Pet BLS

reaper

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With the current billing difficulties for some California patients, everything is a big deal right now. We do not use oxygen to pretend we care about people or pets.

I will treat a pet, if they present with injuries that I can control will bandages, etc.

Most pets put on o2 are due to smoke inhalation, so that is treating them.

Trust me, your service wastes more o2 a day, then what you are useing on that pet!
 

micsaver

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Now I will introduce you all to my lovely girlfriend - The Veterinarian in training...
Hey all. Its good to hear that our fellow Emergency Staff in the human world are caring about pets. I've been an Emergency and Critical Care vet nurse for 6 years now, so pet CPR is kind of a specialty of mine.
Some things to know:
1. Check oral mucous membranes to assess color/CRT; CRT should be less than 2 sec, color should be "bubblegum" pink. Give 02 if any deviations from this. Shoving an O2 tube up or against a nostril is fine as long as the pet tolerates it. Or, cut a small hole in a disposable plastic solo cup, thread O2 line through that, and place over pet's muzzle.
2. Assess pulse at the medial saphenous (femoral) artery. Auscultate heart beneath the point of a bent elbow. Dogs can get all the same arrhythmias humans can, just for different reasons. Dogs have a higher tolerance for VPCs, but still don't do well with V-tach. We don't tend to defib dogs for V-tach. Don't defibrillate a dog unless under a vets direct supervision (as in, the vet is on scene or one the phone with you). You don't shave them, just use a ton of gel, no alcohol. A flaming pet is no fun for anyone.
3. Success of in-hospital CPR is about the same as humans. Big university and some specialty hospitals can do all out life support for dogs and cats. I've put dogs and cats on ventilators, transfused them, done hemodialysis on them, etc. I've seen owners spend tens of thousands of dollars on their pets. I've also seen owners spend nothing.
4. Out-of hospital CPR success studies are harder to do since we don't have EMS in the vet field. I have heard of some stories of owners intubating their dogs with garden hoses and such. Some of those patients live, some die. The success rate of not trying is 0%.
5. I agree with the previous descriptions of chest compressions and overall technique with one alteration. For dogs under 20 kgs, compress directly over the heart. Cats can be done this way, too, but you might only need one hand. For dogs bigger than 20 kgs, compress at the widest point of the chest. This causes the thoracic cavity to act like a bellows and is more efficient at moving blood around. The rate of chest compressions is about 60-100 per minute, depending on the size of the dog. Breaths are about 20 per minute. Ensure you are getting good expansion. I'm told dogs and cats are easier to intubate than humans. Never tubed a human before :)
6. If you're interested in pet CPR, take a class. EMS people like you guys probably have a way better chance of saving a dog than your average joe shmo. I commend all of you for your work and dedication to the field of life saving. All our veterinary knowledge of CPR is taken and modified from the work EMS has done over the years. With that, we can save both human and animal lives.
 

reaper

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Very good post, with great info!
 

Sasha

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3. Success of in-hospital CPR is about the same as humans. Big university and some specialty hospitals can do all out life support for dogs and cats. I've put dogs and cats on ventilators, transfused them, done hemodialysis on them, etc. I've seen owners spend tens of thousands of dollars on their pets. I've also seen owners spend nothing.

While my piggies are family, that is waaay excessive for an animal. Really? Seriously?
 

reaper

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I normally treat my dogs myself. I have spent upwards of $6k on one of my horses though.
 

Juxel

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Here was another police dog that was taken via ambulance to the vet for surgery after being shot. It doesn't specifically say the dog went via ambulance, but it's still interesting.

Read the story here.
 

EpiEMS

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I'm quite concerned about possible risk to the provider here...mightn't an anxious dog or cat be aggressive rather than receptive to care?
 

DesertMedic66

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The fire department I used to work at carries animal BVMs.

There was a structure fire where the firefighters pulled out a dog during the interior attack. The dog was in full arrest. After compressions and adapting a human BVM to work for the dog they got a pulse back. About 5-10 mins later the dog was running around on scene. A local reporter was there and got video of it. After seeing the video the public wanted us to have animal BVMs on the engine. I believe there are 3 different sizes (cat size, dog size, and one that looks like bear size lol)
 

DPM

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I don't know about CPR but I read a story of one of our search dogs in Afghanistan getting treated by the lads on the ground. IIRC the doggy was all smashed up from a hand grenade, but the blokes stopped the bleeding and he was casevac'd and survived.
 

bstone

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I am pretty sure that our EMT licenses/certifications to not extend to animals. Practicing medicine on them would be tantamount to practicing vetrinary medicine without a license. You could have your EMT license/cert revoked and face possibly criminal charges.
 

