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How to get my horse through bushfire injuries

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Publié le

with Dr Erik Noschka University of Adelaide
for Horse SA
https://www.horsesa.asn.au
https://www.adelaide.edu.au/vet/horses

Publié dans : Formation
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How to get my horse through bushfire injuries

  1. 1. How to get my horse through bushfire injuries Erik Noschka, DVM, MS, PhD Equine Surgeon, Uni Adelaide
  2. 2. Outline 1.  General considerations 2.  Burn injuries a) Epithelial surfaces b) Smoke inhalation and toxins 3.  Triage 4.  First Aid – Treatment 5.  When to call the vet 23/02/2015Dr No, How to get my horse through bushfire injuries
  3. 3. General considerations 1.  Preparedness a)  Trailer training b)  Trailer access c)  Escape routs, alternate paddocks d)  First aid course e)  Stocking Sedation, Medication and Bandages f)  First responders network 23/02/2015Dr No, How to get my horse through bushfire injuries
  4. 4. Burn injuries Thermal injury vs. Smoke inhalation barn fires: CO, CO2, Toxins Complications: laminitis; lacerations; colic … 23/02/2015Dr No, How to get my horse through bushfire injuries
  5. 5. Burn injuries - thermal Epithelial surfaces •  Skin •  Eyes / Cornea •  Airway •  Nostrils, nasal passages, throat •  Trachea, bronchi •  alveoli 23/02/2015Dr No, How to get my horse through bushfire injuries
  6. 6. Burn injuries - thermal Epithelial surfaces of the Airways •  Heat à cell death à edema à partial airway obstruction à inflammatory cascade à protein leakage into lungs à emphysema •  Other organs: microvascular injury + tissue coagulation à systemic shock (circulatory collapse) à inflammatory + coagulation cascade à edema 23/02/2015Dr No, How to get my horse through bushfire injuries
  7. 7. Treatment 1.  Systemic Shock a)  IV fluids b)  Plasma c)  Anti-inflammatories 2.  Pulmonary Edema / Emphysema a)  Diuretics (Furosemide) b)  Antibiotics 23/02/2015Dr No, How to get my horse through bushfire injuries
  8. 8. Burn degrees 1st degree (~sun burn) 2nd degree Partial Deep 3rd degree (full thickness) 4th degree Superficial epidermis to basal layer Epidermis + dermis Entire Skin lost (epidermis, dermis + fat) Entire skin + muscle + bone + fat are burned Painful less pain No sensation Erythema edema Heals in 2-2.5 weeks Heals in 3-4 weeks 50% Fluid and Protein loss Shock Infection Excellent prognosis Excellent prognosis Guarded prognosis Guarded- good prognosis Benefits from grafting Grave prognosis Benefits from grafting Can develop vesicles and blisters Wounds are life threatening
  9. 9. Triage 1.  Principles a)  Containment at safe place (experienced personnel) b)  Thorough physical exam —  Problemlist —  Prioritize —  Do I need the vet? 2.  Treatment a)  Cool tissues b)  Provide with Fluids c)  Provide with humidified oxygen (lung injury, hypobaric chamber) d)  Anti-inflammatories e)  Analgesia f)  Nutrition 23/02/2015Dr No, How to get my horse through bushfire injuries
  10. 10. Treatment 1.  Cool tissues a)  Ice cold water b)  Water hose 2.  Fluids a)  Offer water (plus electrolytes) b)  IV fluids —  Balanced electrolytes —  Plasma extender (hetastarch) —  plasma 23/02/2015Dr No, How to get my horse through bushfire injuries
  11. 11. Treatment 3.  Anti-inflammatories / Analgesia a)  NSAID’s b)  Vitamin E (1.000 IU alpha-tocopherol) ameliorate lung injuries c)  DMSO (first 24 hours) if ineffective one dose dexamethasone d)  Pentoxifylline e)  SSD (silver sulfa diazine ointment - Flamazine) topical f)  Opioids / Ketamine 4.  Antimicrobials a)  Topical +/- systemic 5.  Nutrition •  Highly nutritious food •  burns >30% of body surface à energy expenditure doubles •  Free choice alfalfa hay •  Add vegetable oil •  Gradual grain increase 23/02/2015Dr No, How to get my horse through bushfire injuries
  12. 12. Management 1.  Life threatening conditions first addressed a)  Systemic shock —  Balanced IV fluids (max. 20l for adult, edema risk) b)  Protein loss —  Max 10-20l plasma c)  Pulmonary edema / emphysema —  Antimicrobials —  Bronchodilation —  Ventipulmin / Albuterol d)  Upper airway obstructions —  tracheostomy 2.  Skin lesions a)  Cold water hosing b)  Clipping c)  Cleaning (weak, sterile Chlorhexidine solution) / debridement (loose eschar) d)  Topical applications —  Anti-inflammatory / antimicrobial (SSD, water based, also on eschar) rarely systemic AB —  Dressings e)  IV fluids if > 20% of surface skin burned (max 20l) 23/02/2015Dr No, How to get my horse through bushfire injuries
  13. 13. Management Vesicles and blisters management •  1st and 2nd degree burns Ø  Leave intact first 24 to 48 hours Ø  Protect raw skin from infection and less painful Ø  After 24 to 48 hours à partially excise + topical antimicrobial ointment •  Smoke inhalation and facial burns Ø  nutritional considerations Ø  damage to mucosa in the mouth and upper airways —  Water soaked hay —  Ground feeding à airways drainage 23/02/2015Dr No, How to get my horse through bushfire injuries
  14. 14. When to call the vet? 1.  Cases we can’t safe a)  Unconscious, recumbent, major/ extreme burns 2.  What can I do to start … 23/02/2015Dr No, How to get my horse through bushfire injuries Photo: R. Reid Hanson, DVM, Dipl. ACVS third-degree burn
  15. 15. More time for questions References: Equine Wound Management; Stashak, Theoret Dr No, How to get my horse through bushfire injuries

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