
Sound is made by increased secretion in small airways.
B – Respiratory Sounds – Dull (2)
Muted or no sound.
Due to pneumothorax, diaphragmatic hernia.
CIRCULATION – What are the 6 Perfusion Parameters?
- Mucous Membranes (MM’s)
- Capillary Refill Time (CRT)
- Heart Rate (HR)
- Pulse
- Temperature
- Haemorrhage
C – Mucous Membranes (MM’s)
What are the main descriptions of MM’s? (9)
Pink
Red
Pale
White / Grey
Yellow
Cyanotic
Petechiae
Ecchymosis
Feel
C – What do Pink MM’s indicate & how to describe the colour? (2)
Normal, adequate perfusion
Salmon pink in colour.
C – How to describe Red MM’s & what do they indicate? (6)
Injected.
Vasodilation.
Pyrexia.
Sepsis.
Toad toxicity.
Brick red.
C – What do Pale MM’s indicate? (3)
Anaemia.
Lack of circulating RBC’s.
Reduced perfusion.
C – What do White / Grey MM’s indicate? (2)
Severe anaemia.
Hypoxia.
C – How to describe Yellow MM’s & what might they indicate? (4)
Icteric
Jaundice
Liver disease
Severe haemolysis (distruction of RBC’s).
C – How to describe Cyanotic MM’s & what do they indicate? (2)
Blue or greyish blue
Severe hypoxia → 02 immediately!
C – How to describe Petechiae on MM’s & what does it indicate? (2)
Reddish–purple dots
Indicates clotting disorder → immediate action!
C – How to describe Ecchymosis on MM’s & what might it indicate? (3)
Bruising
Bleeding underneath
Paintbrush appearance.
C – How should MM’s Feel & what do they indicate if abnormal? (3)
MM’s should feel moist
May be dry or tacky if dehydrated.
Slimy texture or increased salivation may indicate nausea or toxicity.
C – What are the Capillary Refill Time (CRT) ranges?
1 – 2 seconds: Normal, adequate peripheral perfusion.
> 2 seconds: Decreased peripheral perfusion eg. shock, heart failure.
< 1 second: Hyperdynamic – vasodilation eg. high blood pressure, pyrexia, local irritation.
What does a CRT of 1 - 2 seconds indicate?
Normal, adequate peripheral perfusion.
What does a CRT of 2 seconds indicate? (3)
Decreased peripheral prefusion.
Eg. Shock, heart failure.
What does a CRT of <1 second indicate? (5)
Hyperdynamic – vasodilation
eg. high blood pressure, pyrexia, local irritation.
C – What are the 3 main abnormalities with Heart Rate (HR)?
Tachycardia: Fast heart rate.
Bradycardia: Slow heart rate.
Arrhythmia: An irregular or abnormal beat of the heart.
C - Tachycardia
Fast Heart Rate