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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.
Equestrian injuries. This chapter reviews the current evidence for the epidemiology of pediatric equestrian injuries. Methods: The relevant literature was searched through the use of MEDLINE (1966-2004) and SPORT DISCUS (1975-2004) searches, hand searches of journals and reference lists and discussions with experts and sporting organizations worldwide. Keywords and Mesh headings used in all searches included horse racing, children, pediatric injuries, sports injuries, equestrian injuries and sports trauma. Results: Limited data exist on the epidemiology of pediatric equestrian injuries. Most studies note the high ...
A review of horse-related injuries in a rural Colorado hospital: implications for outreach education. The literature contains many studies on the types of injuries sustained in horseback riding incidents. Most advocate the use of equestrian helmets to prevent head trauma. However, information is limited on other specific prevention strategies. Methods: A 4-year, retrospective, and prospective review of medical records pertaining to horse-related injuries in a southwestern Colorado hospital yielded a sample of 85 patients who had been injured while riding or tending to horses. In addition to the record review, patients were interviewed during ED discharge, inpatient treatment, or in a follow-up...
Tracheal perforation managed by temporary tracheostomy in a horse. Tracheal trauma with resultant rupture is uncommonly reported in veterinary literature. We report the case of a 16-year-old Thoroughbred gelding that sustained a 1 cm longitudinal perforation of the dorsal tracheal membrane in the proximal cervical region. The horse subsequently developed dyspnoea due to acute upper respiratory obstruction secondary to severe emphysema of the guttural pouches. A temporary tracheostomy caudal to the site of tracheal perforation was performed under local anaesthesia. This procedure helped relieve the upper airway obstruction and aided resolution of the injury by...
Resuscitation and emergency management for neonatal foals. Early intervention can dramatically alter outcome in foals. Cardio-pulmonary cerebral resuscitation can be successful and clinically worthwhile when applied to foals that arrest as part of the birthing process. Readily available equipment and an ordered plan starting with addressing the respiratory system (airway and breathing) followed by the circulatory system (circulation and drugs) are the keys to success. Hypoglycemia is common in foals that are not nursing and in septic foals. Support of serum glucose can be an important emergency treatment. Respiratory support with oxygen therapy should...
Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 4: Early (acute) relaparotomy. Early (acute) relaparotomy after surgery for equine colic is widely considered to be an acceptable treatment option for management of certain post operative complications. However, there is relatively little published information about resulting complication rates and short- and long-term outcomes. Objective: To document the proportions, indications, complication rates and survival rates of horses undergoing acute relaparatomy following colic surgery. Methods: History, clinical findings, surgical findings and procedures, post operative treatments and outcome of 300 consecutive surgical colic c...
Use of web-based data collection to evaluate analgesic administration and the decision for surgery in horses with colic. There is no current veterinary information with regard to data entry on a website. We therefore completed a prospective study on use of analgesics in relation to the need for abdominal surgery using a web-based survey instrument. Objective: To establish an internet-based data entry system that could be used to record prospective data on horses with colic. Objective: Failure of horses to respond to the initial administration of an analgesic is an indicator of the need for abdominal surgery. Methods: A survey was developed to determine if the response to administration of an analgesic during a v...
Digital blood flow and plasma endothelin concentration in clinically endotoxemic horses. To measure plasma endothelin-1 (ET-1) concentrations and digital blood flow in clinically endotoxemic horses. Methods: 36 adult horses that underwent emergency celiotomy for primary gastrointestinal tract disease. Methods: On days 2 and 5 following surgery, Doppler ultrasonographic digital arterial blood flow measurements were obtained. Hematologic and biochemical analyses were performed, and plasma concentrations of ET-1 and endotoxin (lipopolysaccharide) were determined. A scoring system based on 9 clinical variables was used to assign horses to group B (quartile with greatest cumulative sco...
Horse-related injuries in children: a review. Horseback riding is an increasingly popular activity among today's youth, providing them with the opportunity to learn responsibility and respect for animals. However, it can also be associated with severe injury, of which many physicians are unaware. In 2002, there were an estimated 13,400 emergency department visits nationwide for horse-related injuries among children younger than 15 years. When using a severity score to compare it with other childhood injuries, equestrian-related injury ranked second only to pedestrians being struck by a car, and had a higher score than all terrain vehicle,...
Isoflurane measurement error using short wavelength infrared techniques in horses: influence of fresh gas flow and pre-anaesthetic food deprivation. To quantify the isoflurane measurement error arising from the use of short wavelength infrared (IR) anaesthetic gas analysis during low flow anaesthesia in horses. Methods: Prospective clinical study. Methods: Sixty-four client-owned horses referred for elective or emergency surgery (age 1-16 years, body mass 400-650 kg). Methods: Horses were divided into four groups based on duration of pre-anaesthetic food deprivation period (FDP) and fresh gas flow during anaesthesia: a high flow group with normal FDP (n = 16) and three groups with low flow and normal (n = 29), long (n = 5) or no (n = 14) F...
