First Aid Flashcards
(275 cards)
1
Q
define first aid
A
provision of initial care for illness/injury that is usually performed by a non-expert
2
Q
what does first aid consist of?
A
a series of simple, sometime life saving techniques that an individual can be trained to perform with minimal equipment
3
Q
what does the veterinary surgeons act of 1966 state about first aid?
A
anyone can perform first aid on an animal provided it is to preserve life, prevent suffering, prevent the deterioration of the patients condition
4
Q
how does the RCVS define the limits of first aid?
A
provided what is done is done to save life, stop pain and suffering and is done as an interim measure before seeking veterinary assistance, it is unlikely that what has been done has gone beyond first aid
5
Q
what can VN perform under schedule 3?
A
assist vet and carry out certain procedures under guidance and not in a body cavity
6
Q
what are the 9 key rules for telephone conversations about potential emergencies?
A
introduce yourself (by name)
be polite and calm
ascertain nature of problem asap
establish who the caller is and whether or not they are registered with the practice or not
obtain owners details including mobile number they will be using during transport
quote for emergency costs
clear directions to practice (postcode and parking)
taxi or animal ambulance information for alternative transport
gain ETA and advise staff
7
Q
what is the main purpose of the phone conversation?
A
to decide if the condition is life threatening or not
8
Q
how should a distressed/hysterical client be dealt with?
A
remain calm, sympathetic and patient
reassure them of the relevance of questions
9
Q
what should happen if the condition is life threatening?
A
animal is brought to the practice immediately
10
Q
what should be asked to ascertain how urgent a problem is?
A
known or suspected toxin ingestion onset of signs (gradual or rapid) current medical conditions current medication breathing - normal, easy? responsive able to walk normally recent trauma
11
Q
what are 11 examples of life threatening emergencies?
A
respiratory distress severe bleeding collapse/unconsciousness rapid abdominal distention inability to urinate sudden onset neurological signs severe vomiting and hemorrhagic diarrhoea extreme pain witnessed ingestion of toxin bone fracture dystocia
12
Q
what advice should be given over the phone to foreign objects patients?
A
don’t remove
keep animal calm and still
bring to vets asap
13
Q
what advice should be given over the phone for uncontrollably bleeding patients?
A
a calm owner leads to a calm dog, leading to reduced HR and so blood loss,
apply pressure through a clean towel
tourniquet if bleeding cannot be slowed with pressure and only if <20 mins from practice
14
Q
what are 5 examples of non life-threatening conditions?
A
mild/moderate vomiting non-hemorrhagic diarrhoea small wound with minimal blood loss polyuria/polydipsia weight bearing lameness a short single seizure
15
Q
how should small emergency patients be transported?
A
in baskets (cats and small dogs)
16
Q
how should large emergency patients be transported?
A
on a blanket or board, should be made secure in boot of the car
17
Q
how should broken bones and dislocations be managed/
A
keep patient confined. Small cage of collapsible kennel is ideal, if not use a large blanket/towel to support patient and prevent further movement
18
Q
what is different about first aid away from the practice?
A
same principles apply, encourage owner to assist - extreme caution to keep yourself safe, particularly with wild animals
19
Q
what is the purpose of an emergency/crash box?
A
gives immediate access to drugs and equipment
20
Q
where should the crash/emergency box be kept?
A
in the same place at all times so everyone knows where it is
21
Q
what items should be found in an emergency/crash box/
A
ET tubes laryngoscope O2 supply anesthetic circuits IV catheters in various sizes clippers scissors tapes and bandages to secure IV ECG machine Syringes and needles suction machine/bulb syringe Dog urinary catheters (different sizes) good light source drug dosage charts drugs used in cardiac resus anti convulsant drugs steroids anaesthetic drugs analgesics fluids
22
Q
define polydipsia
A
drinking lots
23
Q
define polyuria
A
urinating lots
24
Q
what are common symptoms of an epileptic seizure?
