A Comprehensive Look at Pet First Aid BASIC ASSESSMENT, COMMON EMERGENCIES AND LIFE SAVING TECHNIQUES
April 12, 2014
Animal Transport During An Emergency BREATHE & MOVE SLOWLY!! Apply a muzzle Place blanket behind the dog Gently transfer onto a blanket or firm surface of
appropriate size With one person on each side, pull taught and lift equally.
Basic Assessment Stage One: Breathing – From a safe distance, how is the animal breathing? Respiratory rate: Count how many breaths taken in 15 seconds and multiply by 4 A normal respiratory rate for a dog is 15-30 breaths per minute. A normal rate for a cat is 20-30 breaths per minute. A very fast rate could indicate difficulty breathing, pain, or stress. Effort: How easy is it for the animal to breath? Are they taking rapid, shallow breaths? Are they having to use the abdominal muscles to move air? If the mouth is open, what color is the tongue? A gray or blue coloration indicates a lack of oxygen Is there any excessive noise associated? (excluding normal panting)
Stage Two: Mucus Membranes If breathing is not compromised, slowly move in to apply the muzzle. Check mucus membrane color: (gums and tissue in the corners of the eyes) - can be done with muzzle on - Can be difficult in dogs such as chows with pigmented gums. Dark red mucus membranes- one stage of shock or hypertension Light pink to white mucus membranes- progressed stage of shock or anemia Pink- normal Yellow- Possible liver compromise Grey, Blue- lack of oxygen Are gums moist or dry and tacky? Capillary Refill Time: While assessing mucus membrane color, check capillary refill time. Reveals how well the body is maintaining vascular stability (blood pressure) To perform test: Apply gentle pressure with one finger above the teeth on the gum line Release pressure and count how many seconds needed for the color to return Normal= 2 seconds Too fast or too slow may indicate shock, anemia, or internal bleeding. Avoid gingivitis- may skew results
Stage Three: Heart Rate Assessed by palpating the pulse of the femoral artery or directly on chest The femoral artery is located inside the rear leg just behind the femur. Heart Rate: Apply gentle pressure and count the beats for 15 seconds then multiply by 4 A normal heart rate for a dog is 60-160 beats per minute in medium to large dogs, and 180-220 beats per minute in small dogs and puppies. A normal heart rate for a cat is a maximum of 240. How easy is the pulse to feel? A fast heart rate could indicate shock, anemia, pain or stress A slow heart rate could indicate a very serious level of Shock Bounding (very strong) or very weak can also be an indicator of shock
Stage Four: Temperature Not necessary if animal is in a high state of stress or if it is obvious that there is a dire emergency Assess with flexible rectal thermometer only- no glass Helpful in cases of suspected heat stroke or if the animal is just not acting right.
Normal temperature for a dog or cat is 99°F- 102.5°F
Too high may indicate heat exhaustion/stoke, infection, or stress Too low may indicate a very serious level of shock
Basic Assessment Stages (Work to maintain safety) 1.
•Respiratory Rate •Respiratory Effort
2.
•Capillary Refill Time •Evaluate Hydration
3.
•Heart Rate •Pulse Strength
4.
•Temperature
Shock Clinical signs: early stages
Clinical signs: progressive stages
Increased heart rate Increased respiratory rate Rapid capillary refill time Injected (red) mucus membranes Increased pulse pressure
Rapid heart rate Weak pulses Prolonged capillary refill time Pale mucus membranes Hypothermia ( low body temp) Lethargy Loss of consciousness
Heat Stroke Brachycephalic breeds such as English Bulldogs, Pugs, and Boston Terriers are especially at risk
Symptoms: Excessive panting Bright red gums and tongue Gums feel dry to the touch Thick saliva Excessive trembling Staggering Laying down and refusing or unable to get back up A rectal temperature over 104 ° F (needs immediate veterinary attention) A rectal temperature of 106 °F or greater (dire emergency) NEVER SUMERGE OR SATURATE WITH COLD WATER!! Will pack heat into the core and literally cook organs
Treatment:
Remove dog from the hot environment Immediately get a rectal temperature if possible DO NOT Submerge or saturate with cold water or ice!! (this may make internal damage more severe) Place cool, wet rags or washcloths on major blood vessels such as the jugular vein (along the neck) and the femoral artery (inside the rear leg). Replace often. Slightly dampen the dog with lukewarm water and place directly in front of a fan to safely wick away heat- Do not soak! Offer cool water to drink but do not force water into the mouth Most effective treatment is with IV fluids and medications administered by a veterinarian! Call or visit a vet right away - even if the dog seems better. Internal damage might not be obvious to the naked eye.