Principles of early wound management. The equine practitioner can positively influence wound healing by dispensing appropriate treatment in the first few hours after injury. Positive actions in the early period include hemostasis, meticulous cleansing and debridement of the wound, the use of effective but nonirritating products to disinfect the wound, closure (if indicated)with minimal tension on the suture line, the judicious use of drains,and ensuring adequate tetanus protection. Furthermore, a thorough assessment of the wound and the patient in the initial period after trauma provides pertinent information on prognosis. Finally...
Management of burn injuries in the horse. Extensive thermal injuries in horses can be difficult to manage. The large surface of the burn dramatically increases the potential for loss of fluids,electrolytes, and calories. Burns are classified by the depth of injury: first-degree burns involve only the most superficial layers of the epidermis;second-degree burns involve the entire epidermis and can be superficial or deep; third-degree burns are characterized by loss of the epidermal and dermal components; and fourth-degree burns involve all the skin and underlying muscle, bone, and ligaments. Burns cause local and systemic effects. Rout...
Management of neck and head injuries. The horse, a flight animal that is used extensively by man, frequently receives injuries to its neck or head that result mostly from its management and handling. Better facilities, training of the horse, and horsemanship skills of the handler could prevent many of these injuries. Because many body systems can be involved, with potentially major consequences regarding health, performance, and appearance, early recognition of trauma and competent treatment are crucial. Progress has been made in the treatment of some tracheal and esophageal injuries. Severe tracheal trauma and rupture of the esop...
Nonfatal injury rates of Utah agricultural producers. The purposes of this study were to identify the source and frequency of agricultural injuries in Utah, and determine an injury rate for common agricultural activities. Previous studies conducted in Utah examined injury rates by utilizing emergency room logs. This study collected data directly from the source, farmers and ranchers in Utah, and included all modes of treatment. A random sample of Utah Farm Bureau members were mailed questionnaires to assess the number of injuries occurring during the past three years, the mode of treatment for the most recent injury, and the percentage of time sp...
Rapid analysis of fatty acid-binding proteins with immunosensors and immunotests for early monitoring of tissue injury. Fatty acid-binding protein (FABP) holds promise for early detection of tissue injury. This small protein (15kD) appears earlier in the blood than large proteins after cell damage. Combined its characteristics of high concentration tissue contents and low normal plasma values provide the possibility of a rapid rise above the respective reference values, and thus an early indication of the appearance of tissue injury. A general review was presented on the current status of different types of FABP for the detection of tissue injury in patients with myocardial injury, brain injury and also in athl...
Patterns of maxillofacial injuries related to interaction with horses. Studies of trauma patients have described patterns of injuries sustained from unfortunate encounters with large animals. However, the patterns of maxillofacial injuries have yet to be reported. The goal of this investigation was to describe and report on maxillofacial injuries that are associated with interaction with horses. Methods: Charts were selected from the trauma registry by E-code at a level 1 trauma center in Portland, OR. A retrospective review was performed on charts collected from the previous 5 years (1998-2002). Data were collected according to patient, pattern of injuries, and ...
The mosaic of equestrian-related injuries in Greece. This study aims to estimate the burden and describe the profile of equestrian injuries in Greece, where horses, donkeys, and mules are still used in agriculture and where horse riding is a popular leisure activity. Methods: Prospectively collected information on 140,823 injuries reported in the national Emergency Department Injury Surveillance System was examined and 244 equestrian-related injuries that occurred during farming, equestrian sports, or horse racing were analyzed. Results: The estimated countrywide injury incidence for farming and equestrian sports combined was 21 per 100,000 pers...
Pediatric farm-related injuries: a series of 96 hospitalized patients. Ninety-six children were admitted during a 9-year period to a pediatric level 1 trauma center for treatment of farm-related injuries. The age range was from 6 weeks to 17 years (median, 7.5 years; mean, 7.6 years; standard deviation, 4.4). Thirty-nine patients (40.6%) had an animal-related injury, including 36 children (37.5%) who had an injury associated with a horse. Amish children had an increased risk of horse-related injury when compared with non-Amish children (p=0.04; RR=2.09, 95% CI: 1.18<RR<3.70). Thirty-seven patients (38.5%) had farm machinery-related injuries, including 14 ch...
Cardiac emergencies and problems of the critical care patient. Cardiac disease and dysfunction can occur as a primary disorder(ie, with pathology situated in one or more of the cardiac structures) or can be classified as a secondary problem when it occurs in patients with another primary problem that has affected the heart either directly or indirectly. Primary cardiac problems are encountered in horses presented to emergency clinics; however,this occurs much less frequently in equine critical patients than cardiac problems arising secondary to other conditions. Nevertheless,if primary or secondary cardiac problems are not identified and addressed, they c...
