Development of Triage Score and Management Criteria during Initial Stabilization in Taiwan Wild Bird Rescues

• Main Authors: Chia-Ying Wu, 吳珈瑩
• Other Authors: 季昭華
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/45yjn7

碩士 === 國立臺灣大學 === 臨床動物醫學研究所 === 106 === 　　To overcome high mortality rate encountered in wild bird rescue and achieve early prediction of prognosis, establishing a triage system and management criteria for birds is mandatory. A scoring system was set up to evaluate the outcomes of different levels of stabilization managements under different patient factors. 　　Signalment and physical examination parameters including body condition score, heart rate, respiratory rate, mentation, severity of symptoms and hydration state of 200 rescued birds from several wildlife rescue facilities were collected from October, 2016 to August, 2018. Prognosis and stabilization manner based on invasiveness including overnight stabilization, oxygen support, subcutaneous (SQ) fluid therapy and intravenous(IV) or intraosseous(IO) fluid therapy during the first 48-hour-hospitalization were also recorded. The Wild Bird Triage Score was set up by logistic regression analysis to predict mortality of the first 48 hours. Chi-Square Tests was performed to compare result of different management in similar score. 　　Logistic regression model indicates the heart rate score, tenting skin score and mucus membrane color score have positive correlation with mortality rate (P<0.05). The model was tested for receiver operating characteristic curve, and the area under the curve was 0.729, with 67.4% sensitivity, 70.3% specificity at the cut-off point -1.4049 The positive likelihood was 2.30. 　　The result of Chi-Square Tests demonstrate no significant differences in the first second and third class, while significant differences are noted in the fourth class. In the fourth class, the average mortality of IV/IO class are lower than SQ class, 　　The three factors are related to cardiovascular system and neurological system, similar to previous literatures of human and small animal medicine. Therefore, evaluation of cardiovascular system and neurological system should be the first priority after animal admission. In a previous study, mallard ducks showed heart rate alternation after acute hemorrhage. These risk factors were not investigated in previous wild bird prognostic indicators studies. It emphasized different rehabilitation stages may require different assessments. As for therapy strategy, intravenous or intraosseous fluid therapies could reduce mortality rate in patients of different severity, while subcutaneous fluid therapy is more appropriate for patient of medial severity. 　　The study established a general wild bird triage score system which offered a guild line based on non-invasive and rapidly assessable examinations. Apply to the scoring system, clinicians can estimate the first-48-hour mortality rate of hospitalized wild birds and provide appropriate treatments.