Equine Triage Flashcards
What equine cases are emergencies?
- Respiratory distress
- Colic
- Dystocia
- Collapse/recumbency
- Extreme pain
- Sudden onset lameness
- Fractures
- Severe wounds (including synovial injuries)
- Ocular injuries / severe ocular disease
- Urinary obstruction
- Toxin ingestion
When triaging equine cases you need to prioeties cases. give examples of Priority 1, 2, 3 and 4
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Priority 1: Immediate action (or might die)
- Examples: History of head or spinal trauma, History consistent with internal injuries, Life threatening haemorrhage
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Priority 2: Do not move (or could become unfixable)
- Examples: Fracture, Tendon rupture / laceration, Joint instability, Vascular or neurological damage
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Priority 3: Requires urgent attention (cases where you need to recognise the complications and treat them urgently or the prognosis will be compromised)
- Examples: synovial or bony involvement, contaminated wounds
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Priority 4: Delayed action (does not need an urgent / emergency visit)
Can be difficult to decide without examining in patient
If in doubt, always offer emergency visit and advise on potential issues / complications if not seen. If client has called as an emergency, they are usually worried enough to need an emergency visit..- Examples: chronic wounds/injuries, but remember these can progress and become urgent (e.g. development of synovial infection)
A client sends you photos of these horses out of hours (Sunday morning) and asks whether they need an emergency visit.
Is this an emergency and does it needs to be seen today, and give your reasons for this..
The chestnut horse had fallen on the road and had open wounds into both its carpal joints. Priority 3 based on the location over synovial structures.
A client sends you photos of these horses out of hours (Sunday morning) and asks whether they need an emergency visit.
Is this an emergency and does it needs to be seen today, and give your reasons for this..
The black horse is Priority 4 – this had a wound previously over its tendon, was turned out in a field and was spotted by another owner, with excessive granulation tissue in the wound (caused by the excessive movement of the wound edges) – not urgent and can be debrided as a routine appointment
what is the fisrt step of triage when the animal is in front of you?
Start by standing back and getting an overall impression of the patient – look for gross abnormalities and observe stance and demeanour
* Degree of lameness
* Conformational changes / Gross abnormalities
* Location and discharge from wound (what structures might be involved)
* Degree of Blood loss (severity and duration)
* Degree of contamination (type, duration and extent)
*
Jumped over a gate onto Barnet High Street. Loads of blood, lots of spectators. Horse able to walk with minimal lameness.
What priority is it?
What are the main risks with this wound?
Priority 3 – urgent attention, not life threatening (unless it communicates with the thoracic cavity). There is a reasonable amount of muscle in this region and minimal contamination. It healed well by a combination of primary and secondary intention – there was some wound breakdown and the biggest challenges were trying to get the horse to remain quiet and still during box rest and not bite the wound whilst it was healing
If there is a wound, what equipment do you need in order to perform an exam?
what are you looking for during this?
- Animal is in pain – risk to yourself, owner / handler and animal
- May need to sedate / anaesthetise / give analgesia first
- May need to re-examine
Sterile gloves (to avoid contamination)
KY jelly (to clip around the wound without contaminating)
Sterile probe
Looking for:
* Presence / absence of crepitus (distinguishing fractures and emphysema)
* Degree of contamination
* Soft tissue involvement
* Bony involvement
* Swellings and effusions
This horse caught its leg on wire in its field, repeated attempts to free itself resulted in this damage to the dorsal aspect of its hindlimb (metatarsal region)
After the mud was hosed off, this was the appearance of the wound. On palpation, you can feel directly down to the bone, and the surface feels roughened with small grooves palpable in the surface of the bone.
List the structures that have been damaged, starting from outside to in.
What are the potential complications with this wound?
- Skin, extensor tendon, periosteum, bone
- Complications – dehiscence of wound, unable to repair extensor tendon, damage to periosteum associate with risk of sequestrum formation. This healed and did not form a sequestrum, it needed a skin graft and took around 12 months to heal. The horse had a mechanical gait abnormality associated with the extensor tendon deficit but returned to work