Primary And Secondary Care for Dogs...While conducting your primary assessment and treatment talk to the owner explaining what you are doing as you progress. Try to allay their fears

Canine First Responder ©

Primary And Secondary Care for Dogs

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Acknowledgements Content: Dr. Lori H. Feldman. Member of the Veterinary Emergency and Critical Care Society USA Greenwich Veterinary Hospital Connecticut. Dr. Henry J. Feldman. NYU School of Medicine Dept. of Medical Informatics For their Canine CPR quick reference table and advice from their web site Rescue Critters® Van Nuys California Audio Visual Material. Fiona Anderson at Pet Alert www.petalert.com For valuable content and advice on procedures for canine first aid British Blue Cross For more useful free booklet downloads and advice. PDSA As above RSPCA As above www.mjfirstaidtraining.co.uk www.caninefirstresponder.co.uk www.canine-rehabilitation.co.uk Publishing and research Michael A Jones Emergency First Response Instructor 2712 Certificates in canine psychology, member of the Institute for Animal Care Education, Member of the Companion Animal Therapy Study Group. CHC Foundation in Canine Health Care (Distinction), Foundation degree in Advanced Canine Behaviour Management (Distinction). Diploma in Forensic Science (Distinction).

This student manual is for use only by Authorised Instructors trained by MJ First Aid Training and the certificates issued to students reflect this with the Caduceus DNA water mark and the Instructors unique membership number. If you received this as part of a training course which is not authorised by MJ First Aid Training please inform us at [email protected]

© Michael A Jones EFRI 2712. VERSION 1.4 2012

The only Canine First Responder Student Manual

Approved by Emergency First Response and For Use only with MJ First Aid Training Canine First Responder Courses all other use is

forbidden.

http://www.petalert.com/

http://www.mjfirstaidtraining.co.uk/

http://www.caninefirstresponder.co.uk

http://www.canine-rehabilitation.co.uk/

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First aid and CPR courses have been around for many years and follow accepted guidelines set out by organisations and governing bodies for the provision of first aid and CPR protocols to the lay person. There are other courses and training providers that offer pet first aid courses but sadly there aren’t any governing bodies to oversee the standardisation of training. When we first wrote the Canine First Responder Course the aim was to keep it in a logical sequence of care mirroring that standard set out for human first aid protocols and we achieved this resulting in the first Canine First Responder program being delivered in 2008. In 2010 the Irish Veterinary Association and the Irish Veterinary Nurses Association approved the canine first responder course awarding six continuing professional development points to any of its members completing training with our approved instructors in Ireland. First aid is the rendering of basic care and life support pending evacuation to more advanced medical treatment and in the case of animals that would be veterinary treatment. Throughout this book we will cover the basics of primary care and secondary care in a logical sequence of priority which follows the same priority a veterinarian, veterinary nurse or specialist emergency

medical animal technician would follow if they were first on the scene of a injured or ill animal. The aim of this book is not to make the reader a qualified veterinarian or nurse it is to give you the basics of amongst other things, recog-nising emergency situations with your dog and being able to identify when within the sequence to notify your veterinarian of a problem and when within the sequence it is appropriate to evacuate to more advanced care and facilities. Having said that, it is not a “how to” manual as there is no substitute for hands-on practical training and we recommend enrolling on a CFR course to gain that experience with a qualified Instructor.

Contents Section One The Role of the Canine First Responder ................................4 Giving Care ............... .............. 5 Personal Safety ........... .............6 Dealing with Stress ....................7 Primary Definitions......................8 Emergency Medical Services.....9 CPR and the ABCS .................10 The S’s ........................... ........13 Knowledge Review One ..........18 First Aid ....................................20 What’s Normal for My Dog .......23 Knowledge Review Two ..........24 Quick Quiz ...............................49 Statement of Understanding ....51 ABC’s quick Reference ............52 Responder Form ......................54 ABC’s Chart ............................ 55

Introduction

First Aid Priorities Assess the Scene for safety Prevent cross infection

between patient and rescuer Assess the condition of the

patient Deal with any life threatening conditions first Contact the veterinary or

animal hospital as early as

possible for evacuation advice Continual circle of care

during evacuation to more advanced medical care

Only for Use by MJ First Aid Training Instructors © 2012

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As stated in the Introduction, there is no substitute for practical hands on training but this manual will give you a foundation of what to do in the event of an emergency with mans’ best friend, your dog. Doing Your Best First aid can be a life saving thing even with just a little knowledge but sometimes even though you did your best the outcome isn’t a favourable one. So long as you have done your best and acted within the scope of your training and experience then you can rest knowing you did all you could.

No Need for Perfection Thankfully it’s in the past but there was a call for perfection in first aid training: a bandage had to look a certain way, CPR had to be measured by a computer and a perfect strip run off before students could obtain a certificate. To borrow the phrase from Emergency First Response; “Adequate care provided is better than Perfect Care Withheld” So we focus on providing the best care we can to the best of our abilities.

The Role of the Canine First Responder

Your Responsibilities In human first aid responsibilities are clearly defined so in an effort to standardise protocols we have borrowed from those responsibilities and are as follows: Assess the Scene safely and quickly and

alert veterinary staff of the emergency Protect the casualty and others at the

scene from possible danger To identify as far as possible the injury or

nature of the illness affecting the casualty To give the casualty early and appropriate

treatment, treating the most life threatening conditions first

To arrange for the casualty’s evacuation to advanced medical treatment with a veterinary as soon as possible

If advanced medical care is needed,

then to remain with the casualty until arrival at or by the veterinary

Report your observations to veterinary

staff and stay if requested to assist To prevent, as far as possible, cross infection between casualty and rescuer

Injured Dog

Oncoming Traffic in both lanes

Possibility of being bitten By second dog

Assess the Scene


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Dogs can’t talk to us and tell us what’s wrong and likewise we can’t tell them what we are about to do that will not hurt them further as we are tying to help. Dogs communicate through body language and what are termed calming and stress signals. If we are confident and positive in our approach then the dog will understand this. It’s also advisable to approach from the side as dogs view a head on approach as a threat gesture. In the animal kingdom there are only humans and primates that are ventral (approach each other from the front) all other animals are dorsal (they approach each other from the side). We have another consideration when dealing with a canine casualty; the human owner. Emergencies with a dog can be very emotive situations. Their pet is injured and they don’t know what to do so “confidence in action” is the watchword of the Canine First Responder. The owner needs to feel their pet is in safe hands so you can create an air of confidence and assurance by: Being in control of your own reactions

and of the problem Acting calmly and logically Being gentle but firm Speaking to the owner kindly but in a

clear and purposeful way

Building Trust

While conducting your primary assessment and treatment talk to the owner explaining what you are doing as you progress. Try to allay their fears by answering questions honestly, if you don’t know the answer say so. Continue to reassure the owner even after you have finished your treatment and offer to help with the transportation to the vets. Ask if there is

someone you can contact for them, a family member or friend who could lend moral sup-port at the veterinary clinic or animal hospital. Even if you know there may not be a favourable outcome to events, keep talking to them and reassuring them for support at this troubling time. In the event it is a child who is with the dog at the time of the emergency then try to obtain contact details of family you can contact to come and be with them. Most children have a mobile phone these days with numbers programmed in for home, Mum and Dad at least, ask if you can use their phone to contact them for them. Be tactful and discrete when explaining what’s happened as the child will already be distressed and if they are in earshot they will be able to hear what your are saying over the phone. Keep to the facts so as not to create any more alarm than is necessary.

Giving Care with Confidence

Be Reassuring and Confident


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While delivering first aid to a sick or injured animal it is important to thoroughly assess the scene to ensure what ever caused the injury or illness can not be the cause of injury or illness to the rescuer. Another important factor in scene safety is the use of barriers to prevent disease transmission from patient to rescuer and vice versa. Gloves, resuscitation face shields, safety glasses and masks are all effective in helping to reduce the

risk of disease transmission. Animal to human diseases are called zoonotics and include Rabies, Lyme's Disease, Leptospirosis (Weils Disease) and hepatitis Additionally we need to look after our psychological state as well as dealing with emergency situations can be stressful for the First Responder.

Looking After Yourself

Personal Safety All too often in emergency situations it is tempting to dive straight in and give care but the head must rule the heart, two casualties are no use to anyone if you become injured. Stop, Think then Act is the mantra. The body’s natural defence mechanism in stressful situations like emergencies with your dog is the Fight or Flight Response. The body produces larger than normal amounts of adrenalin and cortisol which stimulates the

heart to beat faster, raises the pulse and induces sweating and you will be more alert than usual. These are normal bodily responses to emergency situations.

Stay Calm Take a few deep breaths, gather your thoughts and this will enable your mind to be clear and focus on the steps you need to take to deal with the situation at hand.