A
dog appears to not be responding and is shaking uncontrollably and has passed urine/faeces
25
define triage
process of organising patients according to the severity of their condition and getting treatment within an appropriate length of time
26
what are the key parts of information gathering?
preparing all consent forms
prepare critical care monitoring sheet
pre-populate all patient information fields and highlight fields to be gathered
write down the history gathered on the telephone
write down all information as you get it or assign a scribe
27
what 9 parameters should be recorded in the primary survey?
```
heart rate
pulse rate
mucous membrane colour
capillary refill time
respiratory rate
respiratory effort
gait
mentation
temperature
```
28
what parameter should be measured before the patient is handled?
respiratory rate and effort
29
how long should the primary survey take?
30 seconds
30
what makes up the primary survey?
A -airway
B- breathing
C- circulation
31
what should be checked relating to the airway in the primary assessment?
patency -is the patient able to breathe
32
what should be checked relating to breathing in the primary assessment?
is the patient making good breathing efforts
33
what should be checked relating to the circulation in the primary assessment?
does the patient have spontaneous circulation (is there a pulse)
34
what must happen if the answer to any questions in the primary survey is no?
survey is stopped and patient receives CPR
35
what is being assessed during the major body system assessment of the cardiovascular system?
heart rate and pulses
36
what should be recorded during the major body system assessment of the cardiovascular system?
heart rate and pulse quality
mucous membrane colour
capillary refill time
blood pressure
37
how should the the heart rate and pulse be assessed?
digital pulses, osculation
38
what should be considered about pulse quality?
whether its bounding, strong or intermittent
| if irregular is it regular! (sinus arrhythmia) or irregular
39
what HR is considered tachycardia in dogs?
120 BPM
40
what HR is considered tachycardia in cats?
180 BPM
41
what HR is considered bradycardia in dogs?
60 BPM (although consider dogs fitness)
42
what HR is considered bradycardia in cats?
120 BPM
43
what are icteric mucous membranes?
yellow/jaundiced
44
what pulse should be used to test peripheral circulation?
metatarsal
45
what should be assessed during the major body system assessment of the respiratory system?
rate, effort (does this differ on inhalation/exhalation) and any associated noise.
46
what respiration rate denotes tachyaponea in the dog and cat?
>40 resps
47
what findings in the major body system assessment of the respiratory system would suggest respiratory distress?
```
cyanosis
open mouth breathing
abducted elbows
extended neck
paradoxical respiratory movement
dilated pupils
```
48
what is paradoxical respiratory movement?
chest moves in on inspiration and out on expiration (flail chest)
chest moves out and abdomen moves in (ruptured diaphragm or pleural effusion)
49
what should be assessed during the major body system assessment of neurological signs?
non ambulatory patients - can they feel the limbs, do they respond to pain test
ambulatory patients - is gait normal
changes in mentation
any seizures
50
what can affect response to painful stimuli?
mentation of the patient (may feel the pain but disinterested in responding)
51
what changes of mentation should be noted?
whether patients are: alert/normally responsive, obtunded, stuperous, comatose
52
what does obtunded mentation mean?
rousable but quiet
53
what does stuperous mentation mean?
rousable with painful stimuli
54
what should be checked during major body system assessment of urinary systems?
palpation of bladder (size and feel)
| ability to urinate
55
what is the final check of the primary survey?
rectal temperature
56
what should be checked while taking rectal temperature?
any blood, any faecal staining on perineum (indicates recent passing of faeces), anal tone (lack of tightening around thermometer indicates neurological damage)
57
what should be taken in a capsule history?
```
age/sex/breed
presenting complaint
last seen normal?
last ate/drank/urinated
vomiting/diarrhoea/coughing
toxins/trauma
is the condition static or progressive
other conditions/medications
```
58
what is the purpose of a secondary survey?
identify problems that could rapidly become life threatening
59
what should be checked during the secondary survey?
head, chest, abdomen, limbs and tail
60
what areas of the head should be checked in the secondary survey?
nose - haemorrhage, swelling and discharge (bilateral or unilateral)
mouth - pectical haemorrhage, eccymosis, dry/excessive salivation
eye - reflexes, light response, nystagmus/strabismus, mucous membrane colour
ears - symmetry, discharge, head tilt
61
what can nystagmus/strabismus indicate?
head trauma or neurological condition
62
what should the chest should be checked for in the secondary survey?
dysponea, crepitus, wounds, swelling, auscultation
63
what is crepitus?
crackling under the skin which indicates presence of air
64
what should the abdomen should be checked for in the secondary survey?
swelling, bruising, painful bladder
65
what should the limbs and tail should be checked for in the secondary survey?
fractures, dislocations, neurological function (weakness, propreoception)
66
what is involved in general nursing care of first aid/emergency patients?