DesertMedic66

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I am pretty sure that our EMT licenses/certifications to not extend to animals. Practicing medicine on them would be tantamount to practicing vetrinary medicine without a license. You could have your EMT license/cert revoked and face possibly criminal charges.

There is actuall a couple of K9 medic classes that teach to about tubing and how to start IVs along with drugs to give a K9.

Also if you hit a dog with your truck your not going to get in trouble. If you hit a person with a truck, yeah your probably gonna get in trouble. So I don't know if anyone would take away your cert for helping an animal.
 

bstone

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There is actuall a couple of K9 medic classes that teach to about tubing and how to start IVs along with drugs to give a K9.

Also if you hit a dog with your truck your not going to get in trouble. If you hit a person with a truck, yeah your probably gonna get in trouble. So I don't know if anyone would take away your cert for helping an animal.

As I understand it unless there is a statute that allows for EMTs to do any intervention on an animal then it would be illegal for an EMT to treat an animal.
 

DesertMedic66

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As I understand it unless there is a statute that allows for EMTs to do any intervention on an animal then it would be illegal for an EMT to treat an animal.

I have no proof either way but I've seen videos online and on the news of EMTs and medics helping dogs/cats/family pets and to my knowledge they did not get in trouble in the slightest.
 

bstone

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I have no proof either way but I've seen videos online and on the news of EMTs and medics helping dogs/cats/family pets and to my knowledge they did not get in trouble in the slightest.

I don't think that any medical board or medical director in their right mind would give an EMT a hard time about trying to save a pet, but we have to keep in mind that it might not be technically legal to do so.
 

Murphy

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From time spent in the world of veterinary ER:

In answer to the original question (several years late) - flow by oxygen rates at 6-15 lpm work great - vary it by how bad off and how cooperative they are... many pets will actively resist oxygen at 15 lpm, even if they are blue.

Beyond trauma and fire, there are many respiratory conditions dogs and cats can have that stress exacerbates and a little oxygen is the best medicine. Rescue groups often will provide masks made especially for dogs and cats, but if they're alert and dypsneic the masks often just add to the stress and make them worse, and you're better off with flow-by.

There's a nice description above of veterinary cpr, so I won't go into that except to say that the standarads have changed: compressions about 100-120 bpm for all size animals, breaths at 6-10 / min.

A dog/cat rarely goes into v-fib, it's usually bradycardia straight to asytole, so defibrillation has even less chance of success than with a human.

Absolutely if you are not comfortable with animals and do not know how to read the signs of a fearful or aggressive animal, be very cautious. And always be cautious with any injured animal.

The holder usually gets bitten first, so personally I'd rather have no holder than an untrained restrainer. While giving oxygen and basic first aid would be unlikely to get you in trouble for practicing veterinary medicine, I'd be more worried about a lawsuit from an owner who was bitten. That can be big money, and then the question comes - will your insurance cover that?

It's not a bad idea to put a gauze muzzle on an injured dog - roll gauze with a bow tie knot slipped over the muzzle can often go on safely and be an effective muzzle that can be quickly released... put a big loop in the gauze, slip it over the muzzle, then tighten and tie a bow. A towel placed over a cat's head will often give them a sense of security as well as slow down the mouth and front feet, just make sure they can breathe. :)

Obviously humans come first. But if you're able to give first aid to an animal on the scene, you've given a great gift to the pet's family.
 

mycrofft

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I returned to volunteer CPR instruction at the local ARC, and lo and behold, there were doggy manikins, complete with one for airway.
 

DrParasite

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NomadicMedic

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My girlfriend is a Critical care/Trauma vet and she called me last night to tell me she had a dog in Vtach, with pulses. After 3 boluses of Lido, the owners decided to euthanize the dog, but it was a pretty interesting case.


My GF was on the phone with a vet cardiologist for a consult, and was texting me at the same time. They don't have any other antiarrythmics at the clinic and no ability to cardiovert. Kind of a shame, but as she said, "the dog was full of the badness..." After the case we talked a bit about it and she brought the EGK home. Pretty wild stuff.
 

FLdoc2011

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My girlfriend is a Critical care/Trauma vet and she called me last night to tell me she had a dog in Vtach, with pulses. After 3 boluses of Lido, the owners decided to euthanize the dog, but it was a pretty interesting case.


My GF was on the phone with a vet cardiologist for a consult, and was texting me at the same time. They don't have any other antiarrythmics at the clinic and no ability to cardiovert. Kind of a shame, but as she said, "the dog was full of the badness..." After the case we talked a bit about it and she brought the EGK home. Pretty wild stuff.

That is interesting. Wasn't even aware there were critical care/trauma vets.... makes sense though. So no defib equipment? Would've thought they have at least something around for OR cases.
 
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