Vet Finals @VetFinals
The Award Winning #VetFinals - free interactive veterinary revision sessions for vet and VN students, helping them revise. Founders @mossposs, @mwhiting81 vetfinals.wordpress.com Nottingham Joined November 2012-
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Good night guys! Hope it was useful - my dog is very confused as to why I haven't fed him yet and just been staring at the computer so I better give him some food!
Thanks for a great case this evening Tom! And thanks to everyone that's got involved with #vetfinals this year!
Wow, I can't believe that is an hour already, anyone got any questions? #vetfinals
Sensible choices - I'm a go big or go home kind of person, so I would opt for methadone. Also paracetamol as an adjunct is an excellent suggestion. Key here is to avoid an NSAID for now until we've assessed perfusion and BP over the longer term #vetfinals
Okay, so we also need to consider what kind of pain relief we are going to use with this patient, what would you like to go for? #vetfinals
Pain! it's important to recognise this, because if the patient was in hypovolaemic shock from bleeding into it's lungs, it will have drowned by now. If you decide to give a fluid bolus to this patient you'll pop more clots and make it worse - a common mistake made. #vetfinals
Excellent! The pedantry worked - so BP is our enemy here, high BP is going to pop those clots. Now many of you have already mentioned treating this but... BP 5 minutes after presentation was - Sys 200, Diastolic 120. Why do you think that's the case? #vetfinals
Flow by/mask in short term sounds sensible, and nasal cannulas long term would be excellent! Cages make it difficult to reassess this patient. Hattie spotted the trick question - contusions, difficult to treat specifically, how could we make them worse though? #vetfinals
Cool, so blood identified - our animal has pulmonary contusions which we need to treat; so a lot of you have already alluded to oxygen therapy as well so - how do you want to treat contusions? How would you like to give oxygen in the short term and long term #vetfinals
Okay great, so we've identified that there is fluid inside the lungs, next question though is what type of fluid? What do you think it most likely is? #vetfinals
Brill - right lets get the scanner out then; on VetBLUE (Bedside Lung Ultrasound Examination) you see the following (if the video attaches properly!!!) #vetfinals
Good replies - Okay, so... T - 37.8c M - pink, CRT1.5 P - 148, pulse quality good. RR - 60, RE - dyspnoea Neuro - PLRs consensual, normal, no anisocoria, mentation is alert and responsive, but painful. What's your main concern? How will you assess? #vetfinals
MBSA and triage is winning - time to be pedantic now though, when you say MBSA or ABC - what are you actually, physically, going to do? i.e. how do you assess those things? #vetfinals
Good evening everyone, I didn't realise this was the last one so I'm honoured! To get the ball rolling; an owner comes running through the door of your practice carrying her springer spaniel shouting "he's been hit by a car" - what are you going to do first? #vetfinals
Just 5 minutes until we kick off and hand over to Tom, remember to use #vetfinals in your replies this evening!
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1K Followers 786 Following Tweeting about veterinary education, professional development and life, and the value to Society of professional regulation.@VetFinals #vetfinals Methadone q4hrs asses on GPS towards the start of the next dose (consider multimodal) + paracetamol
@VetFinals If the pulmonary capillaries are already damaged then over hydration may cause more fluid leakage and higher blood pressure causing further damage? #vetfinals
@VetFinals #vetfinals because we don't want to dislodge the clots that are already there,
@VetFinals #vetfinals TXA to help clotting and stop more haemorrhage? Oxygen best by nasal prongs, but can use mask for now.
@VetFinals #vetfinals b-lines!!! Indicates fluid on the lung??
@VetFinals Main concerns are high hr, high resp rate and dyspnoea. Also pain relief is needed (this may help with the increased hr) I would start with a tfast and auscultation of the chest to check lung sounds do we have fluid etc going to X-ray if stable enough #vetfinals
@VetFinals #vetfinals my main concerns ATM is the breathing. Stick a scanner on that chest! If you can try to get a quic conscious x-ray?
@VetFinals Take the dog and a triage assessment ASAP with MBSA, provide analgesia and perform a FAST scan to assess for internal injuries. Get someone to calm the owner down and get a good history from the owner about when it happened, what they saw. #vetfinals
@VetFinals Pergolide? Depending on size start at 1 tablet per os once a day and review in 4 weeks? #vetfinals
@VetFinals Definitely positive for this time of year? Should be <200/250? #vetfinals