Introduction

• The aim of first aid is to provide effective stabilization and management, to ensure the best outcome for the welfare and wellbeing of your patients.
• First aid can cover a wide range of clinical conditions from a minor problem to the more critical emergency patients.
• All staff should be trained to recognize what is a first aid emergency from the initial phone call to the unexpected arrival of a patient when the owner just turns up at reception.
• Understandably owners can be very distressed and upset on the initial contact but what we as veterinary professionals need to do is have the ability to gain as much information as we can, rapidly assess it and formulate a plan that is beneficial to both the patient and owner. It is important to remember that not all owners will be able to recognize what is or isn’t a true emergency or first aid situation which is why it is so important to ask the right questions to ascertain the severity of the problem.
• Questions to the owner should be specific and concise to gain maximum information, avoid frustration and misinformation. Examples of questions we should be asking include:
  • What is the problem with your pet?
  • How long ago did it happen?
  • Is there active bleeding, respiratory issues, consciousness, visible injury?
  • Is the patient on any treatment for the condition reported?
  • Has this happened before?
  • How long has the patient been ill for?
  • Is it getting worse?
  • Is the owner able to transport the patient to the practice?
• The outcome will be more successful if we are able to:
  • Have good communication skills with the owner as well as your team.
  • Recognize the severity and nature of the problem.
  • Correctly implement the appropriate treatment.
  • Ensure the correct care and monitoring for that species/problem.
• If an obvious injury has occurred and a possible amputation, get the owner to bring in the removed tissue so you can assess this as well, it may also give you an idea of what you are dealing with before handling the patient.
• If any diarrhea or urine has been voided, ask the owner to bring a sample of this in with them for examination.
• If the patient is actively bleeding and the owners are able to, ask them to place a clean lint free dressing over the area and apply pressure until you can see the patient.
• Once it has been established from the initial contact as to the nature of the first aid, ie emergency or not, then a plan can be formulated as to how to best deal with the situation when the patient comes in.
• Always remain calm and be prepared, if you have a good idea from the initial communication then an area can be prepared with all the necessary equipment and consumables that may be needed before the patient arrives, and also the staff available to deal with the case.
• The RCVS requires that all veterinary surgeons in practice should take steps to provide 24 h emergency first aid and pain relief to animals according to their skills and the specific situation.

Technical problems

• Can vomit but unlikely in healthy animals.
• J shaped os penis makes catheterization difficult.
• Urine acidic due to diet.
• Prone to heat stress.
• Can give ferocious bite which may be difficult to disengage from when frightened.
• Significant weight gain (up to 20%) during colder months.

Assessment and preparation for treatment

• On arrival at the practice prompt and professional opinion should be sort, this can be from either the veterinary surgeon nurse if the veterinarian is unavailable, they should be able to recognize and assess the severity of the presenting problem.
• A quick and concise assessment should be made of the patient whilst also confirming all the information from the owner and anything else they may have forgotten to say in the initial contact.
• On assessment we should be looking for:
  • Airway: patency.
  • Breathing: effort, auscultation.
  • Circulation: mentation, mucous membranes, CRT, heart rate, pulse quality, temperature. 
  • Any obvious injury: source of bleeding, general wellbeing of the patient.
  • Wound assessment: abrasions (friction applied to external surface), degloving (skin torn from underlying tissue), puncture (penetrating wound/bite wounds), incision (caused by a sharp object).
  • Abdominal pain: distention/bloating, ischemia, obstruction; auscultation for gut sounds, gentle palpation.
  • Also remember that what the owner is reporting may not be the only clinical condition that the patient may be suffering from.
• The patient, if needed, should be admitted to the practice for the appropriate treatment. The owner’s permission should be sought for any clinical procedures. Depending on the severity of the presenting case and if it is in the best interests of the patient, consent for euthanasia should be obtained Euthanasia.
• At this point it is important to inform the owner of potential costs especially if there are financial constraints.
• Once the initial examination Clinical examination has been finished, if the patient is showing signs of deterioration particularly if in respiratory distress or hypothermia then place them into an oxygen cage/incubator to stabilize before any further testing/treatment
• Prepare a quiet, warm environment for the patient as they may be suffering from shock, also loose body temperature due to being transported to the practice:
  • Incubator, hot water bottles, hot hands (warm water in gloves) blankets (although not too heavy a material), microwave heat pads, electric heat pads.
  • Care does need to be taken so not too overheat especially if the patient is recumbent and cannot move away from the heat source, so regular monitoring of body temperature is needed.
• Set up an oxygen cage/tent if respiratory distress suspected.
• Prepare/warm intravenous fluids, select suitable catheters, syringes and needles.
• Set up for radiography Radiography: digital/ultrasound if needed.
• Normal vital signs and parameters:
  • Heart rate: 200-400 bpm.
  • Respiratory rate: 33-36 bpm.
  • Body temperature: 37.8-40.0°C/100.04-104°F.
  • Life expectancy: 5-15 years.
  • Weight :
    • Male (hob): 1-2 kg.
    • Female (jill): 500-900 g.
  • Gestation: 38-44 days.
  • Weaning age: 6-8 weeks.

Considerations

• How amenable to handling is the patient, would excessive handling cause too much stress?
• What physical condition is the animal in? Is peripheral venous access going to be an issue especially if they are collapsed or with low blood pressure?
• What is the best procedure for the patients’ welfare?

Requirements

Preparation

Fluid therapy

Whole blood

Intramuscular injection

Conditions requiring emergency first aid

Aftercare

Further Reading

Publications

Refereed Papers

• Recent references from PubMed and VetMedResource.

Other sources of information

• BSAVA (2020) BSAVA Small Animal Formulary. 10th edn. BSAVA, UK.
• Girling S J (2013) Veterinary Nursing of Exotic Pets. 2nd edn. Wiley-Blackwell, UK.
• BSAVA (2012) BSAVA Manual of Exotic Pet and Wildlife Nursing. BSAVA, UK.
• BSAVA (2009) BSAVA Manual of Rodents and Ferrets. BSAVA, UK.
• Longley L A (2008) Anaesthesia of Exotic Pets. 1st edn. Saunders Elsevier, UK. pp 85-95.