Advanced Pet First Aid Level 3 (VTQ)

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Comprehensive Assessment and Checking Vital Signs Example

Video 44 of 137
11 min 32 sec
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If you are doing a more in-depth examination of your pet, then you would be looking at feeling and smelling and looking for anything abnormal on them that you could report back to your vet. You would also start to take records and measurements of what we would classify as vital signs. The vital signs that I mean mainly would be a pulse rate, a heart rate, respiratory rate, possibly a temperature if that was something that was safe for you to take on your pet. And also something called a capillary refill time. So we will start at the head end of the animal. What you are looking for, as I said, is anything that is abnormal for your pet and if this is an animal that you know well, then you will get to know what is normal for them, so that if anything else changes you will know that that is not normal for them.

You would start at the head, start at the nose and the mouth and be looking for anything that is not usual. Have a look inside the mouth and have a look at the colour on the inside of the lip or the gum. Now, in most animals, you will find a bit of pink membrane inside the lip or on the gum line. So Elsa has quite a lot of black up here on her gum, but she does have a lot of pink underneath her lip there. This is where you will be looking for what is called the capillary refill. So the gum and the lip have lots of little capillaries running through them. They indicate that there is a good blood supply to the lip and the gum. You have capillaries in lots of parts of the body, but because animals are very furry and hairy, you cannot see those capillaries, but in these locations and also in the membrane of the conjunctiva of the eye, you can see that pink colour. So these are good locations for you to have a look at the colour and then to do what is called the refill. What we do with this, is we find a nice pink area and we put our thumb on it and compress those capillaries. So we are temporarily stopping the blood flow through the capillary. It will go white and then it comes back pink very quickly in Elsa, this is what we are timing.

So in most animals, the capillary refill time is going to be less than two seconds. With Elsa, that is less than one second, it is coming about very quickly, indicating that there is good blood flow, good blood pressure coming out to those capillaries in what we would call the extremities of the body. So if you are getting good blood flow out to the extremities, that is a pretty good indication that you are getting good blood flow around the rest of the body.

Further back, we would start to check ears; again, we are looking for any changes in colour and smell and discharge and pain as well. So if when you are looking in the ears, there is any flinching, head shaking, resentment of what you are doing, then again it is an indication of that there may be an issue in there. Ear canals are very, very long in a lot of dogs and fairly long in other breeds as well, so you will not be able to see to the base of the ear canal, that is what you would go to the vet for so that they would be able to have a look at with an otoscope, but you can notice colour changes and definitely smells that are coming from the ear that may not be normal for your dog.

Coming back, we will be looking at any injuries, along either of the front legs, so you would get your dog to stand up if possible or your cat, whatever you are looking at and start to feel down the leg, feeling around the joints. If you know where the shoulder joint is and the elbow joint and the carpus, then you know you are feeling for those specific joints for any pain, any swelling and any heat, those are all indications that may be an injury to the joint. So feel along, in addition to looking for the swelling and heat, you are also looking for any sign of an injury that may have caused there to be a bleed, so like a cut. In animals, it is very difficult to see cuts if they are quite superficial because of all the fur, but there will often be a little bit of blood on the fur and you may pick that up with your hands when you are looking through.

When you come down to the feet, again, you are looking for bleeding or any sign of swelling and it may not be over a joint, it could be just over a part of the anatomy. So over the foot, over a toe, not necessarily a joint. That may be an indication that a foreign body has entered the foot or maybe a fractured bone. There is going to be pain and there is going to be swelling around wherever that injury has occurred. You want to be making sure that you are looking underneath the foot as well. Having a really good feel in-between the pads of the foot. And making sure they are comfortable with you manipulating that leg around a normal range of movements for each of the joints. So can they extend the leg, can they flex the leg comfortably? And do that with all the joints and just make sure that everything is comfortable.

