Iatrogenic emergencies

Question 1

if haemorrhage after nasogastric intubation

appropriate actions?

Answer 1

do not pack

give time to stop

if not, endoscopy and clotting profiles

Question 2

blood on rectal sleeve after examination

next steps?

Answer 2

inform owner
butylscopamine sedation

lube and lidocaine: protoscopy
evaluation grade of tear and location

Question 3

which grade of rectal tear is this:

mucosa and submucosa

Answer 3

grade 1

Question 4

which grade of rectal tear is this:

muscularis only

Answer 4

grade 2

Question 5

which grade of rectal tear is this:

mucosa and muscularis
serosa intact

Answer 5

grade 3a

Question 6

which grade of rectal tear is this:

mucosa and muscularis
tear into mesocolon

Answer 6

grade 3b

Question 7

which grade of rectal tear is this:

all layers affected

Answer 7

grade 4

Question 8

3 surgical options for rectal tear

Answer 8

1) direct suture
2) rectal liner
3) temporary diverting colostomy

Question 9

medical management of rectal tear

Answer 9

penicillin
flunixin
tetanus status check
+/- epidural and packing of rectum

Question 10

antimicrobial ointment useful for burns?

Answer 10

silver sulfadiazine

Question 11

after a stable fire why may a horse have hypovolaemia

Answer 11

burn shock

tx iv fluids

Question 12

what temp water apply to burns on horse?

Answer 12

lukewarm

not too cold

Question 13

ideal suture material for equine skin layer?

Answer 13

monofilament polypropylene 3-3.5 metric

Question 14

ideal suture material for equine subcutaneous layer?

Answer 14

3 metric absorbable poliglecaprone

Question 15

when managing an equine wound:

1) analgesia IV followed by oral course

2) antibiotics IV/IM followed by oral
- which antibiotic is best for this?
- why can you not give it if you plan on sedating the horse later

Answer 15

trimethoprim sulphonamide

will give fatal arrhythmia

give different AB, sedate and suture, then give trimethaprim sulphonamide after

Question 16

when to remove skin sutures/ staples?

Answer 16

10-14 days after

Question 17

how fast does epithelisation occur?

Answer 17

1mm per week

Question 18

traumatic injuries
slow healing wounds
excessive skin burns
deformity causing scarring

indications for which kind of wound management?

Answer 18

skin grafts

Question 19

what are free grafts?

Answer 19

pinch/punch/ tunnel grafts

using autografts
taken from less visible site
risk of white hairs at donor site

Question 20

what are solid or meshed sheet skin grafts?

Answer 20

used if insufficient skin to cover whole area

pectoral region mostly used> sutured closed after

Question 21

what are meek micrografts?

Answer 21

specialist, more likely for grafts to be accepted, cover large skin defects

Question 22

when does bone sequestrum form?

Answer 22

damaged bone exposed to air

needs to be surgically removed