```
mental needs
physical needs
toileting needs
dressings, catheter and tube sites
nil by mouth/eating
monitoring
```
67
what parameters should be regularly monitored in the emergency patient?
```
pulse rate and quality
mm colour and crt
respiratory rate and effort
temperature
demenour/mentation
body weight (every 12 hours instead of 24)
```
68
how regularly should the the emergency patient be monitored?
every 15 minutes initially, increase interval as time passes/animal becomes more stable
69
what other parameters should be considered during monitoring of the emergency patient?
```
urine output and SG
blood pressure
ECG
pulse ox
CVP
electrolyte and blood gases
```
70
what parameters may remain normal for a period of tme after cardiac arrest/cardiac contractions stop?
mucous membrane colour, capillary refill time and ECG
71
what is involved in basic life support?
CPR
72
what is the aim of basic life support?
keep blood flowing and oxygen delivery to tissues through external support to the body
73
what is involved in advanced life support?
administration of drugs and other treatments to restart spontaneous circulation
74
how many people should be involved in administration of CPR?
minimum of 3
75
which staff within the practice should be trained in CPR?
all, including receptionists and managers
76
what is the name of the detailed veterinary CPR guidelines?
RECOVER
77
what are the 5 main signs of actual or impending arrest?
agonal gasping
absence of a heartbeat or weak and rapid pulses that slow quickly
loss of consciousness
fixed dilated pupils
loss of reflexes (e.g. corneal and palpebral)
78
what is agonal breathing?
short labored breaths, tends to be moaning on exhalation
79
what is the corneal reflex?
a blink in response to light tough on the cornea
80
what is the palpebral reflex?
a blink when light touch is run over the upper/lower eyelids
81
what are the 5 key roles of a CPR team?
```
cardiac compressor
ventilation provider
recorder
monitor
person to draw up medication, place ECG and catheter
```
82
when should the roles of the CPR team be assigned?
as soon as everyone arrives on scene, usually by team leader (senior nurse/vet)
83
what should you do if a patient has arrested or you think they are about to?
note the time
call for help
keep calm
assign roles (or ensure someone does) when help arrives
84
what is the first thing that you should do when starting CPR?
chest compressions should be started as soon as possible, even before help arrives
85
describe the process that should happen on discovering arrest or peri arrest?
start compressions
secure airway and provide oxygen
assign a recorder/leader to record all interventions, monitoring and time
monitor the patient for any pulses and spontaneous ventilation
place a catheter
connect an ECG
86
how often should the cardiac compressor be swapped?
every minute
87
what can pulses tell us about the quality of CPR?
a good pulse during CPR shows compressions are effective and working
88
describe cardiac pump compressions
compression of the chest directly over the heart. The hand is placed around the chest and squeezed
89
describe thoracic pump compressions
compressions over caudal thorax (with animal in lateral recumbancy) or xiphisteinum (when in dorsal recumbancy)
90
on what animals are cardiac pump compressions used?
cats and small dogs
91
on what animals are thoracic pump compressions used?
medium and large dogs
92
how many compressions should be given a minute?
100-120
93
what depth should compressions be?
1/2 to 2/3 thorax width
94
what pulse can be used to assess effectiveness of compressions?
femoral
95
what is a capnograph?
device which measures ventilation and shows CO2 levels leaving the patient
96
what can a capnograph show/
effectiveness of CPR by showing gaseous exchange is taking place
97
how many breaths per minute should be given during CPR?
~20
98
how much should the chest be inflated during CPR?
to normal levels
99
what does ET tube and either an ambubag or anesthetic circuit provide?
intermittent positive pressure ventilation
100
what equipment is needed for basic life support?