Coming further back over the chest. You want to be examining them again for any signs of bleeding, any signs of fur loss, which could indicate there is an issue with that particular part of the body. Maybe there is a skin issue and that is why they have lost their fur, maybe that they have scratched at that particular parts of their body and it is a self-excoriation that they have lost the fur through that way. It may be that there has been an injury and they have managed to rip that fur off through having the injury. Check for all those things. So, as well as feeling, you want to be getting under and having a really good look and making sure that everything looks completely normal.

The other area of the chest is the... This is where you would take your respiratory rate. So you want to be looking and feeling and counting the respiratory rate. So the normal respiratory rates do vary from species to species and even within the species, they vary quite a lot, but generally speaking, for a dog, you would expect a respiratory rate of between 10 and 30 breaths per minute. And for a cat, it would be more like 10 up to 40. They are a lot faster in cats. And then in smaller dogs, it would be faster as well. The main thing is to get used to what is normal for your pet. So have a mental record of what is normal for them. The most reliable respiratory rate is when an animal is asleep, so when they are at rest and they are having involuntary breathing, count it per minute and that is the record that you need to keep a mental note of as their breaths per minute.

The other vital sign that you would be getting around the chest is the heart rate. You are not going to be able to get a heart rate in a lot of animals without using a stethoscope. With some animals, you will be able to place your hand roughly where the heart is on the left-hand side, where the elbow meets the side of the chest. And you may be able to feel the heart in very lean animals. If you cannot, then you would need a stethoscope.

We would listen for the heart in that same location with a stethoscope and again, count the heart rates per minute. The heart rate should normally, as long as there no issues, be the same as a pulse rate. So pulse rates are the rate that we are getting from the arteries elsewhere in the body that is away from the heart. The most common pulse that we take is the femoral pulse, so the femoral pulse is along the inside of the back leg. The femur of an animal is this bone here that runs from the hip to the stifle joint and the pulse that we are going to get runs alongside the inside of the femur. You should be able to feel it up in the groin area. If you put two fingers up into that area, you will be able to feel a pulse and if you count that pulse it should, in healthy animals where there is not a heart problem or a circulation problem, it should be the same as the heart rate. Again, this is something that you can do on your own pet to find out what is normal for them and keep a mental note of it. It will differ, it will vary depending on what they have been doing, if they are asleep it is likely to be quite slow and if they have just been out having a good run, it is likely to be a lot faster, so just be aware of the changes and know what is normal for your pet.

There are other areas of the body where you can take a pulse rate and it may be that in an injury situation, where there is pain or a problem over the back end that you will not be able to take a femoral pulse and you have to go somewhere further up in the animal. The other good pulses to get, on the back of the foot, in between the carpus and the foot and we do not have a lot of muscle there, so you can feel the pulses in that area as well.

In an unconscious animal, you can also take a pulse from underneath the tongue. You can often see those pulses when your animal is asleep or if they are unconscious you may be able to see them there, but in an awake animal it is not the safest area to try and get a pulse. Coming further back, you want to be feeling for, as over the front legs, for any areas where there may be pain, any blood, any discharge, also start to look underneath or through the coat and see if there is any sign of discharge, scurviness, scabbiness going through the coats, because if it is an old injury or if there is not an injury, but there is a skin condition, for example, you may start to notice that there is flaky bits or discharge from a skin condition in the fur. So have a really good feel and look and even smell, because certain conditions will have a distinct smell to them and these are all things that are important to make a note of so you can then relay this back to the vet when you are discussing the changes that you have noticed in your animal.

Coming back to the back legs, if you can get them to stand up again and have a really good feel. Also look, like we said, with the... All over the rest of the body look for any areas where there is fur loss and look for any signs of pain. So when you are feeling, if they are flinching, if they are pulling their foot back when you are touching their foot and also when you are then manipulating the limb, they should be happy for you to flex that joint right up the hip and the stifle and to extend the hip and the stifle back. The same with the hock, you should be able to just bend that and feel around the digits. If you are feeling any swelling or heat, again it is telling you where the location of the injury may well be.

And finally down to the tail and we are having a good feel, looking for all those normal things there, is it nicely furred? Is there any discharge? Is there any pain when you are palpating along the tail?