Lacerations and Wounds May be superficial (skin only) or deep (including tendons or muscles Lacerations presented to a Veterinarian within the first 12 hours can be sutured closed Lacerations presented to a veterinarian after 24 hours usually cannot be sutured If a high amount of contamination is present, the laceration will not be closed due to the risk of infection
Assessment of Bleeding: 1. Mucus membrane color: If the gums are pale and the dog seems weak, immediate veterinary attention is needed. 2. Respiratory rate and effort: a puncture wound in the chest could cause a collapsed lung 3. If the gums appear a healthy pink color and the animal is not in respiratory distress, clean the wounds until help can be obtained.
Controlling Blood Loss: Surface Wounds:
Application of pressure directly over the wound using gauze or cloth will usually stop the flow. Do not wipe or pat the wound Will remove the clot and restart the bleeding. A light bandage may be applied to keep the wound clean and dry and promote further clotting.
Heavy Bleeding:
Apply immediate heavy pressure to the area to slow the flow. With neck wounds, be careful not to restrict the flow of air through the trachea (windpipe).
Wound Care: A wound or laceration due to a bite or other object is considered contaminated.
Primary cleaning: Follow all safety precautions- use a muzzle; animal may require sedation by a veterinarian 1. It is never a bad idea to clip the hair around the effected site 2. If a deep wound or laceration, KY jelly should be placed into the wound prior to clipping to prevent further contamination from hair 3. After clipping, wash wound with chlorhexidine or betadine scrub 4. Rinse thoroughly with water Repeat washing 3 times
NEVER USE Hydrogen peroxide on a wound! It kills healthy tissue
Bandaging: # 1 Rule when bandaging: DO NOT make it too tight!!!! Supplies needed: Non- stick telfa pads (for wound) Rolled gauze Vet wrap or similar Scissors
Special considerations:
Vet wrap tightens as you apply it – be careful! Do not allow bandage to get wet- use rubber glove or sandwich bag to cover when walking outside Keep it clean- dirt and debris under bandage can cause serious complications
Fractures Symptoms and Causes:
Treatment:
Suspected any time normal use or form of a limb or other bone/area has been altered
Using first aid guidelines apply muzzle and place animal on a blanket to use as a stretcher
Usually there will be moderate to severe pain in the area, swelling, bruising, and possibly an open wound with bone protruding.
Get to a vet as soon as possible- the more quickly evaluated increases the chance of proper treatment and healing.
Luxations (Dislocations) Symptoms:
Treatment:
A dislocated joint is very difficult to differentiate from a fracture
Using first aid guidelines - apply muzzle and place animal on a blanket to use as a stretcher
Usually affects a hip, elbow, or shoulder; but any joint may be affected.
Get to a vet quickly. The body attempts to heal luxations very quickly- in just a few hours it may be impossible to reduce the dislocation.
Choking: Easily confused with reverse sneeze, vomiting, or other issue
Symptoms:
Treatment:
If an animal is truly choking: They usually will paw at their face continually Be in a panicked state Show signs of respiratory distress (may include blue tinged tongue and gums)
If a dog is truly choking: Remove collar or anything restricting the trachea Need to see the back of the dog’s throat- sometimes the object is visible Placing your hands into a panicking dogs mouth is very dangerous Use the top lips and bottom incisors to open the jaw If you can see the obstruction, gently use tweezers, pliers, or hemostats to remove Be careful not to push the object further down In case of a bone or sharp object, do not tear tissue when removing.
