Applying first aid When faced with emergency situations, the following principles will help you respond appropriately. The abbreviation DRABC Danger Response Airway Breathing Circulation Assess the immediate environment for potential dangers to you, bystanders and animals. Do not place yourself in danger to rescue an animal. Remove yourself and the animal from a dangerous situation IF POSSIBLE. Is the animal conscious and responding to external factors? Be aware that a frightened animal in shock may react differently to what you expect so always use precautions for your own safety, and theirs. Check the animal s airway is clear and not obstructed. In a conscious animal, be careful not to get bitten. Check for signs of breathing. Is the chest moving? Can you feel expiration breaths exiting the mouth/nose? Are the gums a healthy pink or turning blue/purple? If the animal is breathing, is the breathing laboured, noisy, shallow, or otherwise abnormal for the species? Check for a pulse and heart beat. Are the gums a healthy pink? Is there evidence of external bleeding? Remember, the animal could be bleeding internally even if there are no external signs. Specific first aid scenarios Haemorrhage A haemorrhage refers to blood loss. This may occur suddenly or over a period of time, and may be external (obvious), from an open wound or body orifice, or internal (may be unnoticed until other signs develop). Any haemorrhage must be regarded as serious. Any sudden or severe loss of blood may cause death. Even a slight haemorrhage which continues over a long period may result in loss of enough blood to cause serious problems or risk to the animal s life. Therefore, it is very important for you to be able to 1
control external haemorrhage and be aware of the potential for internal haemorrhage due to injuries such as car accidents. Ways to control haemorrhage: direct digital pressure pad and pressure bandage tourniquet pressure points artery forceps. Direct digital pressure The following steps are used to control bleeding using direct digital pressure: apply pressure to the wound with clean hands press fingers on intact skin on either side of the wound pinch the wound edges together. Material such as gauze swabs may be used to assist stemming blood flow. This is best suited to smaller wounds as a temporary measure until veterinary attention is available. Pad and pressure bandage A pad of material ideally gauze swabs or thick pad of cotton wool wrapped in gauze is applied to the wound and bandaged firmly. If the wound is high up on limb, the entire limb must be bandaged to prevent the lower limb from swelling. If the bleeding continues and seeps through the first bandage, do not remove it, add a second pad and bandage over the first. Removing the first pad will disturb the forming clot and restart the haemorrhage. In a non-clinical setting, a form of this bandage may need to be applied with whatever material is available eg clean towels until veterinary attention is sought. Deep wounds may need to be packed with sterile gauze swabs (not cotton wool or fluffy materials as these leave pieces in the wound) before a pressure pad is applied. Good temporary control of most moderate haemorrhages can usually be achieved with this method until professional help is sought. 2
Tourniquet This is only a very temporary method of reducing major blood flow to a limb to prevent bleeding. Only suitable where bleeding is severe and other methods have failed. As they prevent most blood flow to the area, harm can be done if tourniquets are incorrectly applied, or left on too long. This method is best left to someone experienced in first aid. Do not leave the animal unsupervised. Pressure points This refers to applying pressure to an artery against a bone to prevent the flow of blood. There are 3 points in dogs and cats. These are the: brachial artery (front leg) femoral artery (back leg) coccygeal artery (tail). Experience is required to locate these points and only blood flow from these major arteries is controlled, so it may not be suitable in many cases. This method can only be used for short periods of time. Artery forceps This is limited to veterinary procedures where forceps are available. This specialised form of clamp allows the end of a blood vessel to be clamped and ligated. These may be used to hold the vessel closed until a suture can be inserted by a veterinarian. 3
