Overview of EMS Canine Wound Care
Many military and law enforcement organizations nowadays use dogs in operations that are high-risk and could potentially be fatal. These operations include detecting explosives, patrolling, tracking, and help in finding missing persons. These dogs, including ones serving in the military and other enforcement agencies, are highly skilled and precious members of their teams. They put their lives at risk to ensure the safety and security of their human colleagues and the public.
In situations where these brave dogs get injured, vets are not often available right away. So, it becomes highly important for the people who handle these dogs, along with medics and other individuals who arrive first at the scene, to know how to provide immediate medical help. They need to have the required knowledge and skills to offer emergency care to these canine officers.
Anatomy and Physiology of EMS Canine Wound Care
It’s very important for those providing care for dogs to know the differences between the bodies of dogs and humans. Here are standard vital signs for dogs when they’re at rest and during exercise:
Dog’s vital signs:
Temperature (in Fahrenheit): At rest, it’s usually between 100.5-101.5. During exercise, it rises to between 101.0-104.0.
Heart rate (count of heartbeats per minute): At rest, it’s usually between 60-75. During exercise, it goes up to between 75-130.
Respiratory rate (number of breaths per minute): At rest, it’s typically 10-20 breaths per minute. During exercise, it increases to 30 or even leads to panting.
Mucous membrane color: This refers to the color of the gums. Normally, they’re pink, but they might turn bright pink during exercise.
Capillary refill time (in seconds): This measures how quickly blood refills in the gums after being pressed and released. Normally, it’s between 1-2 seconds and it doesn’t change during exercise. It’s a sign of how well the blood is circulating.
Why do People Need EMS Canine Wound Care
The top three preventable causes of death in dogs due to accidents or injuries are excessive bleeding from wounds, tension pneumothorax (a dangerous condition where air collects in the chest compressing the lungs), and blockage of the airways. Early and appropriate first-aid techniques can prevent about 20% to 25% of these deaths.
Injuries to a dog’s limbs that cause severe bleeding can be life-threatening. To treat these effectively, it’s not recommended to use normal human-sized tourniquets, as they are typically too big and are likely to slip off. To control the bleeding, it’s advisable to:
- Use pressure dressings — bandages designed to apply pressure to a wound — along with agents that help to stop bleeding.
- Apply direct pressure to the wound or tie tightly an elastic bandage around the injured area.
- Consider using specially designed dressings to stop bleeding or a medication called tranexamic acid (TXA) to the wound.
- If bleeding can’t be controlled by direct pressure, pack the wound with special gauze that helps stop bleeding. If the bleeding vessel is visible, clip it using a medical instrument called a hemostat.
When a dog loses a lot of blood, they may need a blood transfusion. The recommended amount of blood to be transfused is 10 to 20 mL per kilogram of the dog’s weight. Start slow with the transfusion and gradually increase the dosage over a period of 4 hours. However, in emergencies where the dog is still losing blood, the whole blood unit may need to be given quickly. But it’s important to remember this could lead to transfusion reaction, causing symptoms like fever, heavy breathing, and swelling of the face.
If dog blood for transfusion isn’t available, an equal amount of plasma and packed red blood cells extracted from dog blood can be used alternatively. It’s critical not to use human blood because that could cause a severe and potentially fatal reaction in the dog.
A medication called TXA is usually available in ambulances and in cases of significant blood loss. When the injury occurred within the last 3 hours, it can be given to reduce deaths from bleeding.
All combat wounds should be treated with antibiotics to prevent infection.
Chest wounds, especially ones caused by bullets, are common in military and police dogs. If the dog has such injury, you should listen to hear if the dog’s breath sounds are normal. Applying direct pressure or a chest seal can stop active bleeding, and using ultrasound or a type of x-ray called a radiograph can help in checking for lung injury or signs of pneumothorax. If symptoms suggest that the chest cavity has been compromised, a needle decompression technique — puncturing the chest cavity to release trapped air — may be used to confirm the diagnosis and relieve tension caused by pneumothorax.
In some cases, where the injury causes fluid to build up in the chest cavity (such as hemothorax, pyothorax), listening to the dog’s heart and lungs may give abnormal sounds. A chest radiograph can help make this diagnosis. Injured dogs usually need medical fluids after trauma, and treatment usually includes giving supplemental oxygen.
