Respiratory introduction Flashcards Preview

SAM 1 > Respiratory introduction > Flashcards

Flashcards in Respiratory introduction Deck (41)
Loading flashcards...
31

Nasal flush

Indications?

Procedure?

  • Indications
    • Foreign body suspect
    • Clean airways prior to rhinoscopy
    • Obtain samples for cytology
  • Procedure
    1. GA and cuffed endotracheal tube
    2. Pack back of throat w/ gauze
    3. Fill 20-30cc syringe w/ 0.9% saline
    4. Place tapered end in nostril
    5. Hold other nostril closed w/ finger
    6. Flush saline quickly w/ a bit of force
    7. Repeat several times
    8. Cats: use dorsal recumbency w/ small towel rolled under neck
    9. Can use Foley catheter for antegrade and retrograde flushes

32

What type of flush is this?

Nasal flush--normograde

33

What type of flush is this?

Nasal flush--retrograde

34

Cytobrush samples

Alternative to?

Technique: easy or difficult?

Quality?

Used for?

Procedure?

  • Alternative to nasal flushing
  • Easier technique
  • Good quality cytological material
  • Cytology and culture
  • Local block, place into nose, swirl around, smear on slide
    • No need to anesthetize patient

35

Bronchioloar lavage

Indications?

Undertaken how?

Can sample what?

 

  • Indications: lung disease involving small airway, alveoli, interstitium (flush out certain sections of lungs)
  • Can be undertaken via bronchoscope or blindly
  • BAL: can sample specific diseased lung lobes

36

Indications for transtracheal washes & aspirates: airway or lung parenchymal disease

Transtracheal wash & aspirate vs. endotracheal or transoral wash & aspirate

  • Transtracheal wash and aspirate
    • Medium-larger breed dogs
    • +/- sedation
    • Landmark: cricothyroid ligament
    • Go through transtracheal rings (less likely to hit nerve)
  • Endotracheal or transoral wash & aspirate
    • Cats and tiny dogs
    • GA required
    • Catheter down ET tube

37

Transthoracic lung aspiration

Indications?

Guidance?

Complications?

  • Intrathoracic mass lesions in contact w/ thoracic wall
  • Ultrasound guidance improves diagnostic yield and safety
  • Complications
    • Hemothorax
    • Pneumothorax
    • Potentially pyothorax later on

38

When is a chest tube indicated?

  • Treatment of pyothorax
  • Management of pneumothorax when air is continually accumulating

39

Review respiratory therapeutics

Antibiotics: considerations?

Glucocorticoid differences

 

  • Antibiotics--considerations
    • What organisms are likely?
    • What antibiotics penetrate resp tissue?
    • Which part of resp system are you treating?
    • Which species of animal are you treating?
  • Glucocorticoids:
    • Differences between anti-inflammatory doses vs. immunosuppressive doses?
    • Difference btn prednisolone, dexamethasone, methylprednisone?

40

Review respiratory therapeutics

Bronchodilators

Anti-tussives

Nebulization + coupage

  • Bronchodilators--usually for bronchitis
    • May allow dose reduction of glucocorticoids in some cases of allergic bronchitis
  • Antitussives--used mainly in dogs w/ dry and non-productive cough due to airway collapse or irritant tracheitis
    • Avoid in moist coughs
  • Nebulization + coupage
    • Improves hydration of lower airways
    • Can administer some antibiotics via this method

41

Therapeutics: oxygen

Indications?

Methods?

  • Indications
    • To treat hypoxemia (PaO2 < 90%)
    • To dec. workload of heart and lungs
  • Methods
    • Face mask--quick, cheap
      • Requires high O2 flow
      • Must stay w/ patient
    • Nasal catheter
      • Patient can move around more
      • Watch flow rate
    • Cage--more expensive
      • Humidity and temp controlled
      • Opening doors decreases O2
    • Intratracheal--emergency
      • +/- sedation/anesthesia or tracheostomy tube
      • Continual monitoring