Equine first aid

Question 1

What are the 7 steps to equine first aid?

Answer 1

Restraint
Control haemorrhage
Control pain
Reduce contamination – see wound lectures
Close wound? – see wound lectures
Bandage for wound protection
Splint fractures and tendon injuries

Question 2

what are the important factors to consider with restriant in regards to equine first aid?

Answer 2

Important factors to consider:
* Is there significant blood loss?
* Will ataxia / weight-bearing make this injury worse?

Physical restraint:
* Competent handler (ideally nurse or colleague), if owner is very upset or injured, involve someone else
* If horse is injured whilst competing, remove all tack and boots, except for bridle
* Ensure you clear an area to examine and treat the horse (large events will have screens and team to help with this)
* Remember that injured horses can react and kick unpredictably, even when sedated
* Wear a hat please!
*

Question 3

What chemical restaint can you use for equine first aid?

Answer 3

• Start with lower doses of alpha-2 agonists and add as needed
• Choose alpha-2 based on duration needed (short duration, e.g. applying splint – xylazine, longer duration, e.g. wound debridement, bandaging and transport – romifidine)
• Can use combination of IV and IM routes (IM has slower onset but longer duration and less ataxia – esp good for travelling horses)
• Always include opioids (butorphanol or buprenorphine most readily available in field situation) – analgesia and reduce touch sensation

Question 4

how can you control haemorhage in equine wounds?

Answer 4

• Pressure (bandage)
• tourniquet
• use of ligatures? - risk fo infection later

Question 5

how cna you contol pain in equine first aid?

Answer 5

Balanced approach with different components:
* NSAIDs (administer IV) NB Passport!
* +/- Opioids, paracetemol
* Splinting / bandaging to prevent movement
* +/- Sedation (alpha 2)
* Local anaesthesia infiltration
* Avoid distal limb local blocks where weight bearing could result in catastrophic injury

Question 6

When are NSAIDS containdicated in equids?
what are the commonly used ones in horse?

Answer 6

NSAIDs contraindicated in hypovolaemia, severe haemorrhage, renal/liver compromise
Commonly used in equine practice are flunixin meglumine (1.1mg/kg SID), phenylbutazone (initial dose 4.4mg/kg IV SID, reducing to 2.2mg/kg IV or oral) and meloxicam (0.6mg/kg)

Can use paracetamol IV and follow up with oral (20mg/kg BID orally) – not licensed, usually added when horse reaches practice/hospital

Question 7

what opiods are used in horses?

Answer 7

Equine e.g. butorphanol, buprenorphine(but more expensive), methadone, morphine
Notes: use opioids with alpha 2 agonists or acepromazine in horses, reduces side effects associated with opioids
Care with use of potent opioids e.g. with respiratory depression, bradycardia, but don’t let that stop you choosing them as v efficacious and provide excellent analgesia (side effects are less commonin animals in pain)

Question 8

how would you apply splints in each of these regions?

Answer 8

Region 1: alignment of dorsal cortices, splint placed dorsally (commercial splints), also for tendon and ligaments
Region 2: splint placed laterally and caudally
Region 3: splint placed laterally (and medially)
Region 4: forelimb - stabilise carpus (but clinical judgement as weight can make it worse)