Patient Triage, First Aid Care, and Management of Oral and Maxillofacial Trauma.

Maxillofacial trauma is a common presentation in veterinary medical practice. Accurate assessment, diagnostics, pain management, and finally repair are tenants to treatment. In addition to typical tenants for fracture repair, the restoration of occlusion and return to function (eating, drinking, grooming) are unique to trauma management in these patients. Options for repair include conservative management (tape muzzles), noninvasive repair techniques (interdental wiring and composite splinting), and invasive repair techniques (interfragmentary wiring and plate and screw fixation).

Clinical Update: Concepts of Prehospital Traumatic Hemorrhage Control in the Operational K9.

Major trauma often involves varying degrees of hemorrhage. Left unattended, any amount of trauma-induced hemorrhage may rapidly become life threatening. Similar to humans, Operational canines (OpK9s) can suffer penetrating trauma and blunt trauma that lead to compressible and noncompressible hemorrhage. Preserving organ function and saving the life of a massively bleeding OpK9 require the implementation of immediate and effective hemostatic measures. Effective hemorrhage control interventions for the exsanguinating OpK9 are similar to those for humans: direct pressure, wound packing, hemostatic agents and devices, pressure bandage, and, possibly, tourniquet application. Although tourniquet application is a life-saving intervention in humans experiencing extremity hemorrhage, it is not considered a necessary, immediate-action life-saving intervention for canines with extremity injuries. This article provides a brief description of the basic methods for identifying life-threatening hemorrhage and achieving immediate hemostasis in the bleeding OpK9 during the prehospital period.

The Operational Canine and K9 Tactical Emergency Casualty Care Initiative.

BACKGROUND: Approximately 20% to 25% of trauma-related, prehospital fatalities in humans are due to preventable deaths. Data are lacking, however, on the nature and the prevalence of operational canine (OC) prehospital deaths. It is plausible that OCs engaged in high-threat operations are also at risk for suffering some type of preventable death. Tactical Combat Casualty Care has significantly reduced human fatality rates on the battlefield. Standardized guidelines specifically for prehospital trauma care have not been developed for the OC caregiver. An initiation has been approved by the Committee for Tactical Emergency Casualty Care to form a K9-Tactical Emergency Casualty Care (TECC) working group to develop such guidelines. SIGNIFICANCE: The intent of the K9-TECC initiative is to form best practice recommendations for the civilian high-risk OC caregiver. These recommendations are to focus on interventions that (1) eliminate the major causes of canine out-of-hospital preventable deaths, (2) are easily learned and applied by any civilian first responder, and (2) minimize resource consumption.

First Aid Tips for Pet Owners

To avoid the feelings of panic that may accompany these situations, we recommend the following steps to better prepare you for a pet medical emergency. The following links summarize the basics you need for giving first aid care to your pet.

Management of rectal tears.

Rectal tears have important medicolegal implications, and severe tears have a poor prognosis. Prompt diagnosis, immediate application of first aid measures, early referral, use of appropriate definitive treatments, and aggressive aftercare will improve the prognosis. The grade of rectal injury will determine the definitive treatment, but there are few guidelines to determine which treatment is best in each case. Bypass procedures, such as colostomy and indwelling rectal liner, have their own advantages and disadvantages, but can facilitate healing and prevent life-threatening complications if they are used with minimum delay. Suture of the tear can be difficult, but should be attempted to hasten healing and to prevent progression of the tear to a more severe injury.

First aid, transport, and triage.

A favorable outcome for a patient suffering acute trauma or disease is more likely if prehospital first aid can be administered. Veterinary facilities should teach their clients about first aid and transport and be able to give instructions over the telephone. Once a patient arrives at a veterinary facility, the entire staff should be prepared so that triage, the primary survey, resuscitation and stabilization, and the secondary survey may be performed efficiently and effectively.

Care of accidental wounds.

In wound management, the first consideration is first aid, and the primary aim must be to minimize further tissue damage. Definitive care includes cleaning, debridement, and repair procedures. Saline solution is the key to cleaning; antibiotics and antiseptics are not always indicated. Debridement should be done surgically. The wound is then managed by primary closure or delayed primary closure, or it is left open to heal by contraction and epithelialization.