Preventing Cross Infection Preventing cross infection is an important part of providing first aid this can be transmitting germs to a casualty or contracting an infection yourself and a particular concern when treating open wounds Gloves are a common sense approach to preventing disease transmission and basic ventilation barriers for mouth to nose rescue breathing are readily available from first aid suppliers and even the corner chemist. The vinyl resuscitation face shields with a simple membrane valve in the middle work best on dogs even though designed for human use and commercial pocket masks also work well on short snouted breeds. We will cover barriers in a little more depth later on.

Gloves

Pocket Mask

Face Shield


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Dealing with Stress After dealing with any emergency it is natural to feel stressed afterwards and very emotional. Stress can have negative effects on a persons wellbeing and it is important to recognise this as a first responder so we can seek assistance with dealing with it as some people are more susceptible than others to its effects. It’s important to understand how to deal with stress to maintain your own health and effectiveness as a Canine First Responder. Any First Responder who has dealt with an emergency scene will tell you that all sorts of emotions run through your mind afterwards from joy and elation to satisfaction but more often than not it is more common to feel upset. After treating an injured dog you may feel, depending on the injury and the outcome: Satisfaction and Pleasure Confusion and doubt Anger and Sadness Never reproach yourself afterwards, try talking things through with a family member, friend, workmate or veterinary personnel. This helps the process of relieving your anxiety over the incident. If possible speak to the owner or someone else that was at the scene as they may be experiencing the same feelings you are.

Delayed Reactions Reactions to a stress event such as an emergency scene can be delayed and manifest much later after the event when you return to your everyday environment. The effect may vary depending on your experience at dealing with situations as a Canine First Responder and the nature of the incident. In the longer term stress can manifest itself in many different ways which can include: Tremors of the hands and stomach Excessive sweating Flashbacks of the incident Nightmares or disturbed sleep Tearfulness Tense and irritable Feelings of withdrawal and isolation These symptoms should pass and exercise and relaxation are good ways to take your mind off things in fact anything you enjoy doing is a good stress reliever.

Severe Stress Reactions

If you witness or experience a severe incident you may find that you experience severe feelings of stress for some time after and these can include: Reliving the event Avoiding Situations, places and people associated with the event Feeling hyperactive and restless It is important to seek medical advice from a doctor or councillor if you experience any of the above.

Looking After Yourself

Talk things through with a

relative or a friend, someone that was

at the scene as they will probably have the same feelings as you.


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Primary means first in a series or sequence; Most Important. Assessment is an appraisal or evaluation. Primary assessment is your first evaluation of an injured or ill dog. During skill development, you’ll practice the steps for conducting a primary assessment. These steps help you check the life line in the continual circle of care and check for life threatening conditions that need immediate attention. Because attending to life threatening conditions is most important, or primary, to caring for a patient, the actions you take based on your primary assessment is called primary care.

Study Questions What are primary assessment and

primary care? What are the ABC’S of the life line? What is meant by continually monitor

and treat the life line? How do you contact advanced

veterinary medical care in your area?

Primary Care Definitions

ABC’S of the Lifeline to help you remember proper sequencing think:

The Circle of Care

Monitor a Patient’s Lifeline - The ABC’S

A = Airway Open

B = Breathing check

C = Circulation - Chest

Compressions (CPR)

S = Serious Bleeding

management, Shock Management, Spinal Injury Management

The “A” in the ABC’S will also aid with recall of

other steps in the sequences such as “Assess the Scene” and “Alert the vet.”

The “B” reminds us to check for breathing but

also “Barriers” and “Rescue Breaths”

The “C” Reminds not only to check circulation but

is also a prompt to “CPR” in the sequence and also for “Choking”

The Three “S’s” remind us in the sequence for

serious bleeding management first then, Shock Management and then Spinal Injury Management.

You check for life threatening conditions and follow an important sequence to

provide care


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The extent of care provided by the Canine First Responder is limited and one of the most important things you can do to assist the patient with a life threatening condition is contact advanced medical care as soon as possible. In the UK veterinary practices have appointment based opening hours and it maybe there is not a vet on site or they may be undertaking emergency surgery or even just routine surgery. The receptionist or veterinary nurse will be best placed to advise you on your best course of action. If you have a 24 hour animal hospital near you, it’s worth programming their phone number into you mobile phone as well as any 24 hour animal ambulances that may operate in your area. During the skills development we will practice calling the vet by simulating calls or directing the owner to.

Emergency Medical Services

Contact the veterinarian at the outset

They may not be on site or already in surgery

“One of the most Important things you can do .... Is

call the vet as quickly as you

can”


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A is for Airway Open and B is for Breathing Check

The “A” in ABC’S also directs you to open the

patients airway. You need to do this as in an unconscious patient the tongue often falls to the back and blocks the airway. As long as no spinal injury is suspected we tilt the head so as to create a straight line in the airway

ABC’S and CPR - Primary Care

Study Questions How do you determine a patient is

breathing during a primary assessment? How does rescue breathing work? What do you do if you discover a patient is not breathing normally? What does CPR stand for, what is it

and how does it work?

The Circle of Care


Breathing Check

Assess the Scene Airway Open


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With the Airway Open, you look, listen and feel for Breathing - a Breathing Check. This is part

of the “B” in the ABC’S.

In the skills development section we will practice muzzling the dog before we get to clearing the airway and checking for breathing but for our purposes here we will assume we have already muzzled the dog. To check for breathing we can begin by placing the ear near to the dogs nose and mouth. Looking towards the chest and seeing if it rises and falls, while listening for signs of breathing. Feel for breathing on your ear or cheek as these are sensitive areas and if the patient is breathing even lightly you should be able to feel it.

ABC’S and CPR - Primary Care You can also place your hand on the dogs chest to feel if it rises and falls. If no breathing is detected we then check move to

“C” in the ABC’S and check for Circulation

at the femoral pulse.

C is for Circulation - Chest Compressions

“C” stands for Circulation and Chest Compression this is

where you initiate CPR. CPR stands for Cardio Pulmonary Resuscitation, it’s a skill that combines rescue breathing with manual chest compressions. To understand how CPR benefits a dog you must first understand how the circulatory system works. The heart pumps oxygen rich blood from the lungs through out the body, it also returns the oxygen poor blood back to the lungs for more oxygen. If the heart is beating erratically or not at all, then rescue breathing alone is ineffective because blood is not circulating. If a dog’s heart stops, you substitute the hearts pumping action to circulate blood through the body. Chest compressions force blood from the heart through the arteries and delivers oxygen rich blood to vital organs. Manual compressions deliver around one third of the normal blood flow to the body, this means CPR can only extend the window of opportunity for the patients’ revival for a short period of time. CPR’s function is to extend that window and give the dog a chance to get to advanced medical care. By performing CPR as an interim procedure, you keep some oxygen rich blood circulating in the dogs’ body, even though it’s not as efficient as the dog’s own heart, CPR may support the body until advanced medical care can be provided, this is a vital link in the chain of survival.

Oxygen rich blood from the lungs pumps through the heart

and is delivered to cells throughout the body


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Another reason to consider CPR as an interim step is because it’s difficult from a Canine First Responders perspective to sustain for long periods. Performing CPR can be tiring when performed for long periods, this is why it’s important to contact the vet as early as possible for advice. During skill development you will progress from opening the dogs’ airway and checking for breathing to performing CPR. After the initial two rescue breaths you will then provide chest compressions. This is accomplished by blowing into the dogs lungs, providing the dog with oxygen. The air around us contains around 21% oxygen and as we only use a small proportion of that oxygen when we breath we exhale more than enough unused oxygen (around 16%), more than enough to support a non breathing dog. After rescue breaths you move immediately to Chest Compressions.

ABC’S and CPR - Primary Care

Chest compressions force blood from the heart through

the arteries.

The Circle of Care


Circulation Check Chest Compressions

CPR works the same regardless of size, the technique is the same in toy breeds, medium size dogs or giant breeds, the depth of compression is the only thing that varies.


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Serious Bleeding Management Experience shows us that when the skin and underlying tissue is cut, scraped or punctures, there is going to be blood. How much blood flows from the wound and how quickly it leaves the body is what determines whether it’s a minor problem or serious bleed. A recent study published in the European Journal of Physiology found the average amount of blood in a dog is 80ml per kilogram so rapid loss of just part of a litre is dangerous and can lead to death. Because serious bleeding is life threatening, you, as a Canine First Responder need to be able to recognise and manage this during a primary assessment, serious bleeding management is the first of the three S’s in the ABC’S of the life line. In general there are three types of bleeding. In an emergency it’s not critical for you to diagnose the exact type of bleeding, however, by knowing the differences, you’ll be better able to judge how serious the wound is and how best to manage it. During skills development you’ll learn how to control

bleeding using direct pressure.