```
Ambu bag/anaesthetic machine and circuits
face mask/endotracheal tubes
laryngoscope
IV catheters
recording sheet
pen
3 people (at least)
Ideally: ECG and capnograph
```
101
describe the collapsed patient
one who can still respond to/is aware of external stimuli
102
describe the unconscious patient
one who is unaware of surroundings
103
describe the alert collapsed patient
normal mentation, can't walk/move
104
describe the depressed collapsed patient
quiet, still responds to name/clapping
105
describe the obtunded collapsed patient
responds only to pain, decreased consciousness
106
describe the unconscious patient
not at all responsive to external stimuli but has a pulse and is breathing unaided
107
what does reduced consciousness usually mean for the severity of an injury?
usually more severe
108
what can the state of consciousness be used to determine?
the severity of a condition that can vary in level (e.g. shock)
109
what issues do alert patients commonly present with?
```
orthopaedic disease (fractures)
peripheral neurological disease (e.g. disk disease)
```
110
what issues do depressed patients commonly present with?
mild/moderate shock and pain
111
what issues do obtunded patients commonly present with?
moderate to severe shock, neurological disease and metabolic disease (e.g. renal failure)
112
what issues do unconscious patients with normal heart rates commonly present with?
neurological disease and metabolic disease (e.g. diabetic coma)
113
what issues do unconscious patients with a high or low heart rate commonly present with?
severe shock or imminent arrest
114
what is the most important nursing consideration of the unconscious patient?
they are unable to protect their airway and so the airway must be positioned so it can be kept clear
115
how should a patient be positioned in order to keep the airway clear?
lateral recumbancy, neck extended gently and head slightly upwards. Mouth opened with tongue out through the gap between canine and premolar teeth
116
what is the essential equipment for collapsed/unconscious patients?
```
ET tubes
conforming bandage (to hold mouth open
oxygen supply
laryngoscope
dog catheters (airway access)
mouth gag (or large vetwrap bandage)
ECG
Blood pressure monitor and capnograph
```
117
how quickly can occular emergencies deteriorate?
fast - should be seen urgently if onset of signs is rapid
118
what are 7 common occular emergencies?
```
traumatic proptosis
occular foreign body
corneal scratch/laceration
corneal ulcer
glaucoma
hyphaema
sudden onset blindness
```
119
what is traumatic proptosis?
forwards displacement of whole globe of eye
120
how do occular emergencies often present?
eye closed/half closed
depressed
unwilling to be touched
121
what is hyphaema?
bleeding into the anterior chamber of the eye turning it red colour
122
what are the main nursing considerations of an occular emergency?
assess entire patient (primary and secondary surveys) and deal with major body system abnormalities first
prevent self-trauma with Elizabethan collar
give analgesia
keep eye moist with false tear solution or sterile saline moistened swabs
keep the patient in a quiet dimly lit kennel
123
what are some common nasal emergencies?
epistaxis
| nasal foreign body
124
how may a nasal foreign body present?
intense sneezing which may ease
125
what are the key nursing considerations of epistaxis?
```
keep calm
elevate the nose and apply cold compress
plug with an absorbent dressing
monitor for hypovolaemia
can use adrenaline on a moistened swab
```
126
what are the key nursing considerations of a nasal foreign body?
will require nasal examination and flush under GA
127
how should a patient be positioned for nasal flush under GA?
sternal recumbancy with rostral end downwards to avoid flush liquid entering trachea
128
what equipment is required for epistaxis?
surgical swabs
adrenaline
absorbent dressings
129
what equipment is required for nasal foreign body?
