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Topic:Emergency Care
Emergency care in horses involves the immediate assessment and treatment of acute medical conditions or injuries to stabilize the animal and prevent further harm. This area of veterinary practice encompasses a range of situations, including colic, traumatic injuries, respiratory distress, and sudden lameness. Emergency care procedures may involve physical examinations, diagnostic imaging, fluid therapy, pain management, and, in some cases, surgical intervention. This topic includes peer-reviewed research studies and scholarly articles that explore the methods, protocols, and outcomes associated with emergency interventions in equine medicine.
Helicopter emergency medical services response to equestrian accidents. Horse riding is a common leisure activity associated with a significant rate of injury. Helicopter emergency medical services (HEMS) may be called to equestrian accidents. Accurate HEMS tasking is important to ensure appropriate use of this valuable medical resource. We sought to review HEMS response to equestrian accidents and identify factors associated with the need for HEMS intervention or transport of the patient to a major trauma centre. Methods: Retrospective case review of all missions flown by Kent, Surrey & Sussex Air Ambulance Trust over a 1-year period (1 July 2011 to 1 July 20...
The epidemiology of horse-related injuries for different horse exposures, activities, and age groups in Queensland, Australia. The dangers associated with horse riding, a popular activity throughout Australia, are well documented; yet, few studies have comprehensively described injuries caused by horses to nonriders. This study aimed to facilitate targeted injury prevention strategies and appropriate trauma management by describing all horse-related injuries, for both riders and nonriders, in Queensland, and identifying those at greatest risk. Methods: Horse-related injury data from 2005 to 2009 were extracted from the Queensland Trauma Registry. Descriptive comparisons were undertaken for demographic, injury, and acu...
Equine-associated maxillofacial injuries: retrospective 5-year analysis. We explored the relation between the causes of facial injuries in equestrians and the presence or absence of associated injuries. Over a 5-year period we retrospectively reviewed all patients who presented to the John Hunter Hospital, New South Wales, with facial injuries that had resulted from activity with horses. We analysed the rates of hard and soft tissue injuries, and of associated injuries by sex and mechanism. A total of 85 patients were included (50 female and 35 male) with an age range of 2-88 years. There was a significant difference in the rate of maxillofacial and associated inju...
Mandibular degloving injury in an Arabian filly. A 6-month-old Arabian filly escaped its handler while being led and slipped on pavement. The referring veterinarian recognized severe, soft tissue damage to the filly's lower jaw and referred the filly to the Veterinary Teaching Hospital for surgical management. Blessure de dégantage mandibulaire chez une pouliche arabe. Une pouliche arabe âgée de 6 ans s’est échappée de son préposé pendant qu’il la menait et a glissé sur la chaussée. Le vétérinaire traitant a reconnu des dommages graves aux tissus mous de la mâchoire inférieure de la pouliche et a recommandé la pouliche à l...
Serial viscoelastic and traditional coagulation testing in horses with gastrointestinal disease. Objectives of this study were to compare the ability of serial thromboelastography, Sonoclot, and traditional coagulation panels to detect coagulopathies associated with disease category, systemic inflammatory response syndrome (SIRS), complications, and nonsurvival in horses with gastrointestinal disease. Methods: Prospective clinical evaluation. Methods: University referral hospital. Methods: One hundred twenty-one horses admitted as emergencies for gastrointestinal disease and 28 healthy adult horses. Methods: Blood samples were collected ≤4 times from emergency horses (admission and if s...
Evaluation of a continuous glucose monitoring system compared with an in-house standard laboratory assay and a handheld point-of-care glucometer in critically ill neonatal foals. To evaluate the applicability and accuracy of a continuous glucose monitoring system (CGMS) in critically ill foals by comparing the performance of the CGMS, a point-of-care (POC) glucometer, and an in-house standard laboratory assay (SLA). Methods: Prospective study. Methods: University teaching hospital. Methods: Seven critically ill neonatal foals requiring intensive care. Methods: Foals were instrumented with a CGMS that measured interstitial glucose concentration every 5 minutes for the duration of 15-79 hours. Capillary and venous blood samples were taken every 4-6 hours for POC and SLA...
Hospitalization due to horse-related injuries: has anything changed? A 25 year survey. Horse riding and horse handling are dangerous. There is a lack of knowledge concerning the incidence of hospitalization due to horse-related injuries and types of injuries in Israel. During the last two decades we have observed an increasing incidence of hospitalizations due to horse-related injuries at our medical center as well as the frequent involvement of pediatric patients. Objective: To investigate these injuries with respect to type, incidence and modes of prevention. Methods: We conducted a retrospective study of medical records for all patients admitted to Assaf Harofeh Medical Cente...
