FIELD MANAGEMENT OF WOUNDS & FRACTURES
Wendy Greathouse
Texas A&M Veterinary Teaching Hospital
In a search and rescue operation the main thought is to help with the recovery process of those in tragic situations. Often during these times it is difficult to look out for ourselves and our rescue dogs. There are dangerous conditions and terrain that we can and can’t see. When the dogs enter unknown areas they may be facing dangerous situations that put them at risk for wounds, luxation or fractures. Being prepared with a plan of action will be beneficial should an accident occur.
Begin by surveying the scene. If this area is not safe then transporting the wounded animal is the only safe option. Take an initial assessment of the environment. You are looking for anything that could be helpful. A soft surface for the dog to lie on or materials that could be modified for a splint are two examples. Secure the wounded dog with at least a leash. A muzzle is always recommended for painful animals. This will keep you safe as well. Towels can be used to cover the head also. Triage the wounded dog to identify the best course of action. Transport immediately, if there are signs of airway, breathing or circulatory problems. If the animal is stable but has a wound, luxation or fracture treatment in the field is ideal.
When treating in the field pain medication may not always be available but if it is now would be an appropriate time to administer it. Information for dosages should be documented with the medications. After the animal has had a moment to respond to the medications then examine the areas of concern. The location of the wound will decide the course of action. Problems on the limbs will be easier to treat versus those on the body. This is mostly due to their hair.
On the canine body it will be a challenge to keep things in place. Open wounds should be handled such that contamination is minimized. Sterile non-adherent products should cover any open wounds first. A layer of padding will provide absorption and comfort. Suggestions for padding are cast padding, towels, pillows or any similar item. In order to keep things in place and slow bleeding you must compress the bandage. This can be done with stretch gauze, torn pieces of a sheet or shirt or anything that can be pulled snug over the padding. It is important that this not be so tight as to cut off circulation. For patients with wounds you may cover the bandage with bandaging tape or a waterproof barrier during transport to a medical facility.
Wounds on the face will probably require sedation as well as pain medication in order to give the best care. A Band-Aid can be used as a temporary cover during transport. The face is difficult due to head shaking and hair so treatment in the field is not recommended.
Fractures and luxation should be stabilized before transportation unless it is the femur or humerus. Bandages that provide adequate immobilization are tedious, complicated and if not done correctly will cause more harm than good. For fractures and luxation of the distal limbs immobilization is ideal. This is accomplished by immobilizing the joint above and below the fracture or luxation. For example, if the dog is believed to have a radius ulna fracture the bandage must keep the carpus and elbow from moving. In the field you may have to be creative when coming up with a splint. Something rigid enough to support the dogs weight and in the shape of the limb is the goal. A SAM splint, tree branch, metal bar or a board splint are good choices for the forelimb. The hind limb can be more difficult due to the shape when standing. Splints that do not accomplish this can distract the fracture and make your pet more uncomfortable. A toe luxation or fracture can be stabilized well with a SAM splint. Tarsal (ankle) luxation or tibia fractures are more complicated. The best choice is something rigid that the dog can bear weight on but will also immobilize the stifle (knee) in a standing position. A SAM splint will probably be too flexible but could be used in combination with a board splint or metal bars. In the clinic we make splints from casting material in order to solve the problem of the curved hind limb. In the field creative thinking is going to come in handy. Some ideas are a perfect branch, two branches duct taped together, bent metal bar, or a layered fire hose. Just remember that it is easier if the dog canurinate and defecate.
In conclusion, there are many options that would be appropriate for temporary treatments. Wounds should be covered to minimize contamination and compressed to stop bleeding. Fractures and luxation should be stabilized by immobilizing the joint above and below. Lastly, the wounded should be transported to a medical facility as soon as it is safe.