Manual of Trauma Management in the Dog and Cat

Kenneth J. Drobatz, Matthew W. Beal, Rebecca S. Syring, Kenneth J. Drobatz, Matthew W. Beal, Rebecca S. Syring

• Publisher: Wiley-Blackwell
• Year: 2011
• Print ISBN: 9780470958315
• eBook ISBN: 9780470959305
• Edition: 1
• Topic: Medicine
• Subtopic: Veterinary Medicine

Manual of Trauma Management in the Dog and Cat provides quick access to clinically relevant information on stabilizing, diagnosing, and managing the trauma patient. The book uses an outline format to provide fast access to essentialinformation, focusing on practical advice and techniques for treating traumatic injuries. Manual of Trauma Management in the Dog and Cat is an ideal handbook for quickly and confidently managing this common presenting complaint.

Beginning with a concise summary of the global assessment of traumatized patients, the heart of the book is devoted to guidance on managing specific types of trauma following definitive diagnosis. Manual of Trauma Management in the Dog and Cat is a valuable quick-reference guide to treating canine and feline trauma patients for general practitioners and emergency specialists alike.

Chapter 1

GLOBAL APPROACH TO THE TRAUMA PATIENT

Kenneth J. Drobatz

1. GLOBAL APPROACH TO THE TRAUMA PATIENT

a. Trauma is defined as a “wound or injury” and may occur secondary to motor vehicle accidents, fall from heights, animal interactions, human-animal interactions, etc. Severity may range from mild to fatal. Trauma may affect only one organ system or multiple organ systems, either directly or indirectly. Therefore, a global and thorough approach is required to improve survival and decrease morbidity in trauma patients.

b. Initial assessment of the trauma patient occurs quickly but can theoretically be broken down into two major phases; primary survey and secondary survey:

i. Primary survey is the assessment of the respiratory and cardiovascular systems, followed by assessment of the central nervous system and urinary tract system.

ii. Secondary survey is assessment of all other systems once the animal's most immediately life-threatening problems, identified during the primary survey, are dealt with.

c. The primary goal in attending to a critically injured trauma patient is to optimize oxygen delivery to the tissues. In fact, during the initial approach and resuscitation of these patients, all procedures are oriented toward this goal. Oxygen delivery is dependent upon cardiac output, hemoglobin concentration, and oxygen saturation of hemoglobin. It is important to optimize these variables at all times.

2. BRIEF PATHOPHYSIOLOGY

a. Traumatic shock results in a maldistribution of blood flow because of increased circulating catecholamines, hypovolemia, and increased vasoactive hormones.

b. Persistent microcirculatory perfusion failure may lead to sludging of blood and increased cellular and platelet aggregation.

c. Endothelial injury due to trauma may result in release of inflammatory mediators and stimulation of coagulation.

d. Damaged cellular membranes, due to poor perfusion or direct trauma, result in release of phospholipids. The enzymes phospholipase, cyclooxygenase, and lipoxygenase produce thromboxane and leukotrienes:

i. Thromboxane causes vasoconstriction, further compromising tissue perfusion and stimulating platelet aggregation.

ii. Leukotrienes and activation of the complement cascade propagates the inflammatory response with mobilization and activation of neutrophils.

iii. Neutrophil release of lysosomal enzymes and toxic oxygen metabolites cause further cellular damage, leading to edema with subsequent increase of oxygen diffusion distance to the cells from the capillaries.

iv. Optimizing tissue oxygen delivery will minimize the perpetuation of these inflammation-producing cascades.

3. ASSESSING AND MAINTAINING OXYGEN SATURATION OF HEMOGLOBIN—THE RESPIRATORY SYSTEM

a. At presentation,...

Table of contents

• Cover
• Title Page
• Copyright
• Dedication
• Preface
• Acknowledgments
• Contributor List
• Chapter 1: GLOBAL APPROACH TO THE TRAUMA PATIENT
• Chapter 2: TRIAGE AND PRIMARY SURVEY
• Chapter 3: SHOCK IN THE TRAUMA PATIENT
• Chapter 4: MONITORING THE TRAUMA PATIENT
• Chapter 5: ANESTHESIA AND ANALGESIA FOR THE TRAUMA PATIENT
• Chapter 6: TRAUMA-ASSOCIATED THORACIC INJURY
• Chapter 7: TRAUMATIC BRAIN INJURY
• Chapter 8: TRAUMA-ASSOCIATED PERIPHERAL NERVE INJURY
• Chapter 9: TRAUMATIC SPINAL INJURY
• Chapter 10: URINARY TRACT TRAUMA
• Chapter 11: TRAUMA-ASSOCIATED ABDOMINAL PARENCHYMAL ORGAN INJURY
• Chapter 12: TRAUMA-ASSOCIATED BILIARY TRACT INJURY
• Chapter 13: TRAUMA-ASSOCIATED BODY WALL AND TORSO INJURY
• Chapter 14: TRAUMA-ASSOCIATED GASTROINTESTINAL INJURY
• Chapter 15: TRAUMA-ASSOCIATED OCULAR INJURY
• Chapter 16: TRAUMA-ASSOCIATED MUSCULOSKELETAL INJURY TO THE HEAD
• Chapter 17: TRAUMA-ASSOCIATED SOFT TISSUE INJURY TO THE HEAD AND NECK
• Chapter 18: TRAUMA-ASSOCIATED MUSCULOSKELETAL INJURY TO THE APPENDICULAR SKELETON
• Chapter 19: TRAUMA-ASSOCIATED MUSCULOSKELETAL INJURY TO THE PELVIS, SACRUM, AND TAIL
• Chapter 20: BITE WOUND TRAUMA
• Chapter 21: TRAUMA-ASSOCIATED AURAL INJURY
• Index