Injuries associated with recreational horse riding and changes over the last 20 years: a review. To assess the incidence and distribution of recreational equestrian injuries seen in the Kent and Sussex region and review the available literature on this subject. Methods: This is a retrospective case series with historical controls. Methods: Kent and Sussex region, England. Methods: Injuries related to horses in the recreational setting. Methods: Subjects were selected from our acute injury database. Notes of all patients presenting with horse riding-related injuries between January and December 2010 were reviewed. Skeletal injuries were confirmed using our Picture Archiving and Communicati...
Traumatic foot injuries in horses: surgical management. Managing traumatic foot wounds in horses may require surgical intervention. These wounds include coronary-band and heel-bulb lacerations, septic pedal osteitis, septic navicular bursitis, sepsis of the collateral cartilages, and hoof-wall injuries. This article provides a practical overview of the surgical management of these types of wounds.
Acute encephalopathy with concurrent respiratory and metabolic disturbances in first known parenteral human administration of flunixin meglumine and acepromazine maleate. Flunexin is a nonsteroidal anti-inflammatory drug approved for veterinary use in horses and cattle. Acepromazine is a phenothiazine derivative used in horses, dogs, and cats. Human exposure to these substances is rare. Methods: We report a case of a human injection of two equine medications, flunixin and acepromazine, which resulted in altered mental status, respiratory alkalosis, gastrointestinal bleeding, and elevation of liver transaminases in a 43-year-old woman who worked as a horse trainer. The patient intentionally self-injected these medications and subsequently presented to the Emerge...
Anesthesia for the horse with colic. This article discusses anesthesia for horses with colic from acute gastrointestinal disease. Emphasis is placed on new developments in pre-, intra-, and immediate postoperative management over the last decade, including early goal-directed therapy (EGDT) in the resuscitation of septic patients, the controversy over the optimal fluid type to administer, and the management of complications, such as cardiovascular depression, hypoventilation and hypoxemia, and decreased colloid oncotic pressure (COP). An update on analgesia is also provided; older drugs such as ketamine and lidocaine are increasi...
Equestrian injury is costly, disabling, and frequently preventable: the imperative for improved safety awareness. Horse-related injury can be severe and disabling. We investigated the causes, severity, and costs of equestrian injury with the goal of injury prevention. A retrospective review of horse-related injuries from 2001 to 2008 identified 231 patients with a mean age of 38 years and a mean Injury Severity Score of 11 (range, 1 to 45). Mean length of stay was 5.5 days. Fifty-nine patients (25%) required 84 surgeries. Helmet use was 20 per cent and of the 172 patients not wearing a helmet while mounted, 38 per cent received potentially preventable head injuries. There were three deaths of which two we...
[Causes, injuries, therapy and possibilities of prevention of equine-related accidents. Results of a 2-center-study]. Horse riding is associated with a high rate of injuries. The possibilities of prevention are limited because of deficient knowledge about the causes and mechanisms of equine-related accidents. In the present study 198 equine-related accidents were analyzed and based on these data risk groups were identified and guidelines to improve safety in horse riding were formulated. Methods: In this 2-center study the accidents of 169 riders over a period of 12 months were analyzed. Data on equine-related patterns of injury and the resulting treatment were collated from the clinical records. Additionally...
Controlling equine influenza: policy networks and decision-making during the 2007 Australian equine influenza outbreak. Rapid, evidence-based decision-making is critical during a disease outbreak response; however, compliance by stakeholders is necessary to ensure that such decisions are effective - especially if the response depends on voluntary action. This mixed method study evaluated technical policy decision-making processes during the 2007 outbreak of equine influenza in Australia by identifying and analysing the stakeholder network involved and the factors driving policy decision-making. The study started with a review of the outbreak literature and published policy documents. This identified six policy ...
Flow rates of large animal fluid delivery systems used for high-volume crystalloid resuscitation. Large animal species in states of shock can require particularly high flow rates for volume resuscitation and the ability to deliver adequate volumes rapidly may be a rate-limiting step. The objective of this study was to determine the maximum flow rates of common combinations of IV catheter, extension set, and fluid administration sets. Methods: University veterinary teaching hospital. Methods: In vitro experimental study. Methods: Maximum flow rates were measured using combinations of 4 IV catheters (3 14-Ga and a single 10-Ga), 2 IV catheter extension sets (small bore and large bore), and 2...
Anesthetic management of a horse with traumatic pneumothorax. A traumatic pneumothorax and severe hemorrhage were present in a mare with a large thoracic wall defect, lung perforation, and multiple rib fractures. General anesthesia was induced to allow surgical exploration. We describe the anesthetic technique, and discuss the management of the ventilatory, hemodynamic, and metabolic disturbances encountered. Gestion de l’anesthésie générale d’un cheval avec un pneumothorax d’origine traumatique. Nous décrivons le cas d’une jument présentée avec un important déficit de la paroi thoracique d’origine traumatique, une perforation pulmonaire...
