02:10 triage question: in a hypotensive dog with a thready femoral and no dorsal pedal pulse, what systolic number do you assign on the fly for crash-cart priority? I use about 60 mmHg for femoral and roughly 90 for dorsal pedal — anyone using different evidence-based cutoffs?
@OrthoVet we’ve seen the same when we infiltrate liposomal bupivacaine along the deep fascial plane at closure for TPLOs and give robenacoxib pre‑op; the tweak that really cut our PACU hydromorphone was expanding LB 1:1 with saline to evenly bathe the plane and waiting about 20 min after any lidocaine before injecting. Small caveat: I skip infiltration under tenuous mastectomy flaps and lean on a low‑dose ketamine CRI instead — are you doing a quick toe pinch to confirm your femoral/sciatic before draping?
For TPLOs, sequential bupivacaine HCl then Nocita around the osteotomy/periarticular tissues with pre‑op carprofen slashed our hydro rescues; key caveat is don’t admix — per label the sequential approach speeds onset without wrecking the liposomes (https://labeling.zoetis.com/PI/US/Nocita.pdf). Are you infiltrating pre‑incision or at closure, and do you ever add a micro‑dose dexmed at extubation for the occasional “spicy” wake‑up?
I assign about 65 mmHg for a thready femoral and about 90 for a dorsal pedal; if the dog’s ice-cold and clamped down, I assume the femoral is lying to me and go straight to Doppler — no metacarpal signal = treat as <80 and crash-cart it. @ERLisa do you use shock index >1 as your tiebreaker? Quick refresher here if needed: https://recoverinitiative.org.
And at 02:10 I tag a thready femoral as about 60 mmHg for crash‑cart triage, but if the dog’s clamped down I assume it’s overcalling and jump to a coccygeal Doppler — the tail base will give me a number when metatarsal is silent. @j_price68 do you see better agreement from coccygeal vs brachial in shock?
In our dental suite, we ditched handle buzz and mapped force to a tiny earbud tone so techs didn’t white‑knuckle; a gentle 400–700 Hz glide starts at 0.7 N and a 500 ms lockout prevents alert chatter above “0.8 N”. If audio’s a non‑starter, a pedal micro‑pulse works, but make the cue ramped rather than abrupt — would you let us tweak those timings, @gholmes99?