Lecture 10A- Triage

What is triage?

The prioritization of treatment based on medical need.

What should you visually assess during triage?

Ventilation effort, ventilation pattern, and any audible airway sounds.

What abnormal things should you look for during triage?

Blood, vomitus, or anything abnormal for the patient.

What should you notice about the patient during triage?

Posture and level of consciousness.

How quickly should stabilization begin for Category 1-2 patients?

Within 5 minutes.

What is Category 1?

Obvious emergency.

What is Category 2?

Strong potential for emergency.

What is Category 3?

Potential emergency.

What is Category 4?

Non-emergent.

What is a primary survey?

An initial brief assessment of the patient.

What should you always remember during the primary survey?

Your ABCDEs.

What does A stand for in ABCDEs?

Airway

What does B stand for in ABCDEs?

Breathing

What does C stand for in ABCDEs?

Circulation

What does D stand for in ABCDEs?

Dysfunction

What does E stand for in ABCDEs?

Whole-body examination

What are the ABCDEs in order?

Airway → Breathing → Circulation → Dysfunction → Examination.

How can the airway be assessed?

By visualization, palpation, and auscultation.

What are examples of airway/breathing emergencies?

Apnea, airway obstruction, open chest wounds, severe pneumothorax, and hemothorax.

What are clinical signs of airway/breathing problems?

Stridor, intercostal retraction, decreased breath sounds, restlessness/anxiety, cyanosis, and absent air exchange.

What do large airway obstructions usually sound like?

Loud sonorous or squeaking sounds during inspiration or expiration.

What do lower airway obstructions cause?

Wheezes.

What can cause diminished heart and breath sounds?

Pneumothorax, pleural effusion, and diaphragmatic hernia.

What do crackles suggest?

Fluid-filled airways, such as pulmonary edema, pneumonia, or contusions.

When can crackles be heard?

During inspiration or expiration.

How is circulation assessed?

By visualization, palpation, and auscultation.

What are signs of inadequate perfusion?

Abnormal level of consciousness, increased heart rate, abnormal pulse quality, pale mucous membranes, prolonged CRT, decreased appendage temperature.

What can cause inadequate perfusion?

Hypovolemia, pump failure, toxicity, anesthesia overdose, severe hypo/hyperthermia, severe electrolyte abnormalities.

How is nervous system dysfunction assessed?

Through visualization and palpation.

What neurological parameters are particularly important to assess?

Level of consciousness, pupillary light reflex, menace reflex, posture, and response to pain.

What can abnormal pupil size with a diminished pupillary light reflex indicate?

Neurological involvement, assuming no ocular trauma is present.

What is hyperesthesia?

Increased sensitivity to stimulation/pain indicating possible nervous system abnormality.

How is superficial pain tested?

By pricking or pinching the skin.

How is deep pain tested?

By applying a strong noxious stimulus to the toes or a joint.

What does withdrawal of an appendage alone indicate?

A spinal reflex; it does NOT rule out a more proximal spinal cord lesion.

What is E in ABCDE?

Whole-body examination.

What is the purpose of the whole-body examination?

To identify additional injuries or abnormalities.

What can a whole-body examination uncover?

Major lacerations and bruising, among other abnormalities.

What is a secondary survey?

A timely, systematic evaluation of each body system after initial stabilization.

What comes first: primary or secondary survey?

Primary survey, followed by stabilization, then the secondary survey.

What does HBC stand for?

Hit By Car.

What emergency commonly requires immediate triage and is specifically emphasized in the lecture?

GDV (Gastric dilatation-volvulus).

What are examples of emergencies requiring immediate triage?

GDV, HBC, respiratory distress, urinary obstruction, saddle thrombus, toxins, and seizures.

What does GDV stand for?

Gastric dilatation-volvulus.

What are common examples of veterinary emergencies?

Gunshot wounds, snakebites, burns, dog fights, poisonings, foreign bodies, and parvovirus.

What are common cardiovascular emergencies?

Cardiopulmonary arrest, hypovolemic shock, congestive heart failure, and aortic thromboembolism.

What are common non-cardiac emergencies listed?

Acute abdomen and poisoning/intoxications.

What are common urogenital emergencies?

Azotemia, acute renal failure, and FLUTD with obstruction.

What are common reproductive emergencies?

Pyometra and dystocia.

What is dystocia?

Difficult or abnormal labor/birth.

What are common endocrine emergencies?

Diabetic ketoacidosis (DKA) and hypoadrenocorticism.

What information should always be gathered during a triage phone call?

Owner name, patient name, breed, age, chief complaint, and prior medications.

What determines the follow-up questions during telephone triage?

The type of emergency.

What should you always recommend to the client during a triage call?

Bring the patient into the clinic.