The S’s Serious - Bleeding, Shock and Spinal Injury

The Circle of Care


Serious Bleeding Management

Study Questions What are the three types of bleeding

and how are each identified? What is shock, what can cause it and

what are the indications of shock? What does the spinal cord do in the

dogs body and why is it important to protect the spinal cord during

primary care? What indications might signal the

need for spinal injury management? In what circumstances should you

always suspect a spinal injury? What are two situations where you

must move an injured or ill dog?


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Arterial Bleeding Arterial Bleeding can be recognised when bright red blood spurts from a wound in rhythm with the heart beat. This is the most serious type of bleeding since blood loss occurs very quickly. If a major artery is cut death can occur within a minute.

Venous Bleeding Venous bleeding can be recognised when dark red blood steadily flows from a wound without rhythmic spurts. This bleeding can be life threatening and must be controlled as quickly as possible.

Capillary Bleeding Capillary bleeding can be recognised when blood slowly oozes from the wound. This slow bleeding may stop on its own or is typically easy to handle with direct pressure. Any time a dog has serious bleeding, use barriers and call the vet immediately and quickly render care to prevent blood loss.

The S’s Serious - Bleeding

Arterial Bleeding

Venous Bleeding

Capillary Bleeding


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Shock Management Any injury or illness, serious or minor, which stresses the body, may result in shock. In reaction to a medical condition the body pools blood into one or more vital organ. This reduces normal blood flow to other tissues depriving cells of oxygen. During shock the body begins to shut down, shock is a life threatening condition that is easier to prevent from getting worse than it is to treat after becoming severe. Shock management is the second “S” in the ABC’S. During primary assessment and care, you take the first steps to managing shock by dealing with other life threatening conditions. Checking that a dog is breathing normally and is not bleeding profusely helps to maintain normal blood flow. You render additional care by keeping the dog still and maintaining their body temperature . You may elevate the hind legs if it doesn’t aggravate any other injuries. Continuing to monitor the dogs life line until the vet arrives or while evacuating to the vet also contributes to shock management.

The S’s Serious - Shock

The Circle of Care


Shock Management

To identify shock in a dog, look for these indications: 1. Rapid weak pulse 2. Pale gums or mucus eye membranes 3. Possibly shivering 4. Confusion, anxious, restless or irritable 5. Altered levels of consciousness 6. Vomiting 7. Thirst 8. Dazed look 9. Shallow but rapid, laboured breathing. Even if you don’t recognise any of these signs and symptoms in a dog, continue to manage for shock when you provide emergency care. Remember, it’s better to prevent shock than to let it complicate a dogs condition.


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Spinal Injury Management The spinal cord connects the brain with the rest of the body and organs. Nerve impulses, or messages between the brain and the body travel down the spinal cord. An intact , functioning spinal cord is essential for life. Vertebrae are rings of bone surrounding the cord and run from the neck to the lower back, these bones make up the backbone or spinal column. A spinal cord injury may result in permanent paralysis or death. The higher up the spinal column the injury, the more likely it will cause a serious disability. This is why it’s so important to guard the head, neck and spine when attending to an injured dog.

Important: Never move a dog unless absolutely necessary. A dog with a severe injury will unlikely be able to move. However, a less severe injury will not necessarily keep a dog down. Dogs will often try to get up and move away, because an injured spinal cord is so fragile, allowing the dog to move around could turn a minor injury into a permanent disability. With a dog that is unconscious it is a little easier to keep them as still as possible but a conscious dog will try to move if you physically restrain them. Whichever scenario you find yourself in it is important minimise movement and support the head. If you need to open the airway, do this as carefully as you can and avoid side to side movements of the head. If you need to perform CPR the dog will most likely be on its side anyway so leave them in this position and avoid as much as possible twisting or jarring the spine.

The S’s - Spinal Injury Management

The Circle of Care


Spinal Injury Management

The spinal cord is surrounded by vertebrae that protect it. A serious blow, fall or jolt could cause a break and damage the cord.


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If you didn’t see the injury occur or the circumstances surrounding the injury are not clear, look for these indications that may signal the need for spinal injury management. 1. You observe a change in the dogs consciousness 2. The dog has difficulty breathing 3. The dog has difficulty moving body parts if it does try to move 4. The dog vomits 5. If the dog is sitting or walking, it loses balance or falls over These are common indications of back or neck injury, however, none may be present even though the dog has an injury so, regardless of whether the indications are present or not or you suspect an injury, treat as such. Spinal injuries generally result from falls or other blows associated with accidents. There may be other incidents that injure the spine, but you should always suspect a spinal injury in these circumstances: 1. Traffic or car accident 2. Being thrown from a vehicle 3. Falling from a height greater than the dogs own height 4. Severe blow to the head neck and back 5. Lightening strike 6. Serious impact injury 7. Being kicked by large cattle or horse

When you must move a patient As a general rule; we should only move a dog with a spinal injury if absolutely necessary and there will be instances where we have to move the dog such as, to treat in position would pose a danger to the first responder and the patient. Your instructor will cover these scenarios on the skill development part of your course.

The S’s - Spinal Injury Management


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Name: Date: _______________________ 1. When a dog needs emergency care, time is critical because: (Tick all that apply) _____ a. It becomes more difficult to administer first aid. _____ b. The chances of successful resuscitation diminishes with time. _____ c. When a dog has no heart beat and is not breathing, irreversible brain damage can occur within minutes 2. From the Introductory statement below, which one would you select when asking permission to help a dog? _____ a. I’m a vet can I help you? _____ b. Hello, my name is __________________, I’m a Canine First Responder can I help your dog? _____ c. I have some medical training can I help your dog? 3. You should never fear harming a patient when performing CPR on a dog who isn’t breathing

and who’s heart has stopped because you cannot make them worse.

True ⎕ False ⎕ 4. As a Canine First Responder what general rule may help you avoid infectious pathogens?

(Tick all that apply) _____ a. Always place a barrier between you and any moist or wet substances originating from the patient _____ b. Have the owner perform the steps of primary and secondary care as you talk them through it. _____ c. Have the owner bandage their own dogs wounds whenever possible. 5. Number order the steps (1 to 12) as they happen in the real time sequence on the circle of care chart below

Knowledge Review - Primary Care

The Circle of Care


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6. What would you do if the owner did not have their phone or vets number to hand? ________________________________________________________________ 7. CPR alone is enough to restart the heart

True ⎕ False ⎕ 8. Match the type of bleeding listed below with the description of how each is identified Dark red blood, steadily flowing without rhythmic spurts. _____ Blood slowly oozing from a wound _____ Bright red blood that spurts from a wound in rhythm with the heart beat _____ a. Arterial Bleeding b. Venous Bleeding c. Capillary Bleeding 9. What are the indications of shock (Tick all that apply) _____ a. Pale or bluish tissue colour _____ b. Altered consciousness _____ c. Dazed look _____ d. Thirst _____ e. Rapid, weak pulse _____ f. Headache _____ g. Confusion, anxiety, restlessness or irritability _____ h. Vomiting _____ i. Shivering _____ j. Shallow, rapid breathing _____ k. Earache 10. In what circumstances should you always suspect a spinal injury? (Tick all that apply) _____ a. Lightening Strike _____ b. Serious impact injury _____ c. Falling from height greater then the victims own height _____ d. Traffic or car accident _____ e. Being thrown from a vehicle _____ f. Being kicked by large cattle or horse _____ g. Severe blow to the head, neck or back

Knowledge Reveiw - Primary Care


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Every day dogs have mishaps or get sick. Some may be evolved in bad accidents or suffer from serious illness, yet remain conscious and responsive. Their conditions may not be life threatening, yet they still need medical care. The Canine First Responder Secondary Care or first Aid teaches you to assist an injured or ill animal by offering first aid and support while waiting for the vet to arrive or prior to evacuation to the veterinary surgery. The course prepares you to render emergency aid for common medical problems that are not immediately life threatening. As you learned in primary care, any time you approach a patient to provide emergency care, regardless of injury or illness, you perform a primary assessment and monitor the patients life line. During this course, you’ll review the ABC’S - assuring there is no imminent threat to the dogs life - then practice providing care that reassures, eases pain and reduces risk of further harm. If veterinary services are close by, you may never need to use these skills however, if these service are unavailable or delayed due to time or distance you may need to use your skills to render first aid.

First Aid - Secondary Care

The Four Skills of Secondary Care

Injury Assessment Illness Assessment Bandaging Splinting for Fractures

Definitions Secondary means second in a series or sequence. An assessment is an evaluation or appraisal. Secondary assessment is your second evaluation of an injured or ill dog. Once the patient is stabilized during primary care, you attend to the next level of emergency care - secondary care. This the care you provide to a patient with injuries or illness that is not immediately life threatening. During skills development , you’ll practice injury assessment that helps you determine the location and extent of all the patients injuries. You’ll also learn the steps for illness assessment that help you identify and report medical problems that affect the dogs health and may aid in treatment. Bandaging wounds, sprains and strains along with splinting fractures round out the skills you need to provide secondary care.


