Trauma: overview

Cardiovascular system

Emergency

Aim

• Arrest hemorrhage and restore blood pressure to maintain adequate vital tissue perfusion.

Procedure

• Control external hemorrhage - ligation or compression bandage to all exposed bleeding tissue.
• Warmth, restrict movement.
• Analgesia     - but avoid respiratory depressants.
  An animal with chest pain (eg fractured ribs) will ventilate better with analgesia.
• Restore blood pressure with intravenous fluids    :
  • Blood - crossmatched if possible    .
  • Plasma.
  • Plasma expanders.
  • Electrolyte solutions    .
• Consider need for emergency surgery if continued evidence of blood loss.
• Assess:
  • Femoral pulse.
  • Capillary refill time (CRT).
  • Respiratory rate.
  • Packed cell volume    and total plasma protein    .
  • Electrocardiogram - if readily available or poor response to fluid therapy    .
  • Patient demeanor.

Follow-up

• Monitoring as above.
• Check blood supply to traumatized areas:
  • Edema.
  • Pulse.
  • Warmth.
  • Local CRT.
  • Pressure bandage - check not restricting venous return.
• Maintain fluid balance IV or PO as necessary.

Sources

Publications

Refereed papers

• Recent references from PubMed .

Other sources of information

• Rozanski E (2003) Approach to the trauma patient. A Bridge to the Future Veterinary Conference. http://www.iknowledgenow.com/tocbridgetothefuture.cfm .