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, etc.) |
|
|
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 |
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|
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. |