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Illness vs. Injury Throughout this manual, you’ve read the words injury and illness. When discussing secondary care. It’s important to understand exactly what these terms mean. An injury is defined as physical harm to the body. Examples include: Cuts, scrapes and bruises Chest wounds Head, eye and dental wounds Burns Dislocations and fractures Temperature related problems, Hypothermia, frostbite, hyperthermia, etc.


An illness is an unhealthy condition of the body. Illness may be caused by pre-existing conditions such as allergies, heart disease or diabetes. They may also be due to external factors such as ingestion of toxins or poisons. Generally, illnesses are determined by looking for clues or signs that the dogs body is stressed and also by listening to the owner describing symptoms.

Study Questions What is Secondary Assessment and

Secondary Care? What is the difference between injury

and Illness? What is Assessment First Aid?


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Signs and Symptoms A sign is something you can see, hear or feel. For an injury assessment you look for signs such

as wounds, bleeding, discolorations or deformities. You also listen for unusual breathing sounds and feel for swelling or hardness, tissue softness or unusual masses.. For an illness assessment you look for changes

in tissue colour, breathing rate, consciousness, shivering or seizure. You listen for breathing

difficulty and check their pulse. A symptom is something the owner tells you is

wrong.


Medic Alert Tags In a medical emergency, information is critical. Dogs with serious or diagnosed medical conditions may have a medic alert tag on their collar to provide instant information to Canine First Responders. This tag may list their problems, medication, allergies, vet and/or owner contact details. Always check for a medic alert tag. It can provide you with information you need to provide proper care.

The Owner Tells You Symptoms

You Look, Listen and Feel for Signs


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What is Normal for My Dog There is no standard answer as all dogs, like people, are different. All dog owners will know when there is something wrong with their pets. They may be off their food, listless, not very eager to go out when they are usually chomping at the bit. What we can give is a set of normal values that should roughly apply to all dogs.

Normal Values:

Normal Temperature:

1. Adult dog: 99.5º F to 102.5º F (38º - 39º C)

New Born Puppy: 96º F to 97º F ( 33º - 35º C) Normal heart rate/bpm:

1. Adult dog: 70 to 120/bpm

New Born Puppy: 120 to 160/bpm

Respiration:

1. Adult dog: 12-20/pm

New born puppy: 15-35/pm

The above is meant to be a rough guide and research will show slight variations depending on the source so this is by no means a definitive guide and meant only to give an idea of average

values. Always seek professional advice from your Vet if in any doubt.

In general your dog should have a healthy appearance, with a coat in good condition, no mucus evident around the eyes or nose. Your dog should look forward to his walks and gentle exercise

and to play games. Most of all have fun with your dog and enjoy him.


Assessment First Aid Assessment first aid is the treatment of conditions which are not immediately life threatening, uncovered during either illness or injury assessment. For example, applying a bandage to a wound or wrapping a shivering patient in a warm blanket is assessment first aid. Although the emphasis on the secondary care course is on rendering emergency care until the vet arrives or the dog is evacuated to the vet, you will find you use your skills to handle common minor medical problems. Cleaning and dressing scrapes and cuts, is assessment first aid. In every situation that involves injury and illness, you’ll follow the sequence and steps that you learn and practice in this course.

Assessment First Aid is the treatment of conditions not immediately Life

Threatening


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Name: ________________________________________ Date: ___________________ 1. Regardless of a patients injury or illness you perform ____________ assessment and

monitor the patients ________________ (Place the correct letter in the blank) a. Secondary, line of life b. Primary, Lifeline 2. Once a patient is stabilised during primary care, you then attend to the next level of emergency care, __________________ a. Injury Care b. Secondary Care 3. An Injury is defined as __________________________________ 4. An Illness is defined as _________________________________ 5. A symptom is: (Place a tick by your chosen answer) a. Something you are told about the patient b. Something you can see, hear or feel 6. First Aid is the treatment of conditions that are not immediately _____________________

Knowledge Review - Secondary Care


25

Contents Primary Care: Primary Care Skill 1 Scene Assessment ................................................................Page 26 Primary Care Skill 2 Barrier Use .............................................................................Page 29 Primary Care Skill3 Muzzling ..................................................................................Page 30 Primary Care Skill 4 Primary Assessment .............................................................Page 31 Primary Care Skill 5 CPR and Rescue Breathing ..................................................Page 34 Primary Care Skill 6 Choking ..................................................................................Page 36 Primary Care Skill 7 Serious Bleeding Management ............................................Page 37 Primary Care Skill 8 Shock Management ...............................................................Page 39 Primary Care Skill 9 Spinal Injury Management ....................................................Page 40

Secondary Care: Secondary Care Skill 1 Injury Assessment ............................................................Page 42 Secondary Care Skill 2 Illness Assessment ..........................................................Page 45 Secondary Care Skill 3 .Splinting for Fractures ....................................................Page 47 Secondary Care Skill 4 Bandaging .........................................................................Page 48

Practical Skills Development - Section Two


26

The goal of doing a scene assessment is to recognise the procedure for assessing the scene for safety and here’s how it’s done:

1. Stop

Look at what caused the injury Are there any hazards Can you make a safe approach

2. Think Can you remain safe while helping What emergency care is needed Alert advanced medical care (Vet)

Think about any training you may have and relax

3. Act Call the vet first as there may not always be a veterinary on duty at the clinic Identify yourself as a Canine First

Responder Follow emergency care guidelines Continue to consider your safety

At the Scene - Scene Assessment

Traffic Accident In the event of a collision between a car and a dog begin by ensuring the engine has been switched off with the hand brake on and in gear or park with the hazard light switched on. Treat the dog in the position found unless the situation dictates moving them to a safer location for treatment. Look for leaking fuel,

brake fluids, engine fluids such as coolant or oil. Use bystanders to direct the flow of traffic away from the accident and to look for any emergency services that may have been called. At all times continue to consider your safety while dealing with a traffic accident.

Accidents involving

traffic require a great deal of caution to be exercised

to prevent any further injury to the casualty or to the Canine First Responder


27

Drowning When a dog gets into difficulty in water we must avoid the temptation to jump in to rescue them. Dogs, like panicked people in water will try to climb on top of you as you swim towards them putting the rescuer in potential danger. Look for something you can throw to them that floats such as a life ring or a rescue throw rope. Getting into the water must always be a last resort and only then if the rescuer can be as sure as they can that they are at minimal risk to themselves.

Inland waterways, even in the height of summer can look deceptively warm and tempting but in the UK freshwater temperatures in those same water ways are hovering between 5 - 10° Centigrade and never really getting much above 18°C. With risk of hypothermia and cardiac arrest due to the shock of jumping into cold water the Canine First Responder should be looking for alternatives to entering the water.


Electrical Shock

Most modern electrical circuits are protected by a circuit breaker which shuts off the supply of electricity as soon as a disruption is detected in the current. However some older circuits may not have this protection so it’s important to treat all suspected electrocutions with caution. Switch off the current at the mains if possible or isolate locally at the socket or switch. Remove electrical cables from the vicinity of the dog by the use of a none conductive material, this could be: Rolled up magazine or newspaper Wooden broom handle

Entering the water should

always be a last resort after all other options have been

exhausted

Plastic handle of some description Anything rubber coated Remember to look for entry and exit wounds on the dog. Entry wounds will usually be around the mouth and gums if they have bitten the electrical cable and exit wounds (electricity has to go to ground somewhere) will usually be through the feet if the dog was standing or on the side they where lying on if laid down.


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Injury to a Dog

It may not always be apparent what caused an injury to a dog, it could have been cut by barbed wire, a broken fence, or been in a dog fight. When assessing the scene we should be looking for the mechanism of injury and as far as possible trying our best to ensure we don’t suffer the same kind of injury through whatever cause. In the case of a fight between dogs we should be asking the owner of the other dog to place them on their lead or in the case of strays contacting local dog control such as the dog warden or police depending on your area provision for dealing with stray dogs If it is broken glass or barbed wire we should be well enough away so as not to cause injury to the Canine First Responder or if we have to treat in situation then can we safely remove it without getting injured?

Remember

. Stop

Look at what caused the injury Are there any hazards Can you make a safe approach

2. Think Can you remain safe while helping What emergency care is needed Alert advanced medical care (Vet) Think about any training you may

have and relax

3. Act Call the vet first as there may not always be a veterinary on duty at the clinic Identify Yourself as a Canine First

Responder Follow emergency care guidelines Continue to consider your safety


The Cause of the Injury or

Illness may not always be apparent.