Shock This is a condition of acute drop in blood pressure due to an upset in the control of circulating blood or as a result of actual blood loss. The body responds by trying to maintain blood circulation to the essential organs (heart, brain and lungs) and it does this by diverting blood away from the less essential organs, for example skin, gastrointestinal tract, muscles etc. Causes of shock include: acute haemorrhage severe fluid loss eg from chronic and severe vomiting, diarrhoea and/or uncontrolled underlying disease traumatic shock when the body s response to severe and acute trauma is to shut down the non-essential circulation. Clinical signs of shock include: pale mucous membranes slow capillary refill increased respiration rate, often exacerbated if animal struggles rapid, weak pulse cold extremities dull, depressed animal collapse with or without convulsions. Treatment of shock To treat shock, you need to: control haemorrhage make the animal comfortable and try to stabilise temperature (cover with blanket if animal feels cold; cool wash if suffering from heat stroke) reduce stress. Remove animal from stressful environment if possible; place in a quiet, darkened room and handle gently. offer fluids by mouth if dog is alert constantly monitor cardinal signs (note down with time) seek veterinary attention. Fractures and dislocations A fracture is a broken bone, the severity of which can range from a small chip to multiple fragments. The urgency for treatment will depend on where 4
the fracture is located and how serious the resulting damage is. There are four main types of fractures: Compound fracture: when the skin surface is broken and a pathway of infection is available to the fracture site. Simple fracture: a clean break with minimal tissue damage. Complicated fracture: when structures surrounding the fracture site have been damaged or lacerated. Multiple fracture: bone has sustained more than one fracture within its length. A dislocation refers to displacement of a bone from its normal position within a joint. Hip and elbow dislocations are often encountered in a veterinary practice and treatment is best left to professionals. Immobilise the limb and keep the animal as quiet as possible until veterinary assistance is available. Clinical signs of fractures Some animals may only show slight signs of lameness, while others may have an obvious injury with bone visible through a skin wound. Some of the more obvious indications of a fracture could include: pain at the site swelling loss of function non-weight bearing lameness deformed appearance of structure involved eg leg or wing bent awkwardly, depression in skull etc. Treating fractures The most important action is to immobilise the fracture. This reduces pain for the animal, as well as the potential for further injury. Any open wound should be covered and a bandage with or without a splint applied to restrict movement. A warm, quiet environment should be provided to encourage the animal to stay still. Seek veterinary attention immediately. As the animal will be in pain and shock, take great care to avoid getting bitten, kicked or scratched. Treating such animals is best done with help to properly restrain the animal so seek assistance if required. There are several ways to safely immobilise a fracture: confine the animal to a small area, preventing it from moving about 5
apply a splint ruler, or similar straight solid object, can be used to support the fractured limb, and then bandaged over until veterinary treatment is available apply a Robert Jones bandage this is a series of padding and bandaging to provide rigid support for a fractured limb strap the limb against the body for support. Remember, treat the most urgent injury first for example, a severe haemorrhage is life threatening, whereas a fracture rarely is. Overexposure: hyperthermia (heat stroke) Heat stroke is basically overheating of the core body temperature of an animal. There are many situations that lead to this condition: confining an animal in a very hot environment eg car over-exercise and excitement (or fearful stress), especially on a hot day lack of water prolonged seizures milk fever in lactating animals unfit/overweight animals exercised beyond their capacity flat nosed (brachycephalic) animals unable to lose heat by panting adequately when hot. Heat stroke affects many of the body s systems, making it difficult to deal with and hard for the animal to recover. Many complications can arise from the condition, even after recovery, so urgent attention is mandatory for an animal suspected to be suffering from heat stroke. It is important to obtain an accurate history of the events leading up to the animal displaying symptoms so that an accurate diagnosis and treatment can be made. Signs of possible heat stroke include: excessive panting noisy breathing distress and anxiety or depression profuse salivation animal will feel hot purple tongue and mucus membranes 6