Critical peripartum disease in the mare. The variety of diseases that occur in the peripartum mare require the examining veterinarian to evaluate the patient and the historical information carefullly so as to make an accurate diagnosis and begin appropriate therapy. An understanding of equine behavior, reproduction. mechanisms of shock,and gastrointestinal and reproductive physiology is requisite for accurate interpretation of the myriad of clinical signs of diseases present in this population. Attention to the unique metabolic and physiologic needs of the pregnant and lactating mare can aid the critical care clinician in providing o...
Monitoring the critically ill equine patient. Measurements of physiologic parameters, such as blood pressure or lactate concentration, are useful to detect occult derangements, such as tissue hypoxia and dysoxia. These tools are also useful in determining the effects of therapy. Monitoring techniques are now widely available for the intensive management of critically ill horses and foals. A number of these have evolved into noninvasive or minimally invasive devices and procedures and provide information that can be used for earlier and more dynamic therapeutic intervention. The goal of increased monitoring is to improve the level of care ...
Anesthesia of the critically ill equine patient. There is a plethora of information regarding anesthetic management of horses; however, controlled studies of the critically ill equine patient are few. These patients should be managed like any equine anesthetic candidate but much more stringently:I. Preoperative evaluation and appropriate therapy may represent the difference between life and death during the intraoperative and recovery periods. 2. The anesthetic induction and maintenance protocol should be based on the individual situation of the veterinary facility and personnel("comfort zone"). 3. Appropriate monitoring and intraoperative s...
Treatment of peritonitis. In summary, peritonitis in the horse is a potentially life-threatening disease that must be treated promptly and aggressively. Therapy should be aimed at reducing systemic shock and hypovolemia, correction of the primary cause, antibiotic and anti-inflammatory therapy, and abdominal drainage and lavage. The prognosis depends on the ability to diagnose and treat the underlying cause and prevent the development of complications. Mortality rates can be as high as 59.7%, with horses developing postoperative peritonitis having a 56% mortality rate. Long-term complications like adhesion formation or...
Factors affecting the severity of horse-related injuries. Horse riding and handling are uniquely dangerous. Knowledge of the risk factors of horse-related injuries is essential to prevent them. We aimed to define the factors that affect the severity of horse-related injuries and the length of hospital stay. A number of 231 patients (136 females and 95 males) with horse-related injuries were studied. A generalized linear model was used to test the effect of age, sex, cause of injury, complexity of the mechanism of injury, year, place of injury and profession of the injured, on the injury severity score (ISS) and the hospital stay. Fall from a horse wa...
Pattern of equestrian injuries presenting to a Sydney teaching hospital. Equestrian activities are associated with a high rate of injury. Attempts to reduce the incidence and severity of injury require accurate characterization of risk factors and pattern of injury. The present study was performed to analyse the injuries seen at an Australian centre where a large number of equestrian injuries present. Methods: Data were collected prospectively over a 3 year period on all equestrian injuries presenting to the Prince of Wales -Hospital complex. These data were compared against and combined with retrospectively collected data over the preceding 3 years at the same cen...
Dystocia in a referral hospital setting: approach and results. Dystocia in the mare is an emergency in which duration has a profound effect on survival of the foal. Specific examination of the effects of dystocia duration on foal survival provides information to enable horse care personnel and veterinarians to manage these cases more effectively and maximise the chances of obtaining a live foal. Objective: Dystocia duration would have a negative impact on foal survival while method of dystocia resolution would not have an effect on foal survival. Additionally, we were interested in determining the effects of dystocia on subsequent fertility. Results: In t...
Diagnostic decision rule for support in clinical assessment of the need for surgical intervention in horses with acute abdominal pain. A prospective survey of horses with colic referred to a university hospital was undertaken to elaborate on a simple clinical decision support system capable of predicting whether or not horses require surgical intervention. Cases were classified as requiring surgical intervention or not on the basis of intraoperative findings or necropsy reports. Logistic regression analysis was applied to identify predictors with the strongest association with treatment needed. The classification and regression tree (CART) methodology was used to combine the variables in a simple classification system. The pe...
Spectrophotometric assessment of peritoneal fluid haemoglobin in colic horses: an aid to selecting medical vs. surgical treatment. In a case-control study in colic horses the ability of spectrophotometric measurement of the haemoglobin concentration in the peritoneal fluid supernatant and visual assessment of the colour of peritoneal fluid supernatant to differentiate between surgical and medical treatment of colic was assessed. Based on previous studies, which have found anda association between peritoneal fluid colour and the kind of treatment required, our hypothesis was that the peritoneal fluid haemoglobin concentration would be higher in horses requiring surgical intervention than in horses amenable to medical treat...
A changing pattern of injuries to horse riders. To describe the demographics and nature of injuries occurring on or around horses, to examine the nature of protective clothing in relation to these injuries, and to compare our data with previously published work in this area. Methods: Patients were identified using the term "sports injury-horse riding" from the departmental database for one calendar year from February 2000. Data were collected regarding demographics, injuries, protective clothing, and outcome. The data were then analysed and compared with the previously published literature. Results: 260 patients' records were analysed. The ...