Try it. Using the pictures, work in practice groups to assess the scene, stopping, thinking and then acting.


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Barriers - Gloves

The most basic from of barrier are examination gloves which help to prevent cross contamination. All examination gloves are ambidextrous so it doesn’t matter which hand they fit and putting on gloves is easy. What we have to consider is removal of those gloves once we have dealt with our casualty and they maybe covered in bodily fluids and contaminants. To remove them carefully we pinch the first glove at the wrist avoiding contact with the outside of the glove and being careful not to snap or tear the glove during removal. Gently roll the glove off turning it inside out as you roll placing the removed glove in the palm of your still gloved hand. To remove the second glove, place your fingers of the un-gloved hand under the glove wrist next to the skin and roll off in the same manner as the first rolling it around the first glove. Place them in a biohazard bag and dispose of in an appropriate manner.

Remember to stop, think and act - assess the scene and alert the vet

Use barriers appropriately Consider using more than one pair of

gloves around broken glass or sharp objects

Use eye shields and face masks

when necessary

Using Barriers

Barriers - Face Shields Face shields are used to prevent disease transmission when giving mouth to nose rescue breaths to a dog. The most common one to use is the one designed for use on humans which is a simple polythene sheet with a membrane barrier in the centre and when in use is placed directly over the dogs nose. Pocket masks also work well on some short snouted breed such as pugs, bull dogs and boxers.

Resuscitation Face Shields are an Effective way to prevent disease transmission

Try it. Practice donning gloves, safely removing them and safe disposal.


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Muzzles Muzzles are an effective way to guard against being bitten, even the most placid dog may bite if in pain or feeling threatened. Muzzles are readily available and a few examples of commercially made ones are pictured below. The problem here is, you may not have every size available to fit all dogs so we can improvise with a crepe bandage from the first aid kit following the steps below. Slowly approach the dog and kneel beside him. It is important not to lean or bend over the dogs head directly as this can be viewed as a threat gesture in the dog’s eyes. Continue to calm the dog and in one smooth slow action, place the muzzle over the dog’s snout. With out rushing fasten off on the neck behind and below the ears. 1. Make a loop in the bandage with a simple

slip knot and place over the snout about two thirds the way along.

2. Pulling it tight enough to keep the jaw from opening enough to bite but still allowing panting, wrap the tails of the bandage

back underneath the snout and put a twist in.

3. Bring the tails below and behind the ears and tie off in a knot or bow.

4. An improvised muzzle.

It is best if the muzzle is left in place until the dog can be treated by a Veterinarian and removed by the Vet when the dog is sedated or calm enough to have it removed. The muzzle should be removed any time it causes or adds to any existing problems but only then if the canine first responder is as sure as they can be that they are not at risk Do not muzzle a dog in shock (More on this later)

Muzzling for Safety

1

3

2

4

Commercially Made Muzzles


Use barriers appropriately Consider using more than one

pair of gloves around broken glass or sharp objects

Use eye shields and face masks when necessary


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Check for Response Assess the scene, apply barriers and after muzzling the dog gently tickle the backs of the dogs front and rear legs to check for a response.

Airway If the dog is conscious it will be apparent he has an airway. Dogs will display various signals when sick or injured such as, baring the teeth, growling, panting heavily rapidly and continually licking their nose and whimpering. All are signs that the patient has an airway. Great care must be taken in approaching as the dog may snap or bite out of fear and pain. Remember, he doesn’t understand what is happening and we can not tell him in terms he will understand. If the dog is unconscious, he will probably already be on his side so leave him in this position. Place the head so it is in line with the neck and pull out the tongue. Again be careful as even an unconscious dog may bite out of instinct

Breathing Check for breathing by holding a wisp of fur by the nose or use the back of your hand to feel for breath. Look along the chest and abdomen for rise and fall for no more than ten seconds.

Primary Patient Assessment


Use barriers appropriately Muzzle the Dog for Safety

Breathing Check

Circulation Check for a pulse in the groin at the femoral artery. Dogs have no detectable pulse at the carotid artery so don’t waste time there. A dog’s normal pulse at rest should be around fifty to sixty beats per minute but can jump to over ninety in the beat of a heart just when they become alert to something let alone under stressful conditions.

Check for Bleeding Check for bleeding. With dogs it is a little easier to see whether they are bleeding as you don’t have clothes hindering your check but great care must be taken as if you inadvertently touch a tender, bleeding wound the dog may react by instinct and snap at you or even bite. While checking the dog over check your gloves at each stage so you will know where the injury is bleeding from, start at the head and work down to the tail then shoulders and hips down to the pads. It is a head to tail, top to toe assessment for bleeding. Treatment for serious bleeding is covered later on page 37.


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Checking for Bleeding Starting at the Head and working your way down to the Tail checking your gloves at each stage to see where any bleeding may be coming from.

Head to Tail Check

Top to Toe Check

Checking for Bleeding Starting at the shoulders working down the front legs to the paws and pads checking your gloves at each stage then repeating this process from the hips down the rear legs.

Head to Tail

To

p t

o T

oe


33

Recovery Position If the dog is unconscious and as long as we don’t suspect any spinal injury (covered later on page 40) we need to assist the dog to maintain an open airway and let any fluids that may have accumulated to drain. We can place a rolled up blanket or pillow under the dogs shoulders making them a little higher than his nose and mouth as illustrated in the picture below.


Quick Quiz What is the first thing we do to ensure safety at the scene?

A. Scene Assessment ⎕

B. Apply a bandage ⎕ Barriers are the most effective way to reduce disease transmission?

True ⎕ False ⎕ Muzzling should be done only after a respon-siveness check

True ⎕ False ⎕ In Primary Assessment we don’t check for bleeding

True ⎕ False ⎕

Primary Assessment is just a head to tail, top to toe check for bleeding

True ⎕ False ⎕ Scene assessment helps us to determine whether it is safe to attend to the casualty

True ⎕ False ⎕ The recovery position helps fluids to drain from the airway

True ⎕ False ⎕

Answers. A. True. False. False. False. True. True.

The Circle of Care

Try it. In your practice groups perform a primary assessment on a responsive and non responsive breathing dog. This will be simulated with manikins for safety reasons. Then place them into the recovery position.


34

Assess the Scene Begin by assessing the scene for safety, apply your barriers and Identify yourself as a canine first responder. Get the owner to call their vet and apply a muzzle while they are doing so. Talk them through what you are doing as this is a distressing time for them. After applying the muzzle gently check for a response by rubbing the back of the dogs legs (front and back) and the neck. If no response we then align the airway as before in primary assessment and pull the tongue forward to clear the airway. Look listen and feel for ten seconds, feeling for breathing, looking along the dogs chest for it to rise and fall and feeling with your hand for the same. Periodic gasping is not normal breathing. If you hear a dog gasping, go ahead and immediately begin rescue breaths and CPR. Mistaking these gasps for actual breathing could mean not

giving CPR when you should Therefore, it’s important not to confuse these occasional gasps with normal breathing. Check for a pulse at the femoral artery.

CPR and Rescue Breathing

Place a resuscitation barrier over the dogs nose and give two normal breaths, the chest should rise and fall, if it doesn’t, reposition the airway until two breaths can be given effectively.

Once two breaths have been delivered locate the chest compression site. Find the compression site by putting the heel of one hand on the side of the rib cage just behind the front legs. Place your other hand on top of the hand already on the chest and interlock your fingers.

Remember to stop, think and act - assess the scene and alert the vet Identify Yourself as a CFR Use barriers appropriately Muzzle the Dog for Safety Continue with primary assessment

checking the ABC’S

The Circle of Care


35

Position yourself so that your shoulders are directly over your hands and your arms are straight – lock your elbows, keep the force of the compression straight down – pushing on the rib cage.

After a chest compression, release, allowing the chest to return to its normal position. Repeat for 15 compressions, as fluidly as possible. This rate is at least 100 compressions per minute the same as for humans. The rate is faster than most people think. After 15 compressions, reopen the patient’s airway and position a ventilation barrier for mouth-to-nose or mouth-to-mask rescue breaths.

Remember: even an unresponsive dog may bite by instinct!

Make sure that the neck is reasonably straight; try to bring the head in-line with the neck.

Remember: Do not over-straighten the neck in cases where neck/head trauma exists.

Attempt 2 rescue breaths, by closing the mouth, and performing mouth-to-nose ventilations. If they go in with no problems continue to give CPR. If not, reposition the neck and try the step again. Visibly inspect the airway by looking into

the mouth, and down the throat for foreign objects occluding the airway. Unlike human-CPR, rescuers may reach into the airway and remove foreign objects that are visible if you still can’t breath into the animal, proceed to the Heimlich manoeuvre. (More later) Continue alternating 15 compressions with two breaths until The Emergency Vet or Animal EMT’s arrives, until the dog revives, until another Canine First Responder takes over for you, or until you’re too exhausted to continue. If you are unable or feel uncomfortable giving a non-breathing dog rescue breaths – relax. Give the patient continuous chest compressions. Chest compressions alone are very beneficial to a dog without a heartbeat. Your efforts may still help circulate blood that contains some oxygen.