unsteadiness on their feet or collapse disorientation convulsions while conscious, or unconscious death. First aid for heat stroke: 1. Move the animal to a cool environment. 2. Wet down animal with cold water. 3. Scrape water off and re-apply. If this isn t done you are trapping a layer of warmed water within the coat and inhibiting the cooling process. 4. Use fanning (electric fans, put in the path of a breeze). 5. Apply ice packs (wrapped in light towel to prevent ice-burn) to the large veins that run down the inside of the limbs and neck. 6. Apply cold wet towels to the animal, changing frequently. 7. Seek veterinary attention. Following the above methods is usually more effective than placing the animal in a cold bath. Drowning is a high risk for disoriented or unconscious animals placed in a bath, so if a bath is used the animal should never be left unattended. If immediate veterinary assistance is unavailable, take the animal s temperature regularly so you can assess when to cease the cooling methods to avoid hypothermia (becoming too cold). Things to consider when transporting a heat stroke patient: always keep the head pointing down to prevent inhaling saliva or vomit make sure that the airway is clear and not kinked continue to cool the animal, keeping a window down or air conditioning running keep the animal calm and restrained, if still conscious adhere to the road rules and drive carefully. Overexposure: hypothermia When an animal cannot maintain their body temperature in a cold and/or wet environment, and become too cold, they are experiencing hypothermia. This condition is common in neonatal puppies and kittens that get pushed away from their mother s warmth. Geriatric animals are also at increased risk of hypothermia. 7
Signs of hypothermia include: a dull, listless animal with slow response to stimulation neonates refusing the teat slow heart rate shallow breathing cold extremities shivering, though very cold animals are often past this point collapse and remaining conscious or becoming unconscious. Treatment Your aim is to slowly warm the core body temperature. Be careful to not apply heat packs or other heat sources that are too hot as you risk burning the animal. Some options include: seeking veterinary attention immediately if the animal becomes unconscious drying the animal if wet placing animal in a warm room, out of the draught, and covering with a blanket. Gently but firmly rub the animal wrapping warmed heat packs or hot water bottles in towels and place between legs (ensure pack/bottles are warm not hot) placing small animals under your shirt for body warmth encouraging animal to eat slightly warmed food once it responds well seeking veterinary advice or treatment if worried. Poisoning The definition of a poison is any substance or toxin that comes into contact with the body in sufficient amounts to cause harm. Poisons may be ingested, inhaled, absorbed or acquired through a bite eg snake envenomation. Brown snakes are responsible for a large number of animal poisonings, particularly in the warmer months of the year. The factors that most affect an animal s reaction to a poisonous substance are: species of animal type of poison 8
quantity of poison route of contact. Types of poisons Some commonly encountered poisons in animals are: anti-coagulants eg. rat bait convulsants eg strychnine, snail bait, organophosphates corrosive eg disinfectants, acids, petroleum products depressants eg human drugs, overdose of veterinary scripts irritants eg disinfectants, gases, plants venoms eg snakes, spiders, ticks. What do you do if you think an animal has been poisoned? don t panic try to determine what type of poisoning has occurred (question owner or witnesses) remove the animal from further contamination (wash off, remove from area) ring your veterinarian and seek immediate treatment and advice on transporting the animal collect all evidence of poison vomit, diarrhoea, snake (if dead!), tick, bait etc to take to vet. This will assist them with diagnosis and treatment options observe vital signs, apply CPR as needed give nothing by mouth unless recommended by a veterinarian. The signs of poisoning are greatly varied and depend on the poison involved. That is why it is extremely beneficial if you can take a known poison with you to the vet if a sick animal had access to it recently. Signs are very varied and may include vomiting, diarrhoea, rapid or strained breathing, change in gum colour, incoordination, paralysis, salivation, local skin reaction and many more! Due to the wide range of poisons and symptoms, diagnosis and therapeutic treatment is best left to a veterinarian. Rules for the home: Keep your medicines out of reach and in a locked cabinet. Pay attention to all poisons such as garden chemicals, petroleum products, insecticides and detergents and only use and store them where animals cannot access. 9
