Parameters to Evaluate During Triage
Parameters to Evaluate During Triage
Parameter | Evaluation | Significance |
|---|---|---|
Mucous membrane color | Pink | Normal PCV and adequate perfusion |
Pale or white | Anemia or shock | |
Cyanotic or muddy | Severe hypoxemia or decompensatory shock | |
Yellow | Increased serum bilirubin due to hepatic disease or hemolysis | |
Capillary refill time | 1–2 seconds | Normal perfusion and rapidity with which capillaries refill with blood |
>2 seconds | Poor perfusion or peripheral vasoconstriction | |
< 1 second | Hyperdynamic states; could be associated with fever, heat stroke, distributive shock, or early compensatory stage of hypovolemic shock | |
Heart rate | 70–120 bpm (small dogs) 60–120 bpm (large dogs) 120–200 bpm (cats) | Normal heart rates; indicate that at least one component of cardiac output is normal |
Bradycardia | Decreased cardiac output and subsequent poor perfusion; cats in particular develop bradycardia (< 120 bpm) in shock; an irregular, slow heart beat can be associated with imminent cardiac arrest, severe arrhythmias, or metabolic derangements ( hyperkalemia, hypocalcemia Hypercalcemia in Dogs and Cats Hypercalcemia is diagnosed when calcium is elevated outside of normal reference ranges. This usually indicates an underlying disease process causing the dysregulation of calcium homeostasis... read more | |
Tachycardia (dogs >180 bpm, cats >220 bpm) | Compromised diastolic filling; sinus tachycardia often results from hypovolemic shock, pain, or primary cardiac disease; tachycardia that is irregular or associated with pulse deficits usually indicates an arrhythmia, and an ECG is indicated | |
Pulse rate and quality | Strong and synchronous with each heart beat | Normal; both femoral and digital pulses should be palpated |
Irregular | Usually indicative of a cardiac arrhythmia | |
Bounding | Hyperdynamic (compensatory) state of shock; indicates an increase in pulse pressure (ie, an increase in systolic pressure, decrease in diastolic pressure, or both) | |
Weak or absent | Decreased cardiac output (including cardiopulmonary arrest), peripheral vasoconstriction, decreased pulse pressure, or thrombosis | |
Level of consciousness | Alert and responsive to surroundings | Normal overall neurologic and metabolic state |
Depressed or obtunded (less responsive to visual and tactile stimuli, sleepy appearance but still arousable) | Can be caused by any illness or decreased perfusion; may be mild, moderate, or severe | |
Stupor (arousable only with painful stimuli) | Severe neurologic or metabolic derangements, including toxin ingestion | |
Comatose (unarousable with any stimuli) or seizures (usually associated with whole body convulsions, salivation, facial tremors, possibly involuntary urination and defecation) | Abnormal cerebral electrical activity from primary neurologic disease or secondary to metabolic derangements seen in diseases such as diabetes, hepatic encephalopathy, hypoglycemia, or toxin exposure; accurate history or prior health problems, current medications, and possible toxin exposure important | |
Level of pain | Vocalization, changes in behavior (avoidance, aggression), or physical changes (tachycardia, dilated pupils, etc) | Clinical signs can be similar to those seen in compensatory stage of shock; pain delays healing and must be treated. |