Antimicrobial use in horses undergoing colic surgery. Recommendations for antimicrobial prophylaxis for surgery are well-described in human medicine, but information is limited for veterinary practice. Objective: To characterize antimicrobial use in horses undergoing emergency colic surgery. Methods: A total of 761 horses undergoing emergency colic surgery (2001-2007). Methods: Retrospective case review. Antimicrobial dose and timing, surgical description, and duration of treatment were collected from medical records. Associations between antimicrobial use and the occurrence of fever, incisional inflammation or infection, catheter-associated comp...
[Epidemiology of equestrian injuries in children]. Children increasingly participate in horseback riding, especially young girls, with more and more accidents during this activity. The severity of the injuries caused by horses seems to be higher than in other sports. Methods: In a retrospective study, we reviewed 303 accidents of children younger than 15 years of age during the past 13 years. Our study only investigated children who were hospitalized after their accident. Results: Eighty-two percent of the injured children were girls, but there was no difference between girls and boys in terms of severity. In most cases, children were hurt by ...
Hippotherapy effects on trunk, pelvic, and hip motion during ambulation in children with neurological impairments. This study investigated the effects of a 10-week hippotherapy program on trunk, pelvis, and hip joint positioning during the stance phase of gait. Methods: Eleven children (6 boys and 5 girls; 7.9 ± 2.7 years) with neurological disorders and impaired ambulation participated. Joint range of motion data were collected via 3-dimensional computerized gait analysis before and after the program. Paired t tests were performed on kinematic data for each joint. Results: Significant improvements (P ≤ .008) and large effect sizes (ESs) for sagittal plane hip positions at initial contact and toe-off we...
Clinical, hematologic, and electrolyte changes with 0.9% sodium chloride or acetated fluids in endurance horses. To describe the clinical and laboratory changes associated with the use of IV0.9% sodium chloride and a commercially available acetated fluid (CAF) to treat endurance horses requiring emergency medical treatment. Methods: Randomized, controlled clinical trial from 2007 to 2010. Methods: Emergency treatment centers of the Western States 100-mile (220 km) endurance ride. Methods: Twelve horses requiring emergency medical treatment in the form of IVfluids completed the study. Methods: Horses were assigned to either the 0.9% sodium chloride group (6 horses) or CAF group (6 horses) and received a t...
Evaluation of L-lactate and cardiac troponin I in horses undergoing emergency abdominal surgery. To evaluate changes in plasma cardiac troponin I (cTnI) and L-lactate (LLt) as prognostic indicators in horses undergoing emergency abdominal surgery. Methods: Prospective observational study. Methods: Veterinary teaching hospital. Methods: Thirty-four horses undergoing emergency abdominal surgery. Methods: Serial blood sampling during various times during hospitalization (hospital admission, and 12, 24, 48, and 72 h postoperatively) evaluating cTnI and LLt concentrations. Results: All horses required surgery for correction of a strangulating (n = 29) or nonstrangulating obstruction (n = 5) of...
Ambulatory equine practice management. The horse owner not only expects outstanding care for their horse; they also recognize and appreciate a well-run equine practice. They expect their veterinarian to show up on time for appointments; they expect to receive decipherable invoices and statements on a regular basis and they appreciate an assistant who enhances the services that their veterinarian provides. A well-managed ambulatory equine practice supports the ideals of both high standards of care and mobility. In fact, a poorly managed practice will ultimately impact the care that an equine veterinarian attempts to provide the hors...
Reproduction in ambulatory practice. The value of providing equine reproductive services in ambulatory setting is well established. Ambulatory practice has been, and will most likely continue to be, the primary provider of equine reproductive veterinary services. The limitations for performing various reproductive procedures in an ambulatory setting are those imposed by the amount of equipment and supplies that must be brought to the patient, as well as those imposed when procedures require additional assistance. This is analogous to human medical care: the ambulance cannot substitute for a hospital but it can certainly provide s...
Equine wellness care in ambulatory practice. Clients want dependable veterinary care and to understand how the services will benefit and meet their horse’s needs. Wellness visits provide ambulatory practitioners with great opportunities to strengthen the doctor-client-patient bond; effective communication with clients during wellness visits, where new literature or facts can be presented, can offer opportunities for demonstrating the value of having the veterinarian maintain a primary role in disease control. The criteria for selecting vaccines, interpreting FECs, and diagnosing dental pathology require the continued need for veterinar...
