1. Clinical examination of the traumatised patient, type of bandage Flashcards
Mechanical caused trauma of the muskoskeletal system
- Wounds, open injuries
- Synovial infections
- Closed injuries ( damage, rupture, penetration)
- Bone fractures
- Luxations
Which type of emergency help can you do before transport of the horse?
- Check circulation
- Pain and anxiety relief
- Stabilize the horse before transport:
What would you use to relief pain and anxiety?
For sedation: Alpha-2-receptors
- Xylasine
- Detomidine
- Butorphanol
- NOT use ACE = Hypotensive effects
Orthopaedic painkilller:
- COX-2 panikillers: Firocoxib
- Be carefull in severe hydration and shock
How to stabilize the horse before transport, which steps do you follow?
- Stop bleedings
- Prevent furhter injury -> avoid open fracture feks
How would you transport a traumatised patient?
Polsters on the side
Support weight bearing by an abdominal sling
In case of a fractured limb, how do you prepare a traumatised patient for transport?
Apply polster + splint (The splint must be one line), causing a short term immobilization
It is important to stabilize over the next joint. So if the fracture is below the fetlock , we need to stabilize over the fetlock and all the way down to the hoof
How would you position the horse in the trailer in case of a fracture in a horse?
Fracture in forelimb = Head towards the back, if there is a sudden stop, the horse will put weight on the backlegs, not the forelegs
Fracture in hindlimb = Head positioned towards the front.
Before transport, you do a brief physical examination, what do we check?
We check the circulatory system and mental state.
- Heart rate: Normal=28-42
- Respiratory rate: Normal 10-18
- MucousMembrane, CRT: Normal: light pink, CRT=below 2
- Temperature: Normal: 37-38
- Check for hydration: check for skin turgor
- Take blood sample: biochemistry, electrolyte
after the physical examination, what to do?
Examine the injury
How do you examine the injury?
- Distant examination: Swelling, presence and degree of lameness
- Palpation: check for wounds, foreign body
- Check for localization and assess if there is a penetration of underlying structures
With what would you assess a bone and what do you evaluate in the bone?
X-ray and CT (if necessary
Evaluate:
- Location
- Complete/incomplete/comminuted
- Displaced(non-displaced
- Articular/non-articular
How would you assess the synovial joint, and what do we evaluate?
By x-ray, with contrast
Evaluate:
- Cartilage/meniscal damage
- Soundness of synovial membrane/bursa wall
- Presence of communication
What would you call an xray with positive contrast into the joint?
Arthrography
What would you call an xray with positive contrast into the bursa?
bursography
What is the dilution of the contrast and how much of it do we use?
Dilution: 25% triiodinated, water-soluble
Volume: depedning on the traget, between 2-20 ml
What are the aims of using a bandage?
- Reducing oedema
- Preventing haemorrhage formation
- Protection of surgical sites from contamination
- Immobilizatoin
- Protection from desiccation (drying up)
In general, we have primary and secondary dressing. What is the primary dressing?
A dressing applied over the surgical site/wound.
It is sterile, semi occlusive and non-adherent gaze
It may be infiltrated with Chlorhexidin or Betaisadona
In general, we have primary and secondary dressing. What is the secondary dressing?
Applied over the primary bandage.
It is elastic bandage and elastic adhesive bandage
We use a 1-2 cm thick padding: sheet cotton of roll cotton
Which types of bandage can we see?
- Hood bandage
- Distal limb bandage
- Robert Jones bandage
- Carpus bandage
- Tarsal bandage
Hoof bandage.
Indications, extension, layers
Indications:
- Covering the hoof after surgical procedures
- Softening hoof capsule
Extension: Under the fetlock joint
Layers:
1. Cotton
2. Elastic bandage
3. Elastic adhesive bandage
4. silver tape
Distal limb bandage.
Indications, extension, layers
Indications:
- Covering surgical sites
- after intraarticular injections
Extension: From coronary band to the carpus or tarsus
Layers:
1. Cotton
2. Roll cotton from distal to proximal
3. Elastic bandage
4. Elastic adhesive bandage
5. Fixed to the hood capsule by impermeable tape
Robert Jones bandage.
Indications, extension, layers
aim: Immobilization of limb and joints
Consist of a standard distal limb bandage, strengthened by additional layers of sheet cotton, should reach 3 times the diameter of the limb.
Carpus bandage.
Indications, extension, layers
Extension: From coronary or fetlock to above the carpus
Layers:
1. Sterile wound gaze
2. Roll cotton: start at the fetlock, go up 15cm above the carpus
3. Elastic bandage
4. Incorporate relieve pad made from cotton at palmar carpal area
5. Incorporate sheet cotton
6. elastic bandage
7. elastic adhesive bandage
IMPORTANT: relieve pressure over the accessory carpal bone for preventing pressure sores or skin necrosis
Carpus splint.
Indications, extension, layers
Indications:
- Luxation
- Fracture
- Tendon rupture
Apply over the robert jones bandage
Extension: From coronary band or fetlock to the proximal limb under the elbow
Layers:
1. Proper polstering
2. Apply on palmar surface
3. Fixation via silver tape
4. Elastic bandage
5. Elastic adhesive bandage
Tarsal bandage.
Indications, extension, layers
Extension: From coronary or fetlock to above the tarsus
Layers:
1. Sterile wound gaze
2. Roll cotton: start at the fetlock, go above the tarsus
3. Elastic bandage
4. Incorporate relieve pad made from cotton at palmar area above the tarsus
5. Incorporate sheet cotton
6. elastic bandage
7. elastic adhesive bandage
Tarsal splint.
Indications, extension, layers
Indication:
- Wound healing protection
- Luxation
- Fracture
- Tendon rupture
Extension: From coronary band or fetlock to the proximal limb above the common calcaneal tendon
Common problems to consider in case of bandages
- Too loose -> Slipping or rotatin of bandage and plsint
- Too tight -> pressure necrosis
- Uneven tension of bandage
- Contamination