If the dog still has trouble breathing despite oxygen supplementation, it may need to be intubated — a process in which a tube is placed in its windpipe to help it breathe.
To prevent the dog from becoming overly cold, use a heating blanket and warm the medical fluids or blood products before they are given.
Abdominal wounds or bruising suggest potential internal injuries. If a dog’s abdomen is punctured and the intestines come out through the wound or are ‘eviscerated’, they should be cleaned, replaced into the abdomen, and the wound should be covered as soon as possible in the field. Any open wounds in the chest or abdomen need a vet to look at them and provide the appropriate treatment as soon as possible.
Preparing for EMS Canine Wound Care
If a military working dog (MWD) is hurt or scared, its behavior might become unpredictable when receiving medical care. To stay safe, those who are treating the MWD should wear gloves and other protective gear. It might also be a good idea to use a muzzle on the dog to prevent it from biting, unless the dog is having trouble breathing.
It could also be helpful to give the dog some medication to help it relax or manage its pain. However, human medications are not always safe for dogs and should not be given without first making sure they’re safe. Some anti-inflammatory drugs (medicines that reduce pain and swelling) that humans use can be harmful to dogs. Meloxicam is one type that is generally safe, but every dog is different. Large breeds like German Shepherds or Belgian Malinois, which are often used as working dogs, usually weigh over 30 kilograms. Any medication given should be carefully measured for the dog’s size to make sure the dose is safe and effective.
How is EMS Canine Wound Care performed
In simpler terms, a dog is considered to have an open and clear airway, which is essential for its breathing, if it can bark, growl or whine. On the other hand, if your pet is choking or having a hard time breathing, signs such as gagging, loud or rapid breathing, too much drooling, strange high-pitched noises while breathing, standing with front legs spread out and body leaning forward, face turning blue, or scratching the mouth or neck could be observed.
In case your pet is having difficulty with its airway or breathing, it’s better to calm the dog first before checking its mouth. Be careful not to put your hands directly in its mouth as it might bite you out of fear or discomfort. Instead, a shoelace can be used to help open its mouth by looping it around the jaw. A leash, rope, or rolled gauze can also be used in the same way. Dogs have relatively larger windpipe openings aiding the removal of obstructions (like a foreign body) directly or through suctioning.
For dogs that are larger than 55 lbs (25 kg) and are experiencing severe breathing problems, where a tube might be needed to help them breathe, certain tools are recommended. A laryngoscope is a tool that helps visualize and access the throat and windpipe. The best endotracheal tube (a type of tube used in these cases) should have an internal diameter between approximately 0.3 to 0.4 inches and should have a cuff (an inflatable part at the end). To measure how deep the tube should go, measure the distance from the upper part of the dog’s chest (thoracic inlet) or middle of the front legs and the central incisor (a front tooth). A shoelace can be tied at this length on the tube before the procedure. After the tube is placed, the shoelace can be used to secure it by tying the lace around the dog’s mouth.
Tables related to medications for dogs are also included here for reference. The first table provides details of doses for treating bleeding in dogs. It includes TXA, whole blood, plasma and PRBC, and freeze-dried plasma. The second table goes over medication options for pain management such as Fentanyl, Meloxicam, Morphine, and others that can be given through different ways—nasal, oral, injections, or intravenous. The third table indicates antibiotics, such as Ceftriaxone Sodium, Cefotaxime Sodium, Ertapenem, Moxifloxacin and Cefazolin, which are generally recommended for any combat-related wounds in dogs.
Possible Complications of EMS Canine Wound Care
There’s no official system or shared database for gathering and sharing information about emergency medical care provided to dogs.
What Else Should I Know About EMS Canine Wound Care?
On the battlefield, the three most common reasons for preventable deaths due to injuries are: bleeding from wounds on the limbs, tension pneumothorax (a serious condition where air gets trapped in the space around the lungs), and blocked airways. These conditions need immediate medical attention, but in military combat situations, medical help from veterinarians might take several hours or even days to arrive.
For instance, during Operation Iraqi Freedom, there were less than 30 veterinarians available for over 600 canines in the field. A study found that there were 11 cases of military working dogs (MWDs) getting injured, and most of these dogs had to undergo at least one medical procedure. The good news is, half of these dogs were able to survive their serious injuries.