```
GA equipment (inc. cuffed ET tubes)
otoscope and laryngoscope
surgical swabs
syringes
sterile saline (1l for 25kg dog)
bowl for catching flush solution
```
130
what size syringe should be used for nasal flush of cat and dog?
dog - 60ml
| cat - 20ml
131
what side should the patient be laid on for CPR?
right
132
what is shock?
an acute state of circulatory collapse
133
define shock
it is defined as the inability of the circulation to transport enough oxygen to meet tissues needs
134
what are the 4 major types of shock?
hypovolaemic
distributive
cardiogenic
obstructive
135
what is the most common form of shock?
hypovolaemic
136
what causes hypovolaemic shock?
loss/reduced of circulating blood volume
blood loss
loss of fluids through diarrhoea/vomiting
137
what is the defining feature of distributive shock?
loss of peripheral resistance
138
what does the loss of total peripheral resistance in distributive shock cause?
allows blood to pool in the small blood vessels
139
what are the 4 main divisions of distributive shock?
septic shock
toxic shock
anaphylactic shock
neurogenic shock
140
what is cardiogenic shock caused by?
heart not working properly so there is inefficient oxygen/blood supply to the tissues
141
what is obstructive shock caused by?
obstruction
142
what are 3 common causes of obstructive shock?
pericardial effusion
pulmonary embolism
gastric dilation and voluvus
143
what are the general nursing considerations that need to be made when treating a patient with shock?
close monitoring as change can happen quickly
oxygen
slow warming after treatment has started
quiet environment to reduce stress and so oxygen consumption
144
what are nursing considerations that need to be made when treating a patient with hypovolaemic shock?
place an IV catheter
intravenous fluids
stop haemorrage
145
what are nursing considerations that need to be made when treating a patient with distributive shock?
find underlying cause ASAP through history and questioning
place IV catheter
IV fluids
146
what are the 3 first aid tests that can be used as markers of shock?
measure blood pressure
measure urine output
measure blood lactate
147
what does urine output during shock show?
whether the kidneys are retaining water and so illustrating reduced blood volume
148
what do lactate levels show?
amount of anaerobic respiration occurring in the tissues and producing lactate
149
what are 4 main cardiac emergencies?
acute congestive heart failure (CHF)
pericardial effusion
aortic thromboembolism
arrhythmias (irregular, tachycardia or bradycardia)
150
what are the key nursing considerations of cardiovascular emergencies?
```
oxygen
place IV catheter
ECG attached to patient
analgesia to help with pain and to calm
kept in a calm and quiet environment
ultrasound ready
prep for pleural or pericardial tap
```
151
what equipment is often used during cardiovascular emergencies?
3 way tap - pericardial or pleural tap
ECG machine
Butterfly catheter (tap)
ECG trace
152
are aural emergencies usually life threatening?
no but can be distressing to owner and patient
153
what are 3 common aural emergencies?
aural foreign body
otitis externa and media
aural haematoma
154
what is otitis externa?
outer ear infection often leading to self trauma
155
what is otitis media?
middle ear infection
156
what are common signs of otitis media?
head tilt and altered walking pattern
157
what causes aural haematoma?
headshaking
| fighting/paly
158
what is an aural haematoma?
collection of blood between skin and cartilage of ear
159
what equipment is required for aural emergencies?
Elizabethan collar
otoscope
analgesia (to prevent further self trauma)
160
what are the 2 main environmental emergencies?
hyperthermia
| hypothermia
161
what can cause hyperthermia?
bracheocephallic breeds are prone due to altered respiration
heat stroke
over exercise
seizure
162
what can cause hypothermia?
sedation
anaesthesia
shock (particularly in cats)
163
what are other environmental emergencies?
burns
smoke inhalation
electrocution
164
what can smoke inhalation cause?
pulmonary oedema
165
what can electrocution cause?
burns and pulmonary oedema
166
at what temperature should cooling start for hyperthermia?
41.5 degrees
167
at what temperature should cooling end for hyperthermia?
39.5 degrees
168
why can active cooling end before the body temperature has returned to normal?
cooling continues within the body
169
what methods of active cooling are there?
fan
cool mat
cooling coats
170
what can be done to raise body temperature in hypothermic patients?
bubble wrapping limbs
warmed IV fluids (including fluid line)
Bair Hugger - warm air filled cover that can be laid over the patient and act as insulation
171
which patients are often hypothermic?
sick/sedated/anaesthetised
172
what methods of heating should not be used in hypothermic patients?
heat lamps or mats where the patient cannot move themselves away from the heat and may get burned
173
what are the main points when treating burns?
