6/10/2015. Multi Purpose Canine (MPC) Restraint and Physical Examination PFN: Terminal Learning Objective. Hours: Instructor:
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1 Multi Purpose Canine (MPC) Restraint and Physical Examination PFN: Hours: Instructor: Slide 1 Slide 2 Terminal Learning Objective Action: Communicate knowledge of Multi Purpose Canine (MPC) restraint and physical examination Conditions: Given a lecture and practical exercise in a classroom environment Standards: Received a minimum score of 75% on a written exam IAW course standards Slide 3 1
2 Reason As a Special Operations Combat Medic, you are responsible to provide emergency medical care to a government owned animal in the absence of veterinary assets. Slide 4 References The Veterinary Merck Manual 9 th edition, published 2005 Birchard, Stephen J. Saunders Manual of Small Animal Practice. W.B. Saunders, 2000 TMEPS Slide 5 Agenda Identify the safety considerations, techniques and equipment for physical restraint of the MPC Identify the key components of the MPC physical examination Identify the key components of assessing MPC vital signs Identify the key components of annotating MPC medical data Slide 6 2
3 Safety Considerations, Techniques and Equipment for Physical Restraint of the MPC Slide 7 Restraint Technique and Equipment Preparation and training prior to an emergency situation is important! Positive control of the head and body Restraint by the handler is ideal Direct restrainer on proper technique if handler is unavailable Medics should socialize with the canine Medics acting as the training objective is highly discouraged Slide 8 Restraint of MPCs: General Approach Animals that are frightened and/or experiencing pain will be much more fractious and cannot be trusted Trust none of them MPC s must be muzzled when doing physical exams or treatments!!! Slide 9 3
4 Physical Restraint Slide 10 Restraint Equipment Muzzles Used to prevent biting Many styles available 2 varieties Basket Cloth Slide 11 Restraint Equipment Field Expedient Muzzle: May be used when animal may be fractious Slide 12 4
5 Chemical Restraint Dexdomitor (Dexmedetomidine Hydrochloride) Given intramuscular or intravenous Dosage based on patient weight IAW product insert minutes of good sedation Reversed with Antisedan (Atipamezole Hydrochloride) Not for use in an animal with a traumatic injury Slide 13 Chemical Restraint Morphine Controlled substance Opiate Subcutaneous or intramuscular injection Intravenous injection not recommended Dosage mg/kg every 3 4 hours IM or SQ IV dose if given is 10% of IM dose given slowly Plumb, D:Veterinary Drug Handbook, 5 th ed. Blackwell Publishing, 2005 Sedation and analgesia Not for use in a patient with a head injury or respiratory distress Slide 14 Safety and Restraint MPCs should be muzzled for all medical procedures Slide 15 5
6 MPC Physical Examination Slide 16 Physical Exam Eyes Abnormal symptoms discharge, swelling of the conjunctiva and sclera, corneal damage Conjunctivitis and Ocular Discharge Normal Corneal Abrasion (stained) Slide 17 Physical Exam Nose Abnormal symptoms discharge, swelling, trauma Abnormal Discharge Normal Fungal Discharge Slide 18 6
7 Ears Physical Exam Abnormal symptoms discharge, redness, foul odor, head tilt, shaking of the head, painful upon palpitation Slide 19 Physical Exam Skin Abnormal symptoms alopecia, redness, hot spots, itching, excessive dandruff Slide 20 Physical Exam Muscle structure, gait, and posture Abnormal symptoms Muscle atrophy, limping, difficulty raising or lowering, hip dysplasia Slide 21 7
8 Anus and genitalia Physical Exam Abnormal symptoms diarrhea, impacted anal sacs, discharge from the penis or vagina Slide 22 MPC Vital Signs Slide 23 Temperature Pulse Respirations Capillary refill time (CRT) Skin turgor Slide 24 8
9 Temperature Obtained rectally Normal values 100 F to F Temperature can be elevated during times of work ( F) Slide 25 Pulse Obtained digitally by palpating the femoral artery or auscultation of the heart Normal values beats per minute Pulse can be elevated during work or training (up to 130 beats per minute) Slide 26 Respirations Obtained by watching the rise and fall of the chest or auscultation of the chest Normal values breaths per minute or Panting Respirations can be elevated during times of work or training Slide 27 9
10 Capillary refill time (CRT) Obtained by blanching the gum tissue and watching for the return of color Normal values < 2 seconds Slide 28 Hydration status (skin turgor) Obtained by tenting the skin along the spinal column Used to assess hydration level 1 5% Dehydrated slight loss of skin elasticity, CRT <3 secs 6 8% Dehydrated loss of skin elasticity, prolonged CRT (>3 secs), dry mucous membranes 9 12% Dehydrated tented skin, dry mucous membranes and gums, CRT > 4 secs, sunken eyes, increased heart rate, rapid/weak pulse, confusion, seizures, unconsciousness Slide 29 Skin Turgor Slide 30 10
11 MPC Medical Data Slide 31 SF 600 Chronological Record of Medical Data Only form used to document medical history in an MPC s Medical Record Slide 32 Deployment Cards Developed prior to deployment Drug doses for common emergency drugs Pertinent medical history JUCO J lb/kg/32kg Sedation Domitor IM 0.7 ml SQ or IM Morphine IM 20 mg SQ, IIM Diazepam IM 10 mg IV Anesthesia Pre-med give both 1. Morphine IM mg IM/IV 2. Atropine IM 1.0 mg IM or SQ OR Glycopyrrolate 0.3mg IM or SC Induction Either I or 2 1. Propofol IV 10ml titrate to effect, slow IV 2. Ketamine mg IV Diazepam IV 10 mg IV Maintenance Fluid Rate 70ml/hr fluid bolus: 250 cc Hetastarch Bolus dose ml , to effect Shock fluid rate 100ml/kg/hr 70.2 lb/kg/32kg Emergency Meds Benadryl mg PO, IM/SQ, q8h Epinephrine 0.65 mg IV OR 1.2mg IT Diazepam IM 16 mg IV for seizures Antimicrobials Cephalexin 500mg PO q 8h Cefazolin 700mg IM or IV q6hr Cefotetan 700mg IM or IV q6hr Metronidazole 500mg PO q12hr Doxycycline 200mg q24hr NORMAL VITAL SIGNS HR RR 24-Pant T= OXYGLOBIN DOSE 250 ML * oxyglobin follows crystalloid fluid admin of at least 500cc Slide 33 11
12 Questions? Slide 34 Terminal Learning Objective Action: Communicate knowledge of Multi Purpose Canine (MPC) restraint and physical examination Conditions: Given a lecture and practical exercise in a classroom environment Standards: Received a minimum score of 75% on a written exam IAW course standards Slide 35 Agenda Identify the safety considerations, techniques and equipment for physical restraint of the MPC Identify the key components of the MPC physical examination Identify the key components of assessing MPC vital signs Identify the key components of annotating MPC medical data Slide 36 12
13 Reason As a Special Operations Combat Medic, you are responsible to provide emergency medical care to a government owned animal in the absence of veterinary assets. Slide 37 13
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