Try it. In your practice groups perform CPS and rescue breaths on the CPR manikin. First practice the steps slowly to make sure your hand, arm and body positioning is appropriate. Next practice the steps again in real time.

CPR and Rescue Breathing


Clear the Airway Look, Listen and Feel for ten seconds

Place Barrier and give Two Rescue Breaths

Deliver 15 Chest Compressions

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Your goal:

Demonstrate how to assist a conscious and unconscious choking patient with a partial or complete (severe) airway obstruction. By following a simple procedure, you may be able to assist a choking canine in expelling an obstruction. Key Points Remember to stop, think, and then act. If the dog is coughing, wheezing or wrenching, observe until the dog expels the obstruction. Unlike people, dogs don’t tend to wonder off when choking. Remember a conscious dog will be wary of approach. Everything must be done slowly and calmly with no head on approach or eye contact. If the blockage is severe, the dog will not be able to cough.

If the dog becomes unconscious, go straight into abdominal thrusts. Dogs who receive the treatment for choking should be medically evaluated to rule out any possible complications from the chest thrusts.

Choking

The Circle of Care

Remember to stop, think and act - assess the scene and alert the vet Identify Yourself as a CFR Use barriers appropriately Continue with primary assessment

checking the ABC’S

1. With the animal sitting down, with its back against your chest

2. hug the animal with your fist in your hand, just below the rib-cage (For small dogs just squeeze with one hand)

3. With both arms, give 5 sharp thrusts (bear hugs) to the abdomen. Perform each thrust as if it is the one that will expel the object. 4. Stop, check to see if the object is Visible in the airway, if so remove it and give 2 mouth -nose rescue breaths. If the breaths don’t go in return to step one

For Small dogs it’s the same procedure as for cats

IMPORTANT: Do not proceed with CPR, even if the animal goes into cardiac arrest. You must clear the airway first.

Try it. In your practice groups assist a conscious and unconscious dog by using the manikin to simulate chest thrusts and abdominal thrusts


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Your Goal: Demonstrate how to use direct pressure and a pressure bandage to manage a serious bleed. Remember to stop, think, then act – assess scene and alert Emergency Vet or Animal EMT’s. Key Points Use barriers appropriately. For serious bleeding, appropriate barriers include gloves, eye shield, personal facemask and ventilation shield. Protect yourself and patient from disease transmission by using gloves and barriers. Perform a patient responsiveness check by gently stoking the dog’s legs and or neck at the side behind the ear giving the canine first responder statement to the owner if present and then if unresponsive go straight to Primary Assessment. Perform a primary assessment – remember bleeding must be severe to be life threatening. Monitor a patient’s life signs. Keep in mind that direct pressure is the first and most successful method for serious bleeding management whether in Canines or Humans. Using a pressure bandage is the next step to control bleeding. A pressure bandage is anything that places constant direct pressure on a wound. How it’s done: Direct Pressure 1. Give the Canine First Responder Statement. Assess the scene and call the veterinarian making sure the airway is open. 2. Put on Barriers. 3. Place a clean cloth or sterile dressing over the wound and apply pressure.

4. Release pressure periodically to determine if bleeding has slowed or stopped. Pressure Bandage 1. while applying direct pressure on the wound, apply another bandage over the sterile dressing. 2. If the bandage becomes blood soaked,

place another clean cloth or dressing on top and bandage in place.

3. Continue to apply direct pressure to the

wound to assist bleeding control. 4. Don’t remove blood soaked bandages

because blood clots in the dressing helping control bleeding. Add more

bandages as necessary. 5. Elevate limbs where possible

Remember

When bandaging a leg for a serious bleed, bandage the whole leg enclosing the foot and pads to prevent swelling of the foot.

Serious Bleeding

The Circle of Care


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How it’s done: Direct Pressure 1. Give the Canine First Responder Statement. Assess the scene and call the veterinarian making sure the airway is open. 2. Put on Barriers. 3. Place a clean cloth or sterile dressing over the wound and apply pressure. 4. Release pressure periodically to determine if bleeding has slowed or stopped. Pressure Bandage 1. while applying direct pressure on the wound, apply another bandage over the sterile dressing. 2. If the bandage becomes blood soaked,

place another clean cloth or dressing on top and bandage in place.

3. Continue to apply direct pressure to the

wound to assist bleeding control. 4. Don’t remove blood soaked bandages be-

cause blood clots in the dressing helping control bleeding. Add

bandages as necessary. 5. Elevate limbs where possible

Serious Bleeding


If needed, clean the wound first

Apply Sterile or clean dressing and apply direct pressure

Release pressure periodically to see if bleeding has stopped then

reapply

Apply a pressure bandage, on legs be sure to bandage the whole leg enclosing the paw and pads too

Try it. In your practice groups begin with a primary assessment and attend to a serious bleeding wound on a canine’s leg. You should progress from direct pressure to a pressure bandage. Also practice direct pressure with dressing only to simulate an area that is difficult to bandage on a canine.

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Your Goal: Demonstrate how to manage shock by conducting a primary assessment, protecting the dog and stabilising the patient. Shock is a result of circulatory system failure. Therefore, it can be life threatening and is a factor in almost every injury or illness. By recognizing and treating shock, you prevent further disability. Key Points Remember to stop, think, then act – assess scene and alert Emergency vet or Animal EMT’s. Protect yourself and patient from disease transmission by using gloves and barriers. Perform a patient responsiveness check by gently stroking the legs or behind the ears/neck and give the canine first responder statement to the owner.

Perform a primary assessment. Monitor a patient’s ABC’s.

Shock results when an injury or illness makes it difficult for the body’s cardiovascular system to provide adequate amounts of oxygenated blood to vital organs and is exactly the same for canines as humans

Always treat an injured or ill Canine for shock even if signs and symptoms are absent. For a responsive dog, he will determine the most comfortable position for himself – usually lying down in the case of injury, etc.

Shock Management

The Circle of Care

How It’s Done 1. treat an injured, unresponsive or unconscious dog in the position found. Do not move if possible. 2. If a spinal injury is suspected manage as

for spinal injuries (More later). 3. Maintain the dogs body temperature based

on local climate. This may be covering to keep warm or shading from the sun.

4. If no spinal injuries or fractures are suspected, elevate the rear end of the dog 15-30cm to allow blood to return to the heart.

Try it - In your practice group, begin with a primary assessment and manage shock for an unconscious dog. Use blankets or towels available to warm the dog. Be resourceful and use whatever is available.


Remember, it’s better to treat for shock and prevent it than have to treat shock when it sets in

Raise the rear end to send blood from the extremities back to the vital organs

Then cover to maintain body heat

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Your Goal Demonstrate how to manage a suspected spinal injury by conducting a primary assessment, protecting the dog and stabilising as best as possible. Key Points Remember to stop, think, then act – assess scene and alert Emergency Vet or Animal EMT’s.

Protect yourself and patient from disease transmission by using gloves and barriers. Perform a patient responsiveness check by gently stoking the legs and neck behind the ears and giving the Canine First Responder statement to the owner and then if unresponsive continue with primary assessment Suspect a spinal injury for any incident involving a fall, severe blow, crash or other strong impact. If possible, perform primary assessment in the position the patient is found. Do not move the

patient unless safety is in question. Monitor canine’s life signs.


The Circle of Care

however sometimes the cord is uninjured. Nevertheless the support structure around it has been compromised and it is now very easy to damage the cord. It is therefore extremely important not to twist, bend or compress the injured spinal column. The most common cause of spinal injury by far is the dog being hit by a vehicle. In dogs, some breeds (Daschunds, Corgis, Miniature Jack Russell and Fox Terriers and other breeds with short legs) are prone to disc problems that can result in mild to severe signs and may result in paralysis without any history of trauma.

SPINAL INJURIES The spinal cord along with the brain makes up the central nervous system. Cells of this system have no ability to regenerate so that once cell death occurs the damage becomes permanent. It is therefore very important to be very careful handling an animal you suspect of having spinal damage. Unfortunately paralysis in our domestic pets can result in euthanasia, as we are unable to cope with their care. However there are many documented cases of dogs with spinal damage living long and healthy lives with the aid of canine wheel chairs. The spine is made up of the vertebrae, the spinal cord, the intervertebral disc and tendons, muscles and ligaments that hold all this together. When the spine is injured, a vertebra may fracture or a disc may rupture. Sometimes the vertebrae are torn apart. The spinal cord can be severely damaged at the time of the accident


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How it’s Done SYMPTOMS AND SIGNS Spinal injuries have a progression of signs going from mild to total paralysis.

