Thursday, May 8, 2008

But Doc, It's his leg that's broken.....

Most of the time when I have to see a dog or cat that has undergone major trauma the owners are concerned about the broken bones. They remind me of the first video they show you in Human First Aid. If you took the course you know the one. The little girl is in the pool and she drowning. The instructor then asks how many of you would jump into the pool. Of course, everybody in the class raises their hands. The camera then pans out and you see the electric pole that fell into the pool. You just jumped in to a pool filled with electricity. I missed the obvious by not assessing the situation first.

Before we get too far in, of course the pain needs to be dealt with. But we need to make sure the important functions are working. So I thought I would give everyone a short list of the way we assess a patient that has been presented after a major trauma. This should help you too in the unfortunate circumstance that you have to deal with a pet that has been in an accident.

In the field the first thing you should do is avoid getting yourself injured. Make sure the area is safe for you to approach.

Just like in the human field, the ABC's are the first area to assess (Airway, Breathing Circulation). However, in animals, we proceed very carefully with assessing the airway. Many of these animals are in pain and I'm not all that interested in putting my hands in a painful cats mouth.

Next, we assess the patients breathing. In the hospital, we have the aid of a stethoscope. But you can get a good read on a patient's respiratory status by just looking. First, look for obvious trauma to the chest wall. Next, you want to observe the rate, pattern and sounds.

Circulation can be the hardest part of the evaluation. The gums of a healthy dog should be pink. However, the shock of pain can make a dog's gums white. I usually use the tongue as my gauge. Painful dogs generally still have a pinkish tongue. Estimating blood loss can be difficult even for someone with training. A little blood on the ground always looks like a lot.

The next thing to look for is the animal's mental status. Does the dog know what's going on? Does she respond to you when you talk to her? Are her pupils even?

Finally, I'm looking at broken bones. Unlike people, dogs and cats don't die from complications of broken bones in the short-term. They need to be addressed for pain and future repair, but they are not usually life threatening.

For tips on how to move a dog or cat that has been traumatized the American Red Cross has a great website:

http://www.redcross.org/news/hs/firstaid/010801petfirstaid.html

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