VEA+110+Triage wk 10

Triage Basic Physical Exam Procedures

What is Triage?

  • Triage is a French word meaning 'to sort'.

  • Involves organizing patient emergencies by level of importance.

  • The most critical patient is seen first.

  • Quick assessment (under 2 minutes) to determine severity.

  • Understanding normal parameters is essential to identify abnormalities.

Normal Parameters

  • Recognizing normal signs helps identify abnormalities.

  • Familiarize yourself with your pets to practice recognizing normal parameters.

  • More abnormal signs indicate potentially more critical issues.

Temperature

  • Use a clean digital rectal thermometer with lubrication.

  • Normal temperature range:

    • Cats: 100 - 102.5 °F

    • Dogs: 100 - 102.5 °F

  • High temperatures may indicate anxiety; notify a doctor if temperature is below 100 °F or above 102.5 °F.

Respiratory Rate and Effort

  • Normal respiratory rates:

    • Cats: 15 to 40 breaths per minute (average 26)

    • Dogs: 15 to 35 breaths per minute (average 24)

  • Count the rise and fall of the chest for 15 seconds and multiply by 4.

  • Signs of distress include:

    • Abdominal breathing

    • Unusual sounds or effort in breathing

    • Elevated respiratory rate (>60 breaths per minute)

Heart Rate

  • Use a stethoscope to listen to heart rate for 15 seconds and multiply by 4.

  • Normal heart rates:

    • Cats: 110 - 140 beats per minute

    • Dogs: 60 - 130 beats per minute (varies by size and breed)

  • Check for irregularities in heartbeats.

Mucous Membrane/CRT

  • Color should be pink with a capillary refill time (CRT) of 1-2 seconds.

  • Test CRT by pressing on the gum; it should return to pink quickly.

  • Note abnormal CRT or abnormal colors for the veterinarian:

    • Pale pink/white: low blood pressure

    • Brick red: high blood pressure

    • Gray/blue: critical oxygen deprivation.

Mentation

  • Observe the patient's attitude and behavior:

    • BAR (bright, alert, responsive) is normal.

    • Look for signs of depression, confusion, pain, or trauma.

Emergency Contact Procedures

  • Record vital information for veterinarians:

    • Current Weight

    • Temperature and CRT

    • Mentation (bright, quiet, depressed, etc.)

    • Respiratory rate and effort.

  • Note any pertinent information from the owner regarding the patient.

Exam Room Procedures

  • Ideally, triage should occur in the exam room.

  • Receptionist notifies staff when a client enters.

  • Triage can be conducted in the waiting room if no exam room is available.

Critical Immediate Actions

  • Take the patient immediately if:

    • Unresponsive

    • Not breathing

    • Gums are blue/gray

    • Bleeding profusely

    • Actively seizing.

Common Medical Emergencies

  • Obtain relevant information from clients about emergencies via phone before arrival.

  • Remain calm; ask open-ended questions for clarity.

Specific Conditions Requiring Immediate Attention

  • Trouble Breathing: needs immediate attention for causes like asthma, infections, or heart issues.

  • Hit By Car: assess injuries and inform the medical team of severity based on owner’s description.

  • Bloat/GDV: immediate surgical intervention required for deep-chested dogs.

  • Saddle Thrombus: cats with hind limb paralysis need urgent care.

  • Urinary Blockage: critical condition in male cats needing urgent intervention.

  • Seizures: frequent or prolonged seizures constitute an emergency.

  • Ingestion of toxins: consult a doctor on a case-by-case basis.

Additional Considerations

  • Lacerations and bleeding should be treated promptly.

  • Persistent vomiting, diarrhea, lethargy, or not eating should warrant immediate veterinary care.

  • Limping pets may require examination on the same day.

  • Small pets (rabbits, ferrets) showing signs of distress must be seen quickly.

References

  • Bassert, J. (2017). McCurnin's Clinical Textbook for Veterinary Technicians, 9th edition. Saunders/Elsevier.