EQ Iatrogenic injury and horse rescue

Question 1

What should you do if iatrogenic injuries occur during visits?

Answer 1

Inform the owner what has happened, explain what needs to be done, discuss cost and prognosis, apologise and empathise, DO NOT accept liability for cost/ losses (VDS)

Question 2

How can nasogastric intubation complications be avoided?

Answer 2

Use an appropriately size tube, lubrication, ensure it is smooth, proper restraint, ventral meatus passes, never force the tube, ensure proper placement before administering fluids

Question 3

What should you do if the horse begins haemorrhaging after NGI?

Answer 3

Leave alone for 5-10 minutes (will generally resolve), warn owners (BEFORE) that this may happen, clotting profile/ endoscopy if doesn’t stop

Question 4

How can rectal examination complications be avoided?

Answer 4

Proper restraint, safe positioning, sedation if fractious, don’t push against contracting rectum

Question 5

Describe rectal tear grading.

Answer 5

1 - mucosa and submucosa, 2 - muscularis, 3a/b - mucosa, submucosa and muscularis, 4 - all layer tear

Question 6

What equipment is needed to provide adequate lavage pressure for debriding wounds?

Answer 6

35-60ml syringe and 18-19G needle

Question 7

What are the indications for primary intention healing?

Answer 7

Wounds less than 8 hours old, healthy tissue at wound margins, eyelids, nostrils and lips

Question 8

What are the golden rules for equine rescue?

Answer 8

1. Horses are unpredictable, 2. Calm with food or a companion, 3. Keep spine side, 4. Prepare - PTS, sedation, 5. Don’t release the horse unless there is a safe route, 6. Plan escape routes

Question 9

What are the key principles burn management?

Answer 9

Check structural damage, check extent, injury depth, cool skin with cold water, clip hair and lavage (0.05% chlorhex), use water based antimicrobials