EMERGENCY - Equine Emergency Flashcards
In regards to the alimentary system, what is classified as an emergency in horses?
Colic
Abdominal trauma
In regards to the respiratory system, what is classified as an emergency in horses?
Dyspnoea
Thoracic trauma
In regards to the cardiovascular system, what is classified as an emergency in horses?
Severe haemorrhage
In regards to the neurological system, what is classified as an emergency in horses?
Spinal or cranial fracture
In regards to special senses, what is classified as an emergency in horses?
Corneal laceration
In regards to the musculoskeletal system, what is classified as an emergency in horses?
Fractures
Tendon and ligament injuries
Wounds
Myopathies
In regards to the reproductive system, what is classified as an emergency in horses?
Dystocia
Red bag delivery
How do you prepare for an equine emergency?
- Know phones numbers of your colleagues, referral practices and disposal contact
- Check your car to make sure you have everything you need such as PPE, equipment, drugs etc
How should you triage over the phone for an equine emergency?
- Determine if this is really an emergency
- Gather signalment information
- Gather a history
- Provide the client with guidance whilst they wait for you to arrive
What are the main steps involved in triage for an equine emergency?
- Identify the stability of the animal
- Identify your patient using their passport, determine signalement and take a history
- Identify and treat injuries that are immediately life threatening and identify which injuries could be exacerbated by moving the animal
- Thorough clinical exam
- Make a differential diagnosis list and plan your treatment and management
What guidance should you provide a client with a colicing horse whilst they wait for you to arrive?
Remove all food from the area and if the colic is violent stay away from the horse and don’t risk human safety
What guidance should you provide a client with a horse with a penetrating hoof injury whilst they wait for you to arrive?
Tell the client not to remove the penetrating object if it is deeply penetrated, however, if the penetration is superficial it may be beneficial to remove it to prevent further trauma if the horse pushes it further in etc.
What guidance should you provide a client with an actively bleeding horse whilst they wait for you to arrive?
Apply pressure to the wound if safe to do so and do not remove the pressure
What do the ABCD principles stand for in equine emergencies?
Airway
Breathing
Circulation
Drugs
What should you do if a horse has an upper airway obstruction?
Emergency tracheostomy
How do you carry out an equine emergency tracheostomy?
- Surgically scrub and administer lidocaine at the upper third of the trachea (if there is time)
- Carry out a midline vertical incision at the upper third of the neck
- Divide the stenothyrohyoideus muscles overlying the trachea
- Stab incision through the annular ligament between the tracheal rings and extend this inision to either side big enough to allow for the placement of the tracheostomy tube
- Secure the tracheostomy tube to the neck
What is the circulating blood volume of a horse?
80 - 100ml/kg
When will a horse begin to decompensate due to haemorrhage?
A horse will begin to decompensate due to haemorrhage if they suffer from approximately 30% acute blood loss
List five clinical signs of significant haemorrhage in horses
Tachycardia
Tachypnoea
Hyperpnoea
Pale/white mucous membranes
CRT more than 2 seconds
What should you do if a horse has severed an artery?
Clamp the artery but be careful of nerves as they often sit very close to arteries
What is the ceiling dose of sedatives?
The ceiling dose of sedatives is where you reach a dose where increasing the dose of a sedative no longer increases the intensity of the sedation, instead it just increases the duration of sedation
When in an equine emergency can it be useful to use xylazine as a sedative?
Xylazine is good to allow you to assess a fractious colic as it can be administered IM and has a short duration of action so you can carry out a safer clinical exam and then reassess the animal when the sedation wears off
Try to get a heart rate before administering the xylazine
What should you be aware of if using detomidine to sedate a fractious colic?
Detomidine is a more potent analgesic than xylazine and this can mask esalating pain which could indicate a worsening colic and alter your treatment plan. Ideally you should only use detomidine for horses with severe and relenting colic pain
Which nine side affects of α2 agonists should be aware of in horses?
Transient hypertension followed by hypo- or normotension
Bradycardia
Mild to moderate respiratory depressionn
Worsen upper airway obstruction
Tachypnoea in pyrexic horses
Reduces gastrointestinal motility (be careful as can cause colic)
Sweating
Diuresis
Hyperglycaemia
How do α2 agonists worsen upper airway obstructions in horses?
α2 agonists cause muscle relaxation which can exacerbate pre-existing airway obstruction
Why should you not offer horses food until they are fully awake following sedation?
Horses that are not fully awake following sedation as they are as risk of oesophageal choke
Which opioid is commonly used in combination with α2 adrenoreceptor agonists in horses?
Butorphanol
Why is butorphanol commonly used in combination with α2 adrenoreceptor agonists in horses?
Butorphanol has a significant potentiating effect on the sedative and analgesic effects of α2 adrenoreceptor agonists
How should you generally administer sedatives to horses?
Generally you administer and top up sedative drugs via an IV bolus
How should you administer sedative drugs for longer procedures?
Administer an IV loading dose followed by continuous infusion
What are the three key clinical signs of colic in horses?
Pawing
Flank watching
Rolling
(T/F) The majority of colic cases in horses require surgery
FALSE. The majority of colic cases can be managed medically
Which significant side effect of NSAIDS should you be aware of in horses?
Right dorsal colitis
What classifies as euthanasia on humane grounds?
-Euthanasia due to a strangulation lesion of the small intestine that cannot be corrected
- Euthanasia of an adult horse with a displaced radius fracture
- Euthanasia of a horse with terminal illness
Which drug should you use for euthanasia in horses?
Somulose
How should you administer somulose?
Place an IV catheter and administer the drug over 10-15 seconds
What dose should you use for somulose?
1ml/10kg
(T/F) Somulose is very unsafe for humans
TRUE. Somulose can be very dangerous if absorbed through your skin or mucosa
