Triage Workshop

What are the important questions to ask when considering equine emergencies?

1. What clinical signs and behaviours have you seen?

2. How long has the horse had clinical signs/when was it first noticed?

3. Has the horse been treated in any way?

4. Has the horse previously had the condition: if so, what was the course of treatment and the response?

What are the most common emergencies in equine practice?

• Colic

• Wounds

• Severe lameness

• Respiratory distress

• Choke

• Eye problems

• Laminitis

What are some treatment considerations in equine emergencies?

• Owner factors

• Horse suitability

• Referral options

• Ethics/welfare

• Concurrent conditions

• Finances

• Availability of treatment

What are some stabilisation options in equine emergencies?

• Condition-specific treatments

• Symptomatic treatments

• Supportive therapies

• Consider home/hospital

What are the key questions to ask when considering exotic emergencies?

1. How long has the animal had clinical signs/when was it first noticed?

2. What is their environment/husbandry like?

3. What are the financial limits: is referral an option?

What are the most common emergencies in exotics practice?

• Respiratory issues

• Gastrointestinal issues

• Cloacal prolapses

• Fractures

• Injuries

• Unresponsive animals

• Neurological signs (e.g seizures)

• Regurgitation

• Fly strikes

What are some treatment considerations in exotics emergencies?

• Reptiles do not show pain outwardly: do not forget about analgesia

• Reptiles are ectotherms: become unresponsive when cold

• Small mammals get ‘gut stasis’ secondary to other issues: can be life threatening

• Acute changes can often be more life threatening than the primary issue(s)

What are some stabilisation options in exotics emergencies?

• Analgesia

• Warmth

• Oxygen

• Fluids

• Monitoring heart rare

• Providing nutrition

• Antibiotics (if applicable)

• Fracture stabilisation (if applicable)

What are some key things to consider in exotics emergencies?

• Reptiles get sick slowly and get better slowly

• Birds get sick quickly and get better quickly

• Prey species (e.g rabbits) often hide disease very well: when they begin to look poorly, they are often very unwell and unable to hide it anymore

What are the most common emergencies in farm animal practice?

• Cardio-respiratory: haemorrhage

• Urogenital: calving/prolapse

• Neurological: hypomagnesaemia/hypocalcaemia

• Trauma

• Intoxications

Which factors should you consider when prioritising farm animal emergencies?

• Body systems/presenting signs

• Location

• Description of events

• Duration of signs

• Treatment administered

Which safety questions should you ask in farm animal emergencies?

1. Is the animal adequately restrained?

2. Is there any machinery involved?

3. Are there other animals involved?

How should you organise your clinical exam in farm animal emergencies?

• Assess main body systems thoroughly

• Create a list of all the problems and prioritise them

• Focus on the main issue(s)

• Think about further treatment moving forwards

Who are the emotional stakeholders in small animal emergencies?

• Vet

• Nurse

• Receptionist

• Client

• Animal

What are the 2 types of language barriers in emergency medicine?

• Veterinary terminology

• Actual language barrier

What are the logistical questions to consider in small animal emergencies?

• Will the patient arrive on time?

• Is there another emergency on the way?

• Will we have time to stabilise the patient before it worsens?

• How big is the patient that’s coming?

• Is the patient insured?

• Can the owner afford treatment?

• Will the owner’s finances affect the treatment that can/should be administered?

• Should we consider euthanasia?

• Should this patient be saved?

• Who has brought the patient in? Owner/guardian/member of the public?

• Can they legally sign

What is meant by the term ‘triage’?

The evaluation and allocation of treatment to patients according to a system of priorities designed to maximise the number of survivors

What is the system of priorities in small animal emergencies?

Body systems

• Cardiovascular, respiratory and neurological are most important

• Renal and abdominal

Intoxications

Trauma (wounds/fractures)

What does DR ABC stand for?

D: Danger

R: Response/rapid bleeding

A: Airway

B: Breathing

C: Circulation

What should you check for if there is no response during a small animal emergency?

Airway:

• Is there anything obstructing the airway?

• Secure with an endotracheal tube if possible

• Take care not to get bitten

Breathing:

• Is the chest rising and falling?

• Can you hear/feel breath?

• If not: give 2 rescue breaths

Circulation:

• Is there a heartbeat/femoral pulse?

• If not: start compressions

Draw out the CPR initial assessment algorithm

What neurological symptoms should you look for during small animal emergencies?

• Seizures

• Abnormal gait

• Coma

What renal symptoms should you look for during small animal emergencies?

• Urine output

• Palpable bladder

• GFAST

What abdominal symptoms should you look for during small animal emergencies?

• Abdominal pain

• Distension (blood/fluid)

• GFAST

What intoxication symptoms should you look for during small animal emergencies?

• History of ingestion

• Strange behaviour

• Organ failure

What trauma symptoms should you look for during small animal emergencies?

• Blood/wounds

• Recumbency

• Lameness/gait abnormalities

Define a veterinary emergency

Any sudden, unforeseen injury, illness, or condition in an animal that threatens its life, or risks permanent damage or severe pain- requiring immediate veterinary treatment

How can you safely work around recumbent animals?

• Wear protective gear

• Approach calmly- avoiding sudden movements

• Protect the head (e.g using a blanket)

• Turn the animal every few hours