IO catheters, venous cut down, thoracic trauma Flashcards
indications for IO catherization (3)
collapsed peripheral vessels (such as in shock)
kittens and puppies too small for traditional IV
traumatic injuries over usual IV sites preventing use of site
potential IO access sites (4)
femoral trochanteric fossa
proximal humerus greater tubercle
ilial wing
tibial tuberosity
what can you not deliver via IO catheter?
chemotherapy
everything else you can, including blood transfusion and colloids
for the first hour, IO fluid administration rates are limited to
11 ml/min
after initial placement of an IO catheter you should
Flush the needle with some heparinized saline to make sure the lumen is free of spongious bone and hematoma.
Next, take a control radiograph to ensure placement into the correct location.
All fluids given via IO catheter should be
warmed.
complications of IO catheter use (7)
pain (from fluids running in too fast or cold)
osteomyelitis
subcut abscess
cellulitis
sciatic nerve injury
epiphyseal injury
bone fracture (in tiny patients)
Emergency veous cutdown is a rapid, non-sterile technique used to
surgically expose superficial peripheral veins for rapid visual IV catheter placement.
If vascular access is not achieved within an apprpriate time frame in emergency situations, an emergency venous cutdown should be attempted.
minor cut down procedure means
18G-21G Syringe needles are
enough to perform minor cut down.
used on cats and small dogs.
major cut down procedure means
you aree using a scalpel blade to do the cut down and at this point it counts as a minor surgical procedure.
blades nro. 11 and 15 are used.
dyspnea MUST be…
characterized.
inspiratory vs
expiratory vs
combination aka mixed dyspnea
signs of inspiratory dyspnea (5)
lips drawn back
neck extension
costal margins easy to see
increased inspiratory time
noise during inspiration (stertor)
signs of expiratory dyspnea (3)
increased abdominla effort in expiration
extended expiration with effort
rapid, shallow respiration, with expiratory grunt sometimes
rule of 5 for resp. distress patient after thoracic trauma
Assess:
RR, pattern, and effort
airway patency check
breathing effort?
pleural space assessment
provide effective respiration
decreased lung sounds can indicate
pleural space disease
e.g. pneumo-, hemothorax, PPDH
increased lung sounds can indicate
pulmonary contusion/injury, pneumonia
pulmonary contusion development after trauma takes…?
6-16 hours after trauma
how can you tell whether your hemothorax is acute and ongoing or old?
measure the HCT/PCV from the blood you pulled off the lungs, compare to venous PCV and repeat both later.
heimlich valve
is a one-way valve usedin pneumothorax chest tubes
the ratchet version would be to use tubing in water bottles
posture of traumatic diaphragmatic hernia animal
extended front legs (seated), paradoxical breathing movements
traumatic diaphragmatic hernia surgery timeframe
studies show a 40% increase in mortality if hernia corrected surgically within the first 24 hours.
However, the below are all indications for urgent surgery nonetheless:
* refractory hypovolemia
* stomach tympany
* continuous hemorrhage (from liver)
* unrelievable abdo pain
Dr.S.U. recommends using non-absorbable suture material, such as 4-0 nylon suture, when suturing the diaphragm.
2 complications of corrected traumatic PPDH
re-perfusion injury
&
re-expansion pulmonary edema
rule 1 of effective triage
RAP,
respiration
alertnee
perfusion