15 mins under running, cold water ASAP but at practise if owner is unable
analgesia
prevent interference and infection
treat shock
174
what are superficial burns?
involve only the epidermis
175
what are partial thickness burns?
involve the epidermis and dermis
176
what are full thickness burns?
involve destruction of the epidermis, dermis and any or all underlying structures (muscle, fat, bones, nerves)
177
are full thickness burns the most painful?
no as nerves are damaged so painful signal cannot reach the brain/be registered
178
what is the other way that burns can be described?
% of body burnt
179
what are the 3 main types of trauma?
haemorrhage
wounds
fractures
180
define haemorrhage
loss of blood from vessels
181
how is haemorrhage best assessed?
cardiovascular parameters - HR, MM, CRT
182
what are the 2 presentations of haemorrhage?
internal
| external
183
how can you tell what vessel is loosing blood?
arteries spurt
| veins and capillaries ooze darker blood
184
what may affect haemorrhage?
clotting disorders
185
what is the main first aid concern with haemorrhage?
apply pressure to wound with sterile dressing and complete primary and secondary survey
186
what may indicate internal haemorrhage?
breathing difficulties
swollen abdomen
melena
blood in urine
187
what can be done to try and slow bleeding in limbs?
partial occlusion of blood vessels above injury in order to reduce supply - only temporary
188
what are the 6 types of wound?
```
incised
lacerated
abrasion/grazes
contusion
puncture
gunshot
```
189
describe incised wounds
clean cut, usually surgical or can be glass/metal
190
describe lacerated wounds
tearing of tissue with a less sharp/more jagged material. Always dirty (e.g. barbed wire)
191
describe abrasion/grazes
don't penetrate skins full thickness and are often very dirty with embedded gravel/dirt
192
describe contusion
bruising- bleeding from capillaries under the skin surface. May indicate deeper injury and often accompanied by abrasion
193
describe puncture wounds
small external wound with massive internal/deep tissue damage. Will rapidly become infected and then liffe threatening
194
describe gunshot wounds
mixed - vary due to differing types of shot. A small entry wound often hides massive internal damage
195
how should a wound be treated on initial viewing?
cover to prevent contamination and complete primary and secondary survey
give analgesia ASAP
once/if patient is stable clip wide area around the wound
flush wound with warmed 0.9% NaCl
then approach vet about dressing/suture
196
what should the wound be covered with prior to clipping to prevent contamination from clipped hair?
sterile water soluble gel
197
what wounds should be flushed under GA and why?
bites/punctures to assess depth of injury
198
what is a fracture?
a break in the continuity of the bone
199
what is a complete fracture?
both sides of the bone are broken
200
what is an incomplete fracture?
only one side of the bone is broken
201
what is the difference between open and closed fractures?
open fractures have broken through the skin, closed have not
202
what is the difference between pathological and traumatic fractures?
pathological fractures are caused by disease rather than direct trauma
203
what are luxations?
dislocation
204
how should a patient with suspected fractures be transported?
minimal movement
| in a cage/box wherever possible
205
what must always be preformed on fracture patients?
primary and secondary surveys as fracture is often no the most life threatening problem
206
what is metabolism?
chemical reactions that occur within living organisms in order to maintain life
207
when do metabolic emergencies occur?
when homeostasis is not maintained by normal metabolic processes
208
what are 5 common metabolic emergencies?
```
hypoglycaemia
hyperkalaemia
hypocalcaemia
hypoadrenocorticism (addisons disease)
diabetic ketoacidosis
```
209
what is hypoglycaemia?
low blood sugar
210
how can an owner aid their hypoglycaemic patient?
smear honey on the gums
211
what are the main signs of hypoglycaemia?
weakness, collapse, seizures, coma
212
what is hyperkalaemia?
increase in blood K+ leading to cardiac issues
213
what can hyperkalaemia lead to?
bradycardia and asystole
214
how can hyperkalaemia be managed once in practice?
