What do you need to get ready before they arrive?
Ok so we've got our bits and pieces ready and the dog arrives and is brought out to the back. What do you do?
We've got a good consensus going on here 🙂 Dom agrees and reminds us of the importance of the neurological system:
We do an assessment…
Neuro: conscious, aware of surroundings, was seen to walk shortly after the accident
Cardiovascular: HR 160bpm, regular rhythm, tall and narrow peripheral pulses, cyanotic mucous membranes
Respiratory: panting, orthopnoeic stance, lung sounds not audible on dorsal thoracic auscultation
Let's start by providing some oxygen! How are we going to do this?
We're right to recognise that it depends on patient stress levels:
Flow-by is good, can also use an oxygen cage.
Masks, nasal prongs and nasal catheters might not be effective/appropriate in an emergency situation. Remember that for a mask to be effective it must be around the muzzle – panting dogs don't like this and increasing their stress is not good!
Nasal prongs are good if they're tolerated. Some people say they're not great if the dog is panting but some oxygen is better than none!
Humidified oxygen is ideal for all of these routes of administration but is not essential in an emergency.
Dom then gave us 4 choices of what to do next:
Did anyone go for anything else?
What's the verdict?
How do we perform thoracocentesis? What equipment do we need and where do we go?
Good job, Dom says we need a needle long enough to get into the thoracic cavity, extension tubing, a 3 way tap and a syringe. A butterfly catheter is commonly used if the needle is long enough (all cats and small-medium dogs).
Have the patient in sternal recumbency, then go for the 7th-9th intercostal space and insert the needle at the cranial border of the rib. As we're removing air, we want to be in the dorsal 1/3 of the thorax.
How many people do we need?
Why is it important to insert the needle off of the cranial border of the rib?
Which layers does the needle go through to get into the thorax?
What are the risks of thoracocentesis?
What is our ongoing plan?
Thanks again for a great session Dom – hope everyone found it useful!