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Flashcards in Soft Tissue Trauma Deck (91)
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What conditions present true veterinary emergencies?

- Respiratory distress
- Neurological abnormalities
- Bleeding from body orifices
- Rapid, progressive abdominal distension
- Dystocia
- Collapse
- Extreme pain
- Fractures
- Severe wounds
- Urinary obstruction
- Persistent vomiting
- Toxin ingestion


Outline the advice that should be given to an owner in case of a veterinary emergency

- Encourage bringing to practice ASAP
- Need to protect the spine (lift gently on rigid board)
- Place in confined space if suspect fracture to minimise movement
- Direct pressure on active haemorrhage
- Calm owner before transport, ensure know the route


Outline the criteria for a P1 (top priority) emergency case

- History of head or spinal trauma
- History consistent with internal injuries
- Life threatening haemorrhage (chest, abdomen worst)
- Cardiorespiratory compromise
- Diagnose based on history, observation and physical examination
- Re-assess -cardiovascular function can deterioratem, CNS signs may become more obvious


What action is required for a P1/top priority emergency case?

Immediate action, high risk of death


Outline the criteria for P2 emergency cases

- Do not move, need stabilisation prior to moving e.g. fracture, tendon rupture/laceration, joint instability, vascular or neurological damage
- Esp. important for large animals


Outline the criteria for P3 emergency cases

- Require urgent attention, but may not be immediately life threatening
- Synovial involvement (can wait 24-48hrs)
- Bony involvement
- Contaminated wounds


Outline the criteria for P4 emergency cases

- Delayed action
- Do not require emergency treatment or urgent action
- Must rule out all previous problems, be prepared to evaluate findings and diagnosis
- Explain to owner what to look for in case of deterioration


In an emergency case, outline the initial assessment of the patient

- If lame, assess degree, appearance of limb may not match up with degree of lameness
- Conformation/gross abnormalities
- Location and discharge from wound
- Degree of blood loss
- Contamination


Outline what should be investigated in the physical examination of an emergency case

- Presence/absence of crepitus
- Degree of contamination
- Soft tissue involvement
- Bony involvement
- Swellings and effusions


List and justify the diagnostic tests that should be included in the assessment of an emergency case

- Radiogrpahy esp. traumatic injury, abdo and thoracic, assess cardioresp., diaphragm, bladder, pelvis
- Ultrasonography (AFAST, assess effusion, haemorrhage, bladder trauma)
- Synoviocentesis if synovial involvement
- PCV/TP to assess blood loss later in disease progression
- Assessment of other body system function using haematology, biochem, urinalysis esp. if may need surgery
- +/- MRI, CT, gamma scintigraphy


Identify the key features of first aid for acute trauma/wounds

- Control haemorrhage
- Control pain
- Reduce contamination
- Bandaging wounds
- Wound closure
- Splinting of fractures/tendon injuries


How can haemorrahge be controlled in acute trauma/wounds?

- Pressure (bandage or manual)
- Tourniquet
- Ligatures for large vessels


What are the components of analgesia in acute trauma/wound cases?

- +/-Opioids (NOT cattle/ruminants)
- Splinting/bandaging to prevent movement of limbs
- +/- sedation


List the NSAIDs that can be used in trauma cases for dogs

- Robenacoxib
- Meloxicam
- Carprofen


List the NSAIDs that can be used in trauma cases for cats

- Robenacoxib
- Meloxicam
- Ketoprofen


List the NSAIDs that can be used in trauma cases for horses

- Flunixin meglumine
- Meloxicam
- Ketoprofen


List the NSAIDs that can be used in trauma cases for cattle

- Ketoprofen
- Meloxicam


What conditions would containdicate the use of NSAIDs in an acute trauma/wound case?

- Hypovolaemia
- Severe haemorrhage
- Renal/liver compromise


List the opioids that can be used in acute trauma/wounds in dogs

- Methadone
- Buprenorphine
- Fentanyl


List the opioids that can be used in acute trauma/wounds in cats

- Methadone
- Buprenorphine


List the opioids that can be used in acute trauma/wounds in horses

- Butorphanol
- Buprenorphine
- Morphine


What is a potential complication when using opioids in horses?

- Can lead to excitation, combine with alpha 2 agonist to reduce this
- Pethidine will lead to horse becoming completely uncontrollable


What are the potential risks when using opioids in acute trauma/wound cases?

- Respiratory depression
- Bradycardia
- NB: Do not let this stop you using them!


How can wound contamination be reduced in an emergency case?

- Gross decontamination
- Clipping
- Lavage
- Antiseptics
- Debridement
- KY jelly in wound


List the different categories of wound closure, and identify the factors that underlie the decision making process

- Primary closure, delayed primary closure, delayed secondary closure, second intention healing
- Depends on contamination, ability to appose wound edges, degree of dead space below


Briefly outline splinting of fractures in emergency cases

- Depends on region, in SA, proximal limb fractures difficult to splint
- Splint the joints above and below
- Open fractures must be splinted
- Robert Jones adequate for distal limb fractures
- Do not pull exposed tissue back through skin


What are the main functions of applying bandages in acute trauma/wound cases?

- Reduces fluid accumulation
- Reduces contamination
- Reduces movement
- Prevents dehydration


What are the potential consequences of incorrect bandaging?

- Tissue maceration and infection
- Continued contamination
- Sloughing of new epithelialisation
- Continued pain for the patient
- Impairment of vascular supply


What are the key client considerations in decisions regarding equine wounds?

- Prognosis for athletic function
- Prognosis for pasture soundness
- Cost
- Duration of box rest
- Time out of work
- Amount of nursing required


Which equine injuries carry a poor prognosis for recovery?

- Compound, open fractures with significant contamination of soft tissue
- Complete fractures involving the femur, humerus and tibia
- Complete lacerations of SDFT, DDFT, SL
- Complete laceration of SDFT, DDFT and distal sesamoidean ligaments