Small toys and bones can easily become lodged in dog’s mouth or trachea
Heimlich maneuver:
The Heimlich maneuver has not been very successful in dogs If you cannot see or remove the object- get to a vet immediately. Attempt Heimlich as a last resort, on the way to a veterinary hospital
How:
Hold dog so rear legs are elevated and nose is close to the ground Apply a thrust of pressure to the stomach Located on the left side just behind the rib cage
Gastro-Distention and Volvulus (GDV) BLOAT Possible causes: Eating just before or just after heavy exercise may induce GDV
Eating rapidly and swallowing copious amounts of air Sometimes it just happens
Symptoms:
Treatment:
Frequent non-productive retching Lethargy Discomfort/Pain (elevated heart rate, panting, pacing) Abdominal distention
Take all measures for prevention No first aid available Requires emergency lifesaving treatment and surgery-
GET TO A VET!!
Poisons: Any chemicals, plants, insects, reptiles, or spoiled foods that might be poisonous to animals If suspected: Attempt to identify what the poison is If chemical or man made toxin- collect package to take with you to the vet- not just a sample If plant or other material take a sample with you Contact your local poison control- have a credit card ready Rinse the skin, eyes, face or mouth to remove any substances you feel are causing localized irritation. The use of a mild soap may be needed. Even if the substance does not seem to bother the skin, wash it off so the dog does not later lick and ingest more poison. Speak to a veterinarian or poison control before inducing vomiting If recommended, administer hydrogen peroxide orally at a dose of 1-3 teaspoons of hydrogen peroxide orally every ten minutes 1-3 times, until the dog vomits
Animal Poison Control Center 888-426-4435 AVAILABLE 24 HOURS/DAY 365 DAYS/YEAR Have a credit card when calling. May be a $65.00 charge
Insect Bites/Stings Symptoms:
Treatment:
Pain at the site of the bite Trembling or shivering Elevated body temperature Swelling of the lips, eyes, face or feet (Allergic Reaction) Difficulty breathing Shock
If possible, remove any stinger that is present with a small pair of tweezers Place ice on the site Administer Benadryl (1mg per pound of body weight) It is difficult to know if any allergic reaction will stabilize or progress to something more serious- get to a vet!
Dehydration: Occurs as the body loses fluids and electrolytes
A dog’s body requires 1 ounce of water for every lb. of body weight per day to maintain life Prolonged dehydration may lead to shock and death Symptoms:
Treatment:
Lack of water or poor water intake, vomiting, diarrhea, and fever Dogs which are dehydrated will exhibit a loss of skin elasticity, have dry lips or gums, a weak rapid pulse, their eyes may have sunken in somewhat and they will appear depressed.
As long as the pet is not vomiting you may administer small amounts of water or Pedialyte orally. The more severe the dehydration, or if vomiting is occurring, veterinary attention and fluid therapy may be required.
Vomiting: A small amount of vomiting (once or twice only) does not constitute an emergency situation Remove food and water for one hour If no vomit after an hour offer a small amount of water Observe closely for lethargy, weakness, or fever Frequent vomiting is a concern (more than 3-5 times in a six hour period) Ingested toxin Pancreatitis (inflammation of the pancreas) Foreign body Dehydration
Diarrhea: There can be many causes for diarrhea in the dog. For one occurrence, allow water but withhold food for 24 hours. A small amount of KaoPectate, 1 teaspoon for every 20 pounds of body weight can be given one or two times 4-6 hrs. apart. Observe for: Weakness or lethargy If the diarrhea contains blood If the diarrhea persists for more than 24hrs
Observe small, geriatric, or young dogs closely for signs of dehydration and hypoglycemia Seizure: Causes:
A history of epilepsy Hypoglycemic crises Toxin ingestion Other medical issue Brain tumor Hemorrhage Unknown reason
Types of Seizures: Mild or Focal
May just involving the face and “fly biting” Staring off into space A head “nod”
Treatment During:
Make sure the animal cannot injure itself against a corner of a cabinet, table leg, etc. Otherwise- Do nothing! They cannot swallow their tongueyou may get bitten if you put your hands in the mouth Do not try to restrain- wait it out
Major or Grand Mal
Dog will lay on side Lips may be curled back exposing teeth Full body convulsions Dog may paddle uncontrollably May urinate and/or defecate
CPR Order of importance: CAB Circulation, Airway, Breathing Compressions alone can be beneficial for the first 4 minutes of CPR only. Ventilation is vital after 4 minutes Perform compressions in 2 minute cycles with as few interruptions as possible
CPR Recommendations: Compressions:
Compressions should be performed at a rate of 100-150 beats per minute The force of compressions should reach 1/3-1/2 of the depth of the chest Chest should fully recoil between compressions Compressions are recommended to be initiated first, but should not be performed longer than 4 minutes without ventilation. Should be performed in 2 minute cycles without interruption There is only a 2% chance of injury related to unnecessary chest compressions WHEN IN DOUBT, START COMPRESSIONS!!