IV fluids and drugs to protect the heart and lower K+ concentration in the blood
215
what is hypocalcaemia?
low calcium
216
what is hypoadrenocorticism?
impaired secretion of adrenal hormones - leads to a multitude of issues including hypo/hyperkalaemia
217
what are the signs of hypoadrenocorticism?
vague - collapse, weakness, depression, acute vomiting or diarrhoea
218
what is diabetic ketoacidosis?
hyperglycaemia over a long period of time leading to cells breaking down proteins and lipids to gain energy as glucose is not being stored.
219
what are the signs of diabetic ketoacidosis?
vague - weight loss, collapse and excessive urination and drinking
220
what questions can be asked on the phone to aid identification of metabolic emergencies?
is the patient lactating (identify hypocalcaemia)
can the patient urinate normally
does the patient have diabetes
has the patient been polydipsic (prior to collapse)
does the patient smell of pear drops (not reliable as not all owners can smell this)
is there sudden diarrhoea/vomiting
are the mm normal and is CRT normal
221
what are 3 main urological emergencies?
urethral obstruction
uroabdomen
acute renal failure
222
what can urethral obstruction be caused by?
cellular debris
stones
cancer
stricture
223
within how many hours is urethral obstruction life threatening?
24 hours
224
what animal is urethral obstruction seen in?
male cats
225
what is uroabdomen?
urine leaking into abdomen due to hole on the urinary tract
226
why can uroabdomen and urethral obstruction lead to hyperkalaemia?
waste cannot be voided and so K+ builds up
227
what is acute renal failure?
sudden failure of kidneys
228
what causes acute renal failure?
blood clots, medication, toxins, end point of chronic renal failure
229
what are the main first aid considerations when nursing a urological emergency?
```
careful and extensive phone triage to discover signalment, drinking, urination and history of trauma
careful handling
pain relief ASAP
place IV catheter
consider whether PPE is needed
```
230
why may PPE be needed for urological emergencies?
some cases of acute renal failure are zoonotic
231
what equipment should be made ready when you know a urological emergency is on the way?
```
equipment for:
monitoring urine output
anaesthesia
urinary catheters
imaging of tract
```
232
on what animals may cystocytosis not be performed?
draining of urine from bladder via needle - not in cats as tissue is too friable
233
what is the main equipment needed in urological emergencies?
IV catheter
suture material
urinary catheter and suture device to hold it in place
IV fluids
234
name 5 common toxins of cats and dogs
```
cats:
lilies
anti-freeze
advantix (spot on for dogs)
paracetamol
poison
```
```
dogs:
raisins
grapes
chocolate
paracetamol (overdose as dogs can metabolise it)
poison
```
235
what are important questions to ask during telephone triage of a toxological emergency?
```
exactly what has been ingested
how much
how long ago
how long exposed (level of absorption and will inform treatment)
body weight of patient
symptoms
contact details
```
236
what should you advise the client when dealing with a toxological emergency?
consider own safety - bite risk and poisoning
safely - bring sample/package
prevent the patient licking dermal contamination
directions to practice
237
what are the 4 key aims of toxological first aid?
identify poison and amount ingested/exposed to
prevent further absorption of poison
treat any signs that develop symptomatically (e.g. ulceration, seizures, pain)
administer antidote (rare) or specific treatment
238
what is a toxbox?
access to common antidotes/poison treatments which are not often needed in practice and would be costly to buy in and often dispose of.
Many locations across the country - may have to drive to get it
239
where can you get more information about poisons?
VPIS - 24hr helpline for both vets and owners
| BSAVA/VPIS guide
240
how much of gastric contents should be cleared by emesis?
40-60%
241
how many hours after ingestion of poison is emesis effective?
up to 3
242
when should emesis not be induced?
with caustic/acidic substances
volatile petroleum (or anything ending in 'ol')
patients with cardiac or laryngeal disease (vomiting will stress heart and patients with laryngeal disease cannot protect airway from vomit)
depressed or seizing patients
patients that can't vomit (rabbits/horses)
243
what drugs are used to induce emesis in dogs and cats?