Pain. Your pet may not be willing to stand or in milder cases jump up onto furniture or use stairs.

In mild cases your pet may appear wobbly especially in the hindquarters. It may fall easily when turning corners.

Your pet may become weak in its hindquarters and have difficulty getting up. It may scuff its nails and wear them down so they bleed.

You may notice that your pet stands on the upper surface of its toes instead the pads.

As symptoms worsen your pet may not be able to get up. Your pet may no longer respond to gentle touch in the area behind the damage to the spine. Leg movement becomes weaker.

Total paralysis. The legs appear floppy and the animal cannot move them voluntarily. Your pet may be incontinent. Strong pain to the affected

area will not cause the animal to turn to see the cause of the pain. Withdrawal of the foot from pain (such as having its toes pinched) is a reflex, and does not involve the brain or indicate if the spinal nerves are complete.

MANAGEMENT

Prompt veterinary treatment may prevent paralysis and euthanasia for your pet.

Keep your animal as quiet as possible no matter the cause.

For trauma cases lift your pet supporting the injured spine so as little movement as possible occurs at the injury site. Put small pets in a basket or a box. Larger dogs should be carried on a board or between several people.

Under no circumstances should a pet with suspected spinal injury be allowed to jump or use stairs.

If your pet is incontinent keep the fur as clean and dry as possible. Towels can be used to catch urine. Vaseline (or like) can be smeared on nearby skin to prevent urine scold.


Try it

In practice groups, begin with a primary assessment and attend to an unconscious dog also practice moving a canine with suspected spinal injury using blankets and improvised stretchers


42

Your Goal Demonstrate how to conduct a head to toe injury assessment on a dog and note injuries to report to veterinary staff or specialist emergency animal medical technicians. A head-to-toe injury assessment helps you recognize, attend to and report both external and internal injuries that may affect a patient’s condition. Key Points Use this skill to determine what first aid may be needed in the event of any injury – especially when Emergency Medical Service is either delayed or unavailable. Remember to stop, think, then act – assess scene and alert the vet or specialist animal EMT’s. (emergency medical technicians) Protect yourself and patient from disease transmission by using gloves and barriers. Perform a patient responsiveness check by giving the responder statement and gently touching the feet and legs and along the dog’s side. Perform a primary assessment and monitor and treat the patient’s lifeline if needed. Only perform injury assessments on a conscious dog.

When possible, perform the assessment in the position the patient is found. If wound dressings are in place, do not remove during the assessment. Look for wounds, bleeding, discolorations or deformities. Listen for unusual breathing sounds. Monitor a Patient’s Lifeline - The ABC’S Feel for swelling or hardness, tissue softness, unusual masses, joint tenderness, deformities and changes in body temperature. Make mental notes of the assessment and report findings to veterinary personnel. Avoid giving injured patient anything to eat or drink, as they may need surgery.

Injury Assessment

The Circle of Care

Avoid giving injured patient anything to eat or drink, as they

may need surgery.


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How It’s Done

1. Deliver the responder statement, asking permission to assist. Explain what you’ll be doing during the assessment. Put on gloves. 2. Stabilize the patient and make them as comfortable as possible. Do not try to restrain the patient as this will cause them to try to move. 3. Immediately stop the assessment if the patient reacts to any part on the injury assessment. Continue to make the patient as comfortable as possible end your assessment and wait for the vet to arrive. Do not move patient unless transporting the dog is your only option to get advanced medical care. 4. Start assessment at the head and work your way down the body to the pads.

Injury Assessment

Head to Tail

To

p t

o T

oe

5. Feel for deformities on the patient’s face by gently running your fingers over the head, cheeks and snout. 6. Check the ears and nose for blood or fluid. If present, suspect head injury and stop further assessment. 7. Check the eyes for smooth tracking. The eyes should move together. Also, check pupil size. 8. Feel the skull and neck for abnormalities. If the patient reacts and is in pain, stop the assessment. 9. If you can reach the shoulder blades, slide or place one hand over each shoulder blade and gently push inwards. 10. Move hands outward to the shoulders and press gently inward with the palm. 11. Place palm of the hand in the dog’s chest in front of the fore legs and apply gentle pressure. Section Three – Skill Development 12. Place one hand on the shoulder to stabilize the front leg and gently slide the other hand down the upper arm, elbow and wrist then repeat on the other leg. 13. Inspect chest for deformity. Place a hand, palm in, on each side of the patient’s rib cage and gently push inward.


44

14. With two fingers, gently feel the spinal column. Cover as much area as possible without moving the patient. Gently touch along the patient’s spine, feeling for abnormalities right along the tail. 15. Using one hand, gently push on the patient’s abdomen. Apply gentle pressure with the free hand supporting the back. 16. Move hands over the hipbones, palms inward, and gently push in on the hips. 17. Starting at the hip, slide your hand down the rear leg, knee, lower leg and pads as you did with the front. Gently press the sole of the foot against your hand then repeat on the other leg. 18. Note areas of pain or abnormality for your report to veterinary personnel. Continue to monitor and treat the patient’s lifeline.

Injury Assessment

Note areas of pain or abnormality

for your report to veterinary personnel

Try it In your practice groups, perform an injury assessment on a canine manikin and have one of the group come up with an imaginary injury. Through your assessment you should discover the injury.


45

Your Goals Demonstrate how to conduct an illness assessment by: Asking the owner and obtaining information about a patient’s medical history. Checking a patient’s respirations, pulse rate, temperature, and tissue colour. Reporting findings to Veterinary personnel. An illness assessment helps you identify and report medical problems that affect a patient’s health and may aid in the patient’s treatment. Key Points Use this skill to determine what first aid

may be needed in the event of any illness – especially when Emergency Medical Service is either delayed or unavailable.

Remember to stop, think, then act – assess scene and alert EMS. Protect yourself and patient from disease

transmission by using gloves and barriers. Perform a patient responsiveness check

by giving the responder statement and gently touching the feet and legs and along the dog’s side.

Perform a primary assessment, and

monitor and treat the patient’s lifeline if needed.

Only perform illness assessments on conscious, responsive patients.

When giving information to Veterinary personnel, avoid using the word normal. Provide measured rates per minute and descriptive terminology.

Section Three – Skill Development Signs are something you see is wrong

with a patient. Symptoms are something the owner tells you is wrong.

To help guide your assessment, remember that: The average breathing rate for adult dogs is between 12 and 20 breaths per minute. A patient who takes less than eight breaths per minute, or more than 28 breaths per minute, probably needs immediate medical care. The average pulse rate for adult dogs is between 70 and 120 beats per minute. Average temperature is warm and pads should feel dry to the touch. Noticeable tissue colour changes may indicate heart, lung or circulation problems. By conducting an illness assessment on a healthy dog at home, you will be able to recognize differences later when you assist an unhealthy dog.

Illness Assessment

The Circle of Care

How It’s Done 1. Find a paper and a pen/pencil to record illness assessment information. Use the notes page in the participant manual. 2. If possible, get someone else to record information while you attend to the patient. 3. Put on gloves.


46

Finding Pulse Rate 1. To find pulse rate using the femoral artery: Locate the patient’s hip with the tips of four

fingers of one hand. Slide the fingers down into the groove of

the groin on the side closest to you. If you can’t find the pulse on the side closest to you, move to the opposite side. Never try to feel the femoral pulse on both

sides at the same time. Count the number of beats in 30 seconds

and multiply by two to determine the heartbeats per minute. Do not use your thumb when taking a pulse. Determine whether the pulse may be described as rapid, strong or weak.

Checking Respiration 2. Look for signs and symptoms of respiratory distress, including:

Wheezing, gurgling or high-pitched noises when the patient breathes.

Patient shows signs of shortness of breath or feeling dizzy or light headed.

Patient shows signs of pain in the chest or other regions of the body. 3. To count the number of times a patient breathes, use one of two methods:

First method: Simply watch patient’s chest rise and fall and count respirations.

Second method: If you cannot see the patient’s chest rise and fall, place a hand on the patient’s abdomen. This position allows you to mask your efforts to obtain a count of the patient’s respirations. Dogs often alter their breathing rate if they become aware of human touch. For both methods, count patient’s respirations for 30 seconds and multiply by two to determine respiratory rate. 4. Determine whether respirations may be described as fast, slow, laboured, wheezing or gasping. Checking Temperature and Moisture 5. Feel patient’s pads with the palm of your hand. Dogs sweat through their mouths mainly which is why they pant to cool down. Verify if the patient has perhaps been doing physical exercise. 6. Determine whether the pads are warm, hot, cool, moist, clammy, etc. 7. Check patient’s temperature with a rectal thermometer. Normal temperature should be between 99.5° F and 102.5° F. Determining Colour

10. Look for apparent tissue colour changes that may be described as extremely pale, ashen (grey), red, blue, yellowish or black-and-blue blotches. 11. If the patient has dark gums, check for colour changes on the gums, tongue and soft tissue of the eye lids.