C- Compressions Positioning Option 1: Circumferential: Use for most small dogs and cats With animal laying on either side, wrap hand around the sternum or chest directly over the heart Perform Compressions by squeezing thumb and fingers 2 Handed Compressions Positioning Option 2: 2 handed technique directly over the heart For deep, narrow chested animals such as greyhounds, obese cats, and medium size dogs With animal laying on either side, place one hand over the other and interlock fingers. Use upper body to perform compressions
2 Handed Compressions Positioning Option 3: 2 handed technique over the widest portion of the chest Adequate for most dogs With animal laying on either side, place one hand over the other and interlock fingers. Use upper body to perform compressions Compressions Positioning option 4: 2 handed technique with compressions on the sternum directly over the heart. For barrel-chested dogs like English Bulldogs With animal lying on back place one hand over the other and interlock fingers. Use upper body to perform compressions Airway:
After an initial 2 minute cycle of compressions at 100-150 beats per minute, quickly check the airway Look for any blood, mucus, vomit, dirt, or any foreign objects as they will obstruct air flow during respirations. Use your fingers or a rag to clear any debris and begin respirations. A quick, sweeping action is very effective
Breathing:
The rescuer holds the patient’s mouth tightly closed, places his or her mouth over the nostrils making a seal, and blows into the nostrils. Extend the head and neck to avoid excess air going to the stomach Breaths should be administered at a rate of 10 breaths per minute Should be delivered with a patient inspiratory time of one second. You should see the chest rise with each breath
Putting it All Together Compressions:
100-150 per minute 30 pumps to 2 breaths 2 minute cycles then check for vital signs Full chest recoil between pumps
Breathing:
10 breaths per minute 2 quick breaths to every 30 compressions 1 second inspiratory time with enough force to make the chest rise each time
Triage Order of importance: 1. 2. 3. 4.
Bleeding (only if a major blood vessel) Is the heart beating? Rate? Is the animal breathing? Rate? Effort? Bleeding (if from minor blood vessel or rectum)
Triage: Special Considerations Bleeding:
Area’s such as the ear, nose, mouth, and feet are highly vascular and tend to bleed more Often looks worse than it actually is An animal cannot bleed to death from such areas Frank Blood (bright red) from the rectum is usually not a life or death situation Some forms of gastro-enteritis can look and smell like deatho Requires veterinary attention o Not immediately life threatening Melena (Black, tarry stools) or dark, coffee ground stool is actually more severe
First Aid Kit o A good pair of bandage scissors o Exam gloves (several) o Tweezers o Pliers o Tick puller o A medium to large hemostat o Telfa pads- mutiple sizes o Zonas- white tape o Vet wrap- 2 inch o Eye flush solution o Chlorhexidine or Betadine scrub o Alcohol o 3x3 gauze o A few 3cc syringes o Rolled bandage gauze (for muzzle or bandaging) o Cauterizing agent (quickstop/cornstarch) o Nail trimmers o KY jelly (or other water based lubricate) o Thermometer o Corn syrup o Hydrogen peroxide (not for wounds) o Homeopathic Arnica Montana
Jewel Willis www.thejoyfulanimal.com info@thejoyfulanimal.com 406-531-2012 Hamilton, Mt Certified Dog Trainer (ABCDT) Tellington TTouch Practitioner (CAP1) Reiki Master/Teacher for Animals and Humans Hospice Support for Companion Animals and their Humans Animal Communication Companion Animal First Aid, K9 Body Language classes Member APDT, Pet Professional Guild