Triage


Triage is a term derived from the French language, meaning a process of selecting or prioritising.

In feline medicine, triage is a pragmatic process of prioritizing patients based on the severity of their condition and the underlying life-threating nature of that illness. It focuses on treating those illness in an appropriate logical manner to avoid unnecessary, contraindicated or expensive treatment.

As a general rule, a comatosed, recumbent cat which has been so for 3 days is less critical than an acutely feverish cat that has become comatosed in the preceding hour. Also, a cat with a femoral fracture that presents 6 hours after the motor vehicle accident, is less critical than a cat which is vomiting frank blood.

Emergency medicine requires rapid diagnostic skills and experience to interpret signs which are often masked by the cat’s temperament (often fractious when injured) and the care-giver’s frantic appeal for veterinary intervention.


Normal clinical values for cats:


Temperature 37.8°C – 39.3°C
Heart rate 120 – 140 bpm
Respiratory rate 16 – 40 bpm
Capillary refill time (CRT) < 2 sec
Capillary colour pink/red
Urine volume 10 – 20 mL / Kg / day
Urine specific gravity (USG) 1.020 – 1.040
Blood pressure < 160/130 mm Hg

Principles

  • The ‘A, B & C’ of triage
  • Normal TPR, haematology and biochemistry values
  • Fluid therapy
– Sodium imbalances (Na+) – Hyponatremia, Hypernatremia
– Potassium (K+) imbalances – Hyperkalemia, Hypokalemia
– Phosphorus (P) imbalances – Hyperphosphatemia, Hypophosphatemia
– Calcium (Ca2+) imbalances – Hypocalcemia, Hypercalcaemia
– Acid/alkali (pH) imbalances – Acidosis/alkalosis, D-lactic acidosis
  • General anaesthesia

Triage cases

  • Status epilepticus
  • Shock
  • Dyspnoea
  • Blood transfusion
  • Acute renal failure
  • Pyometron
  • Gastric-dilation volvulus
  • DIC – disseminated intravascular coagulation
  • Peritonitis
  • Refeeding syndrome

Leave a Reply

Your email address will not be published. Required fields are marked *