Illness Assessment


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Your Goal Demonstrate how to apply a splint to a dislocation or fracture. Splinting may prevent further injury, lessen pain, and reduce the risk of serious bleeding if the vet is delayed or it is necessary to transport the pa-tient to a medical facility. Key Points Use this skill in the event of any injury – especially if Emergency Medical Service is either delayed or unavailable. Remember to stop, think, then act – assess scene and alert Vet. Protect yourself and your patient from disease transmission by using barriers. Perform a patient responsiveness check by giving the responder statement and gently touching the feet and legs and along the dog’s side.

Perform a primary assessment, and monitor and treat the patient’s lifeline if needed. Perform an injury assessment. Use splinting to protect and immobilize a fractured, dislocated, sprained or strained body part.

Splints may include a variety of rigid devices including commercial splints, improvised splints (rolled newspapers or magazines, heavy cardboard, padded board, etc.) or securing the injured part to an uninjured body part (e.g., injured leg to an uninjured leg.) Splint the injury in the position found. Do not try to straighten. Try to minimize movement of the extremity until you complete splinting. If available, place splint materials on both sides of the injury site. This prevents rotation of the injured extremity and prevents the bones from touching if two or more bones are involved. Splint only if you can do so without causing more discomfort and pain to the patient.

Splinting for Fractures

The Circle of Care

How It’s Done

1. Choose a splint long enough to immobilize joints above and below the injury. 2. When using rigid splints, apply ample padding between the splint and the injury. Add padding to the natural body hollows as well. 3. Bandage the splint in place by using a roller bandage, a triangular bandage, an elastic bandage, adhesive tape or other available materials.

5. If the fracture is in the compound, apply a moist, sterile dressing to the injury site and splint above and below and bandage all.

Commercial splinting material on a roll can be cut to suit the


Try it

In your practice groups, splint a tail or a leg using a variety of materials you find in the room and be creative, your Instructor will guide you.

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Your Goal Demonstrate how to bandage a foot, leg, tail or ear using roller bandages and triangular bandages. A properly applied bandage can apply direct pressure to a wound and hold dressing in place to control bleeding. It can also prevent or reduce swelling, and provide support for an extremity or joint. Key Points Use this skill in the event of any injury especially if Emergency Medical Service is either delayed or unavailable. Remember to stop, think, then act – assess scene and alert the vet if necessary. Protect yourself and your patient from disease transmission by using barriers. Perform a patient responsiveness check by giving the responder statement and gently touching the feet and legs and along the dog’s side.

Perform a primary assessment, and monitor and treat the patient’s lifeline if needed. Perform an injury assessment. A first aid kit may include several different types of bandages including triangular bandages, adhesive strips, conforming bandages, gauze rollers (Non-elastic cotton) and elastic rollers. Choose the best bandage based on the injury or make the best use of whatever is available.

Bandaging Minor Wounds

The Circle of Care


How It’s Done

1. Put on gloves. 2. Apply the bandage directly over a sterile dressing covering the wound. 3. Apply the bandage below the wound and work toward the heart. 4. Wrap roller bandage firmly and consistently, but avoid making a bandage too loose or too tight. Cover the foot to prevent swelling. 5. Secure the end of the bandage by tying, tucking or taping it in place. 6. When bandaging the foot, secure the ban-dage by wrapping it around the ankle several times then back over the injury site on the foot. 7. When bandaging the pads, secure the bandage by wrapping it around the wrist.

8. If the elbow is involved, bandage below and above the joint to stabilize the injury site. 9. If the knee is involved, bandage below and above the joint to stabilize the injury. Using Triangular Bandages 1. Use triangular bandages to secure dressings either side of a penetrating object.

Try it

In your practice groups, bandage a leg or tail wound using a roller bandage, then use a triangular bandage to make secure sterile dressings around an embedded object. Encourage each other to vary wound sites.

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Name: ________________________________________ Date: ___________________ Instructions: place an X in the appropriate column and number for each answer which you believe to be correct.

YES NO

□ 1 □ A Primary Assessment is the first of the essential skills?

□ 2 □ Oxygen is necessary for life to continue?

□ 3 □ Gentle stroking the dog’s legs is the correct method for checking

responsiveness?

□ 4 □ In Performing CPR you begin with 4 quick breathes?

□ 5 □ Chest compressions should be done at a rate of at least 100 per minute?

□ 6 □ Canine Standard for CPR suggests that 2 breaths be used first between sets of

15 Compressions

□ 7 □ In canines you should first check the airway and clear before giving 2 rescue

breaths?

□ 8 □ If choking, a canine should be inverted, if size allows, along the forearm and

given abdominal thrusts?

□ 9 □ A canine who has undergone abdominal thrusts should not be checked over by

a Veterinarian afterwards?

□ 10 □ A tourniquet is the best method to stop bleeding?

□ 11 □ A blood clot is the body’s method of controlling bleeding. Our job is to help the

body form the clot?

□ 12 □ By performing all the steps of a primary assessment and care we are treating

for shock?

□ 13 □ Sometimes a canine responder will need to place something over and under a

dog to maintain body temperature?

□ 14 □ Shock only occurs with bleeding?

Quick Quiz


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□ 15 □ Tissue colour in a dogs gums is used as a sign of shock?

□ 16 □ If a dog’s pulse is below 50 beats per minute, it may mean something is wrong?

□ 17 □ The best place to check a dog’s pulse is at the carotid artery?

□ 18 □ Rescuer safety is of paramount importance dealing with any incident?

□ 19 □ With Canines the advice is to CALL FIRST in case there is no Emergency Vet

on duty?

□ 20 □ If a canine has been in a collision with a vehicle, a neck or spinal injury should

be suspected?

STUDENT STATEMENT: I have had explained to me and understand the questions I have missed. Student signature: ___________________________________ Date: _____________

Quick Quiz


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Canine First Responder Statement of Understanding

Instructions: Place an X in the appropriate statements indicating that you understand.

Emergency scenes can be very dangerous. I understand:

□Yes □No

Without barriers to blood and body fluids, accidental exposure to disease can occur. I understand:

□Yes □No

Practice in the essential skills and use of barriers in this course is required for successful completion. I understand:

□Yes □No

When you come to the aid of another whether it is a Canine or a Human, he/she does so by choice as a volunteer, my certificate is to show I have received training not a permit to perform first aid. A permit to come to another’s aid, with out pay, is not needed. I understand:

□Yes □No

Student Name: ____________ _______ Student Signature: ___________________

Date: __________ ___

Statement of Understanding


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ISIS House, Smith Road, Wednesbury, WS10 0PB, UK

Canine First Responders in Action Report Form.

When you use your skills as a Canine First Responder to care for an injured or ill dog, we’d like to hear about it. The incident need not be dramatic, involve a life-threatening condition or necessarily have a favorable outcome. Sharing your story motivates and encourages others to use their skills and provide assistance in emergency situations. This information is also useful to monitor and gauge the effectiveness of Canine First Responder training and assist in future program development. PLEASE TYPE OR PRINT CLEARLY

Name _____________________________________________________________________________________ First Name Middle Initial Last Name Address _____________________________________________________________________________________ City _____________________ County _____________ Country_____________ Postal Code __________ Phone (______) __________________ Email address _________________________________________ Date of your last Canine First Response Certification/Recertification Course _________________________ (Day/Month/Year) Name of your Canine First Responder Instructor/Course Director ________________________________________________________ Instructor No. _________________

Description of Events

Location of Incident _____________________________________________________________________________________ __________________________________________________ Date of Incident ______________________ (Day/Month/Year) On the back of this form, or on a separate sheet of paper, please describe the incident, including the nature of the injury or illness, the skills used to render aid, and if possible, information on the outcome. Please type or print neatly and submit your report to www.mjfirstaidtraining.co.uk or to the postal address above.

□ By marking this box I understand I am granting MJ First Aid Training permission to reprint the details of

this incident for the benefit of other Responders. I understand details that may identify the patient will be omit-

ted but my name as a Canine Responder may be used.

________________________________________________ _____________________________________

Signature Date (Month/Day/Year)

Visit www.mjfirstaidtraining.co.uk for the contact information of your nearest Canine First Responder

Instructor.


MJ First Aid Training Emergency First Response in the West Midlands

http://www.mjfirstaidtraining.co.uk/

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Notes


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Primary And Secondary Care for Dogs...While conducting your primary assessment and treatment talk to the owner explaining what you are doing as you progress. Try to allay their fears

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