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VTT ER PRO
FINAL REVIEW
Question | Answer |
---|---|
Is a technician allowed to apply a tourniquet or pressure bandage in an emergency? | yes |
T/F Blood gas analyzers often require arterial blood samples | TRUE |
What does a fluid pump do? | Delivers large amounts of fluids over a specific amount of time (mls/hr) |
What does a syringe pump do? | Delivers small amounts of a drug over an extended period of time |
T/F most clinics have the ability to at least store frozen blood and plasma, delivered from food banks | TRUE |
T/F it is ok to leave a cat who is open mouth breathing and in respiratory distress, unsupervised in an oxygen cage | FALSE |
T/F When triaging over the phone, the technician should sound panicked to indicate urgency to the owner? | False |
Is it ever ok to provide an owner with a diagnosis over the phone? | no |
How can you tell if you are looking at an arterial bleed? | An arterial bleed will often spout or shoot out blood every time the heart beats |
How can you tell if you are looking at a venous bleed? | A venous bleed will often be slow and steady until it is controlled |
Is an arterial bleed an immediate emergency? | yes |
is a venous bleed an immediate emergency? | depends, however it is not as serious as an arterial bleed |
What is a Hemoabdomen? is it an immediate emergency? | Hemoabdomen means that the abdomen has filled with blood, it is a life threatening emergency |
What are petechial? | small red or purple spots caused by bleeding into the skin |
A German shepherd dog, seemingly painful, comes in w/ symptoms of non-productive retching, distended abdomen, and abnormal behavior. This is a possible_______ and should be seen immediately | Gastric Dilatation Volvulus (GDV) |
A capnograph measures what parameter? | End tidal C02 |
Using a Doppler blood pressure monitor is an example of what? | indirect blood pressure monitoring |
The goal of a phone triage in an emergency is to do what? | Provide information to the owner to help keep the patient stable during transport, get info to halp you prepare for the patients arrival, keep the owner calm |
An owner calls in and tells you her 3yo male neutered cat is yowling and making frequent trips to the litter box. She has 2 cats and is not sure who is urinating in the box, you should had advise her to do what? | Bring the male in for examination and bladder palpation |
When dealing with a fracture situation over the phone how should you advise the client? | advise the owner NOT to push a bone back into the skin if it is sticking out |
All of the following are part of the minimum data base lab tests except which? HCT, Serum color, TP, Blood gas | Blood gas |
What is the purpose of a crash cart? | To have all items necessary during an emergency in one place where they can be accessed quickly and easily |
Name 3 important items a crash cart should contain | ET tubes (all intubation supplies) needles&syringes, ER drugs & dosage rates, notepad to make quick notes for the medical record, ambu bag, 1 pair of large gauze forceps (for removing FB from the trachea) |
How would you handle a telephone triage? include info u want from the owner, your demeanor, and any other important factors | always ask the client their name, phone number location, patients signalment, primary complaint,ETA and pertinent history, Remain calm, never diagnose the patient, keep advice given to how to stabilize the patient for transport to the clinic |
What is dystocia? | Difficult birthing, |
What are 3 signs of dystocia? | More than 2 hrs between births, failure to commence birth within 24 hours of drop in rectal temp, abnormal dark green & smelly discharge, presence of puppy in the birth canal w/o obvious contractions or movement of puppy, active labor 60+min w/no birth |
What does A. B. C. D. stand for? | Airway, breathing, Circulation, Drugs |
List 3 ways we can check for ventilation or oxygen perfusion | Listening for breath sounds, MM color, CRT |
What does CPCR stand for? | Cardiopulmonary cerebral resuscitation |
How often in CPCR successful in animals? | 3-5% of the time, only 10% of those successes are w/o deficit enough that they still make good pets |
Name 2 blood banks local or national | ACCESS Blue Pearl & Northwest Veterinary Blood Bank |
T/F over the needle catheters may be left in for 14 days while thru the needle catheters may only be left in for 3-7 days | False |
T/F Catheters requires daily care and maintenance including checking the IVC site and flushing every 4 hrs with heparinized saline solution | TRUE |
T/F Dehydration is usually only one symptom of an underlying disease state | TRUE |
Are SQ fluids ok for a patient that is severely dehydrated? | NO |
What is the end result of shock? | Cellular damage and death of the cells |
In the early stages of shock what does the body do to try to maintain blood pressure and increase cardiac output? | Vasoconstriction and increase heart rate |
What type of fluid is hetastarch? | colloid |
T/F Crystalloid fluids can be isotonic, hypertonic, or hypotonic | TRUE |
What is the difference between crystalloids and colloids? | Colloids have higher molecular weight and do not easily cross mucus membranes |