Make certain that poisons are out of reach and cannot be knocked down by animals. Never use old food or drink containers for poisons confusion and accidental poisoning can occur very easily. Read directions on containers and use only as directed. Don t allow access to contaminated food. Note that if a cat eats a mouse that has consumed rat sack, the cat is at risk of the poison as well. Be aware of areas that may harbour venomous insects and snakes and take precautions where necessary. Be aware of the symptoms displayed and dangers associated with specific toxins. Burns When attending to animals suffering from burns, it is important to remember that their external burns may not be their only injury. Many burn victims may also be suffering from shock, heat stress, smoke inhalation, chemical poisoning and more. Hence, careful assessment of the animal is important to address such concerns and ensure no further stress is placed on the animal. Some causes of burns in animals: household heaters bushfires ovens and stoves incinerators cigarettes and lighters misused branding irons hot liquids chemicals pool acids. Treatment for burn victims: 1. Remove from source of heat/fire/chemical. 2 Attempt to comfort the animal and observe it for injuries. 3. If it does not stress the animal, apply a damp, cold cloth to minor skin injuries, seek veterinary advice regarding deep burns. 4. Contact a veterinarian for advice and treatment. 5. Do not offer food or water unless instructed by a veterinarian. 10
Abdominal trauma There are many potential causes of injury to the abdomen: car accidents kicks from a larger animal eg horse previous abdominal surgery wound breakdown crushing injury eg heavy weight landing on small animal. Signs of abdominal trauma Quite extensive abdominal injury can occur with minimal obvious, external signs. However an animal with such trauma will start to show signs of distress, discomfort and pain. Hence it is important to be able to recognise these signs as well as obvious injuries. Common signs of abdominal injury include: kicking or pawing at abdomen animal crouching awkwardly to relieve abdominal discomfort abdominal bloating vomiting and/or diarrhoea no production of faeces blood in vomit, urine or faeces localised swelling on underside of abdomen (possible hernia) bruising tenderness or pain when touched around abdomen shock abdominal wall muscle tears (intestines may protrude externally in severe cases). First aid for abdominal trauma Carefully handle the animal to avoid being inured yourself. Keep animal quiet, do not let it jump around. Offer no food or water. If possible, apply soft supportive bandaging not too tight! around the abdomen. This is especially important for open wounds with abdominal contents protruding. Seek veterinary attention. 11
Allergic reactions Like humans, individual animals may react, sometimes violently, to certain substances. This varies from a mild reaction to severe, life threatening emergencies. A severe allergic reaction is often referred to as anaphylaxis, and requires immediate veterinary attention. It may not always be clear that an allergic reaction is occurring, or what the cause of the reaction is. Additionally, animals react differently and presenting signs will always be varied. Some signs that an allergic reaction may be occurring include: history of allergic reactions recent exposure to unusual drug, food, plant or other substance choking, or difficulty breathing skin reaction eg hives, rash or redness, local swelling from injection etc change usually increase in TPR values. First aid When an allergic reaction occurs, carry out the following steps: if possible, remove cause keep animal comfortable and calm and apply DRABC principles seek urgent veterinary attention. Choking Choking, or obstruction of the trachea (windpipe), may be due to a foreign object getting lodged in the airway or from an anaphylactic reaction. While an object blocking the airway needs to be removed, there is a high risk of getting bitten when putting your hand in an animal s mouth. Additionally, you risk pushing the object down the airway further. For this reason, an object that does not still have part hanging out of the animal s mouth is best left for a veterinarian to remove where possible. When veterinary assistance is not practicable, the following techniques may help dislodge an airway obstruction: Small dog Hold the dog upside down by the hind legs or around abdomen and shake vigorously five or six times be careful not to dislocate the joints. Large dog 12
Lay the dog on its side use a pair of long-nosed pliers to clear any solid material that may be obstructing the airway. Meanwhile, keep the animal s neck, and hence airway, as straight as possible to allow maximum air flow. Transport the animal to a veterinarian as quickly and safely as possible. 13