trauma scores and assessment Flashcards
(13 cards)
Why can the human approach to trauma care not be directly applied to veterinary medicine?
There are several limitations and differences between human and veterinary medicine that prevent
direct application of trauma care models: - Veterinary field emergency response is less established;
- Healthcare systems are less centralised; - Clinical roles are not clearly defined in veterinary
practice; - Veterinary medicine lags behind human advances; - Decision-making includes
considerations of animal welfare, cultural expectations, and owner finances; - Patients are non-
verbal, poorly compliant, and often require sedation/anaesthesia for treatment.
What are some key statistics highlighting the impact of trauma in veterinary patients?
- Trauma is the second most common presentation in dogs and cats (O’Neill et al., 2014, 2015); -
Leading cause of death in young cats; - Second leading cause of death in dogs in the USA (Fleming et
al., 2011); - Survival to discharge: 82.5% cats, 92% dogs (Hall et al., 2018); - Common causes of
trauma-related death in military working dogs include haemorrhage, head trauma, tissue destruction,
and pneumothorax (Storer et al., 2024).
What is the ABCDE approach in veterinary trauma?
A non-validated but structured guideline to prioritise trauma care by urgency of life threat:
- A: Airway
- B: Breathing
- C: Cardiovascular system
- D: Disability assessment
- E: External assessment
Describe the Animal Trauma Triage (ATT) Score.
A scoring system assessing perfusion, cardiac, respiratory, eye/muscle/integument, and skeletal systems. Each category is scored for injury severity to total 0–18. Each 1-point increase decreases survival likelihood by 2.3–2.6x.
What is the APPLE score and what does it evaluate?
The Acute Patient Physiologic and Laboratory Evaluation (APPLE) score assesses illness severity in dogs. It uses: pulse oximetry, lactate, AFAST free fluid, respiratory rate, albumin, glucose, creatinine, platelets, WBC, and bilirubin. Helps predict 24-hour survival.
What are the components of the VetCOT Score?
Uses four variables measured within 6 hours of admission: - Plasma lactate
- Ionised calcium
- Signs of head trauma
- Signs of spinal trauma
It provides improved calibration over ATT score for trauma severity.
What is the Modified Glasgow Coma Score used for in veterinary trauma?
Assesses severity of head injuries. Includes evaluation of motor activity, brainstem reflexes, and consciousness level. Helps guide prognosis and management.
How is RIBSCORE used in trauma cases?
RIBSCORE and modified RIBSCORE assess number and type of rib fractures. More severe and numerous fractures predict higher mortality risk.
What is the Shock Index and what does it indicate?
Shock Index = Heart Rate / Systolic Blood Pressure. Higher SI is linked to severe shock, increased mortality, greater transfusion need, and longer hospitalisation.
What is the red-amber-green trauma triage system and how is it applied?
This is a prioritisation tool based on the severity of trauma:
- Red: Immediate mortality threat (e.g., major haemorrhage, head injury, airway obstruction)
- Amber: Potential for morbidity (e.g., bladder rupture, spinal injury)
- Green: Non-urgent musculoskeletal injuries (e.g., closed fractures)
Each pathology is stabilised to de-escalate urgency.
What stabilisation techniques can be used for ‘Red’ life-threatening trauma pathologies?
Severe brain injury:
- Elevate head, oxygenation, manage anaemia, maintain BP, mannitol/hypertonic saline, sedation, anticonvulsants, antibiotics if open injury
Severe respiratory compromise:
- Sedation, oxygen, minimal handling, tracheostomy, thoracic drain, seal thoracic wounds
Severe haemorrhage:
- Blood products, oxygen, direct pressure, tourniquet, abdominal splint, thoracic drain, surgery
How are ‘Amber’ trauma pathologies typically stabilised?
Bladder/urethral rupture:
- Urinary catheter, cystostomy tube, abdominal drain
Maxillofacial fractures:
- Oesophagostomy tube for feeding
Wounds:
- Open wound management
What is the general management strategy for ‘Green’ trauma pathologies?
These are stable musculoskeletal injuries that do not pose immediate threat to life. Management includes external coaptation and open wound care as necessary. Definitive treatment can be delayed.