Is facial swelling concerning in a brachycephalic dog w/ an insect bite? Why? | YES, the dogs airway may become compromised |
Name 2 clinical indicators of dehydration | Increased PCV and High urine specific gravity |
Gastric torsion and heartworms can both result in what type of shock? | Obstructive |
What is likely the most common type of shock seen in veterinary medicine? | Hypovolemic |
What type of patient would you give fluids IO? | Neonates (puppies and kittens) |
Sepsis is defined as......? | A state of circulatory collapse that occurs secondary to inflammatory disease that effects the animals whole body, a result from trauma and anaphylaxsis, a cause of distributive shock |
What does MODS stand for? | Multiple Organ Dysfunction Syndrome |
What does SIRS stand for? | Systemic inflammatory response syndrome |
What is a clinical statae in which cellular energy production has fallen so low that organ function is compromised? | shock |
What do the letters of A CRASH PLAN stand for? | Airway,Cardiovascular, Respiration, Abdomen, Spine, Head, Pelvis, Limbs, Arteries/veins, Nerves |
When checking the airway what would you be checking for? | is the airway clear or obstructed? |
When checking cardiovascular what would you be checking for? | HR,MM color, CRT ( tissue perfusion) |
When checking respiration what would you be checking for? | Is air passing into the lungs (breath sounds/quality) |
When checking the abdomen what would you be checking for? | Distension? can you hear mobility (gas/gurgles )? |
When checking the spine what would you be checking for? | Trauma- if spinal injury is suspected the patient patient should be stabilized on a board to decrease movement of the spine as much as possible |
When checking the head what would you be checking for? | Eyes, ears, nose, face, check for bleeding or CSF(from ears) symmetry of the face ( any drooping or swelling) |
When checking the pelvis what would you be checking for? | trauma or swelling |
When checking the limbs what would you be checking for? | breaks/ lacerations, toes, paw pads ( cleaning and bandaging a toenail/ paw pad injury can make the patient more comfortable |
When checking the arteries and veins what would you be checking for? | Checking for any major bleeding this can be a further indicator of tissue perfusion |
When checking the nerves what would you be checking for? | Checking reflexes (PLR,menace, palpebral, corneal, etc...) |
slow return of the skin back to normal, MM dry, CRT may be increased ( how dehydrated?) | 6-8% |
Prominent signs of shock/ death (How dehydrated???) | 12-15% |
Clinical signs are not detectable (How dehydrated???) | less than 5% |
Slightly increased skin turgor, MM tacky (How dehydrated???) | 5-6% |
Skin remains tented, increased CRT, sunken eyes, tachycardia, weak pulses (How dehydrated???) | 10-12% |
An animal that has cyanotic MM w/ no detectable CRT, severe hypotension, hypothermia, absent of weak pulses, stuporous and bradycardic is in what stage of shock? | Late decompensatory stage of shock |
An animal with pale MM and prolonged CRT, cool skin, weak pulses, tachycardia, and decreased urine output is in what stage of shock? | Early decompensatory stage of shock |
An animal with red or pale MM, bounding or normal pulses, normothermic, rapid CRT, normal urinary output and slight increase in RR is in what stage of shock? | Compensatory stage of shock |
Define dehydration | A loss of fluid that exceeds an animals intake of fluids |
What is the formula for cardiac output? | CO=HR X SV Cardiac output= heart rate times stroke volume |
What is the ultimate goal in the treatment of shock? | to perfuse the tissues with oxygen to prevent cellular death from becoming too great |
Name 2 cryslalloid fluids??? | LRS, Normosol-r, plasmalyte |
What is our most important monitoring tool? | ourselves |
Please list 5 conditions we treat with fluid therapy | Shock, blood loss, Dehydration/prevention, systemic disease, supportive care, diuresis |
Name 3 steps that help to treat shock | oxygenation, fluid therapy, steroids (dex sp) sympathomimetic (dopamine) |
list 2 specific reason it is beneficial to place central lines in critical hospitalized patients | When multiple blood draws/meds/fluid therapy is required for long term care, TPN, CVP, Insulin CRI |
What is dystocia? | Difficult birth |
list 3 signs of dystocia | excessive straining w/o delivery of young, more than 2 hrs between births, presentation of young in birth canal that returns back into the body or does not pass w/ straining |
What is an echo-cardiogram do? | ultrasound of the heart |
What is the common name for the feline thromboembolism? | saddle thrombus |
T/F patients presenting with heart disease may present with injected, pale, of cyanotic MM color | TRUE |
T/F Cat with a history of heart disease often present with a cough | FALSE |
T/F weak pulses are often an indicator of an underlying heart issue going on with the patient | TRUE |
What is pleural effusion? | fluid build up around the lungs in the pleural space |
What is pneumonia? | an inflammation of the lungs that can cause an inability to oxygenate blood |