Apermorphine (Emedog) - dogs
| Xylazine - cats
244
what are the main nursing considerations when performing dermal decontamination?
wear PPE including face mask
use warm water
clip hair where possible instead of washing
take care when drying not to increase skin temp
245
what effect can hot water have on dermal contamination?
increase speed of absorption through the skin
246
what are the main nursing considerations for occular decontamination?
contaminated eyes flushed with sterile 0.9% NaCl
after flushing cornea should be stained with fluorescein and examined for ulceration
check pH
247
what are the 4 most common GI first aid emergencies?
GI obstructions
vomiting
diarrhoea
gastric dilatation-volvulus
248
what is volvulus?
twisting
249
what are the important questions to ask in a telephone triage of GI emergencies?
history of ingestion
sudden unproductive retching, restless, salivation, hard bloated abdomen
vomiting and lethargy
diarrhoea and lethargy
250
what is an important consideration when discussing possible GI emergencies over the phone?
the breed of the dog - deep chested breeds need to have GDV considered
251
what are the main nursing considerations during GI emergencies?
PPE and consideration as to route through practice if infectious disease is possible
ABC's
place a catheter
prepare a stomach tube
consider shock, hypothermia and hypoglycaemia
252
what are the 5 main reproductive emergencies?
```
dystocia
neonatal resuscitation
paediatric emergencies
pyometra
paraphimosis
```
253
define dystocia
difficulty giving birth or progressing with birth
254
what are some key paediatric emergencies?
hypothermia
| hypoglycaemia
255
what is pyometra?
life threatening condition of uterus seen in entire bitches/queens
256
when is pyometra often seen?
4-6 weeks post season (can be up to 3-12)
257
what within a history may indicate pyometra?
vague history of polydipsea, inappetance and vulval discharge
258
what is paraphimosis?
penis extrudes and becomes stuck out of the prepuce
259
within what sort of animals is paraphimosis seen?
entire dogs
260
what indicates dystocia?
unproductive straining for over 1hr after start of stage 2
| unproductive straining for over 30 minutes after last puppy
261
what RR is considered high in cats and dogs?
>40
262
what are the signs of respiratory distress in cats?
```
hunched over
hiding
coughing (hacking sound)
open mouth breathing (can also be seen in distress but only lasts a short term)
blue tinged gums
foam/froth from mouth
```
263
what are the signs of respiratory distress in dogs?
```
constant coughing (especially at night)
exercise intolerance
change in bark sounds/vocalisation
anxious/restless/pacing
panting
stretching neck to make passage of air easier
lack of lateral recumbancy (more sternal)
tired
abduction of elbows
blue gums/foam from mouth
paradoxical/abdominal breathing
```
264
what is sub-cutaneous crepitus?
air escapes from lung through hole and collects in sub-Q tissues
265
what can cause sub-Q crepitus?
break in pleural integrity
266
what happens during a pneumothorax?
pleural space fills with air due to breach in integrity of lung tissue
267
what is a tension pneumothorax?
large hole that becomes rapidly life threatening, the leak functions as the one way valve. Air enters on inspiration and doesn't exit leading to increasing compression of the lung. The air must be drained
268
how should respiratory patients be nursed?
airway should be maintained in obtunded and unconscious patients (extend neck and pull tongue)
provide supplementary O2
restrict movement in small/comfortable space
management of ambient/patient temperature
reduction of stress leading to reduction of O2 need
269
what are the main causes of neurological emergencies?
head trauma
seizures
spinal cord disease
vestibular disease
270
define seizure
uncontrolled burst of electrical activity between brain cells. Causes temporary abnormalities in muscle tone/movement but doesn't necessarily mean loss of consciousness
271
what are the main causes of spinal cord disease?
```
injuries
infections
compression by fractured bone
loss of blood supply
tumor
```
272
what are the signs of spinal cord disease?
weakness
paralysis
sensation is abnormal/lost
bladder/bowel functions are lost or different
273
what is required for seizure patients?
those in status epilepticus require immediate care, those who are no longer seizing may appreciate time in a quiet area to readjust
274
what are vestibular diseases?
group of diseases affecting balance systems
275
what are the main principles of neurological nursing?
```
ABCs
immobilise suspected fractures
head elevated 30 degrees in head trauma
monitor temperature
history of toxin exposure
hypoglycaemia
```
