Triage

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

In equine medicine, triage is a pragmatic process of prioritizing patients based on the severity of their condition and the underlying life-threatening 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 horse which has been so for 3 days is less critical than an acutely feverish horse that has become comatosed in the preceding hour. Also, a horse with a femoral fracture that presents 6 hours after the motor vehicle accident, is less critical than a horse which is vomiting frank blood.

Emergency medicine requires rapid diagnostic skills and experience to interpret presenting clinical signs in face of the care-giver's frantic appeal for veterinary intervention.

Principles

  • The 'A, B & C' of triage
  • Normal TPR, haematology and biochemistry values
  • Fluid therapy
  • Shock
  • Blood transfusion
  • Electrolyte disorders
- Potassium (K+) imbalances - Hyperkalemia, Hypokalemia
- Phosphorus (P) imbalances - Hyperphosphatemia
- Calcium (Ca2+) imbalances - Hypocalcaemia, Hypercalcaemia
- Acid/alkali (pH) imbalances - Acidosis/alkalosis, D-lactic acidosis

Clinical cases