What is laryngeal paralysis? | the state of complete or partial failure of the arytenoid cartilages vocal folds, specifically during inspiration and expiration |
What is often the cause of feline lower airway disease? | Asthma |
T/F a technician may perform a tracheotomy in an emergency situation | FALSE |
Restlessness and anxiety are often symptoms of what? | Respiratory distress |
T/F paradoxical respiration is considered a normal breathing pattern | False |
Stridor is often an indication of what/ | an obstruction of the respiratory system |
When auscultating the heart, what are you listening for? | Gallops, murmurs, arythmias |
What drug to we give patients with CHF to help reduce fluid load? | Furosemide |
What is syncope? | collapse/fainting |
T/F sometimes cyanosis is not detected until oxygen levels have become dangerously low ( in non-anemic patients) | TRUE |
Cyanosis can cause what? | grey tinted MM and skin color |
T/F cyanosis can be caused by hypoxemia | TRUE |
List 3 presenting symptoms of CHF | Coughing (moist/nocturnal) exercise intolerance, Labored breathing |
The DVM wants you to perform a thoracocentesis to help a patient that has air in his chest due to a dog fight & puncture wound. the DVM is most likely treating the patient for what? | Pneumothorax |
10yo MN retriever. Honking sound on inhale, difficulty eating, gagging after a few bites, panting a lot and less energy than normal. loud harsh lung sounds what do u think this patient has? | Laryngeal paralysis |
Should a patient presenting w/ bleach ingestion be made to vomit?why? | no, bleach is caustic |
T/F The darker the chocolate the more toxic it is to the patient | TRUE |
T/F GDV can be managed with fluids and therapy if caught early | FALSE |
T/F Macadamia nuts toxicity usually presents with hind end weakness and is safe to monitor at home | TRUE |
T/F Most patients presenting with mega esophagus have no appetite why/why not? | False, they are basically starving |
T/F A CPL snap test can help test for canine parvovirus | False |
A cat comes in with a topical toxicity, it is cold and in shock, what is your 1st course of action? | treat for shock |
What is the most commonly used drug to induce emesis in dogs? | Apomorphine |
What is the most commonly used drug to induce emesis in cats? | Xylazine |
What is used to measure the electrical activity of the heart? | ECG |
What is the treatment for rodenticide toxicity? | Vitamin K |
Ethylene Glycol toxicity is serious and can cause acute renal failure what can we treat it with? | 80 proof vodka, Antizol-vet, or an ethanol solution |
Acetaminophen toxicity can result in ________ gums which can be an indicator of methemoglobinemia ________________ can help stop this process | Muddy, N-acetylcystine |
During CPCR patients should be given how many compression per min? | 80-100 bpm |
Which CPCR drug inhibits vagus nerve to decrease bradycardia | Atropine |
Which CPCR drug enhances blood flow to the kidneys in dogs? | Dopamine |
Which CPCR drug creates atrial constriction | Epinephrine |
Which CPCR drug stimulates respiration | Doxapram |
Which CPCR drug promote forward blood flow in cardiogenic shock | Dobutamine |
Which CPCR drug improves metabolism by increasing oxygen uptake so lactic acid levels fall | Glucocorticoids |
What GI disease is nicknamed "raspberry jam" | Hemorrhagic gastroenteritis |
What is the treatment for Hemorrhagic gastroenteritis? | Aggressive fluid therapy, pain control, maintain hygiene, put A&D or aquaphor on the anus to relieve pain from diarrhea |
if left untreated, hemorrhagic gastroenteritis can lead to what major complication? | anemia, death |
What 4 routes can poisons/toxins enter the body? | ingestion, injection, inhalation, topically |
How do you triage a potential toxicity? what do you ask the owner? | how long ago were they exposed, did you witness the exposure, what is the substance, what is the animals condition now, |
What is the most important question to ask when triaging a toxicity? | When was the last time the animal was acting normally? |
When would gastric lavage be used? | When emesis is contraindicated ex. corrosive agents. dyspnea, seizures, ccomatose |
What does activated charcoal do? | Binds to toxins/food, |
Why is activated charcoal used? | used to help limit absorption of the toxin, |
Give an example of when activated charcoal would be used | Raisin toxicity, after emesis to absorb remaining toxins |
For what vital function is vitamin K necessary? | coagulation |
What is the main presenting symptom for mega esophagus? | regurgitation |
list 2 presenting symptoms and a treatment for mega colon | unsuccessful defecation, painful abdomen on palpation (may be able to feel impacted feces), Fluids and warm saline enema |
list 2 presenting symptoms and a treatment for FB | Hyper salivation, excessive swallowing, anorexia = SURGERY |
list 2 presenting symptoms and a treatment for Permethrin | tremors/seizures, cats go crazy = baths w/ dawn |
list 2 presenting symptoms and a treatment for grapes/rasins | GI upset v/d= induce emesis, activated charcoal |
What does SLUDDE stand for | salivation, lacrimation, urination, defecation, dyspnea, emesis |
What drug can be used to help with tremors? | methocarbamol |
What toxicity causes SLUDDE? | Organophosphate |