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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.
Trauma and wound management: gunshot wounds in horses.
The Veterinary clinics of North America. Equine practice    June 4, 2014   Volume 30, Issue 2 453-ix doi: 10.1016/j.cveq.2014.04.007
Munsterman AS, Hanson RR.Bullet wounds in horses can cause a wide array of injuries, determined by the type of projectile, the energy of the bullet on entry, and the type of tissue the bullet encounters. Treatment includes identification of all structures involved, debridement of the permanent cavity, and establishing adequate drainage. Bullet wounds should be treated as contaminated, and broad-spectrum antibiotics, including those with an anaerobic spectrum, are indicated. Although musculoskeletal injuries resulting from gunshots are most common in horses, they carry a good prognosis for survival and return to functi...
Acute hemorrhage and blood transfusions in horses.
The Veterinary clinics of North America. Equine practice    June 4, 2014   Volume 30, Issue 2 427-ix doi: 10.1016/j.cveq.2014.04.004
Mudge MC.Treatment of acute hemorrhage in the horse involves targeted medical management and also may involve surgical stabilization. This article provides an approach to the initial stabilization and information on available topical hemostats. The practice of blood collection and transfusion is also described, with attention to new information on viability of transfused equine blood, potential negative effects of blood transfusion, and methods of cell salvage.
Equestrian trauma: injury patterns vary among age groups.
The American surgeon    June 3, 2014   Volume 80, Issue 4 396-402 
Bilaniuk JW, Adams JM, DiFazio LT, Siegel BK, Allegra JR, Luján JJ, Durling-Grover R, Pawar J, Rolandelli RH, Németh ZH.Patients with equestrian injuries were identified in the trauma registry from 2004 to 2007. We a priori divided patients into three groups: 0 to 18 years, 19 to 49 years, and 50 years old or older. There were 284 patients identified with equestrian-related trauma. Injury Severity Score for the three major age categories 0 to 18 years, 19 to 49 years, and 50 years or older, were 3.47, 5.09, and 6.27, respectively. The most common body region injured among all patients was the head (26.1%). The most common injuries by age group were: 0 to 18 years, upper extremity fractures; 19 to 49 year olds, ...
A description of the severity of equestrian-related injuries (ERIs) using clinical parameters and patient-reported outcomes.
Injury    May 2, 2014   Volume 45, Issue 9 1484-1487 doi: 10.1016/j.injury.2014.04.017
Papachristos A, Edwards E, Dowrick A, Gosling C.Despite a number of injury prevention campaigns and interventions, horse riding continues to be a dangerous activity, resulting in more accidents per hour than motorcycling, skiing and football. Injuries are often serious, with one in four patients requiring admission to hospital. This study aims to describe the severity of equestrian-related injuries (ERIs) using both clinical parameters and patient-reported outcomes. Methods: A retrospective study of all patients aged ≥18 years admitted to The Alfred Hospital between January 2003 and January 2008 with an ERI was performed. Specific clinica...
Straight from the horse’s mouth: neurological injury in equestrian sports.
Neurological research    April 13, 2014   Volume 36, Issue 10 873-877 doi: 10.1179/1743132814Y.0000000373
Srinivasan V, Pierre C, Plog B, Srinivasan K, Petraglia AL, Huang JH.Equestrian sports can result in a variety of injuries to the nervous system due to many factors. We describe our series of 80 patients with injuries sustained during participation in equestrian sports. Results: All patients seen at the regional trauma center with injuries associated with equestrian sports between 2003 and 2011 were reviewed; 80 patients were identified. Fifty-four per cent were female and the average age was 37 years (2·2-79·3). The mean injury severity score (ISS) was 9·9 ± 0·7. Only two patients had documented helmet use. Glasgow coma score (GCS) was 15 in 93% of patien...
On and off the horse: mechanisms and patterns of injury in mounted and unmounted equestrians.
Injury    April 1, 2014   Volume 45, Issue 9 1479-1483 doi: 10.1016/j.injury.2014.03.016
Carmichael SP, Davenport DL, Kearney PA, Bernard AC.The purpose of this study is to determine whether discrepant patterns of horse-related trauma exist in mounted vs. unmounted equestrians from a single Level I trauma center to guide awareness of injury prevention. Methods: Retrospective data were collected from the University of Kentucky Trauma Registry for patients admitted with horse-related injuries between January 2003 and December 2007 (n=284). Injuries incurred while mounted were compared with those incurred while unmounted. Results: Of 284 patients, 145 (51%) subjects were male with an average age of 37.2 years (S.D. 17.2). Most injurie...
Effects of acetylcholinesterase inhibition on quality of recovery from isoflurane-induced anesthesia in horses.
American journal of veterinary research    February 26, 2014   Volume 75, Issue 3 223-230 doi: 10.2460/ajvr.75.3.223
Wiese AJ, Brosnan RJ, Barter LS.To compare effects of 2 acetylcholinesterase inhibitors on recovery quality of horses anesthetized with isoflurane. Methods: 6 horses in phase 1, 7 horses in phase 2A, and 14 horses in phase 2B. Methods: The study comprised 3 phases (2 randomized, blinded crossover phases in horses undergoing orthopedic procedures and 1 prospective dose-determining phase). In phase 1, horses were anesthetized with isoflurane and received neostigmine or saline (0.9% NaCl) solution prior to anesthetic recovery. Phase 2A was a physostigmine dose-determining phase. In phase 2B, horses were anesthetized with isoflu...
The use of a modified Delphi approach to engage stakeholders in zoonotic disease research priority setting.
BMC public health    February 20, 2014   Volume 14 182 doi: 10.1186/1471-2458-14-182
Sawford K, Dhand NK, Toribio JA, Taylor MR.After the 2011 cluster of Hendra virus cases in horses in Australia, public health targeted education initiatives at people in the equine industry to reduce human exposure to potentially infected horses. 'Horse owners and Hendra Virus: A Longitudinal cohort study To Evaluate Risk' aims to enhance public health measures through improved understanding of Hendra virus risk perception and risk mitigation strategies among horse owners and horse care providers. This paper describes the stakeholder consultation that was undertaken to ensure the cohort study outcomes were relevant to diverse groups wh...
Does intraoperative low arterial partial pressure of oxygen increase the risk of surgical site infection following emergency exploratory laparotomy in horses?
Veterinary journal (London, England : 1997)    February 8, 2014   Volume 200, Issue 1 175-180 doi: 10.1016/j.tvjl.2014.01.029
Costa-Farré C, Prades M, Ribera T, Valero O, Taurà P.Decreased tissue oxygenation is a critical factor in the development of wound infection as neutrophil mediated oxidative killing is an essential mechanism against surgical pathogens. The objective of this prospective case series was to assess the impact of intraoperative arterial partial pressure of oxygen (PaO2) on surgical site infection (SSI) in horses undergoing emergency exploratory laparotomy for acute gastrointestinal disease. The anaesthetic and antibiotic protocol was standardised. Demographic data, surgical potential risk factors and PaO2, obtained 1h after induction of anaesthesia w...
Monitoring equine visceral pain with a composite pain scale score and correlation with survival after emergency gastrointestinal surgery.
Veterinary journal (London, England : 1997)    January 11, 2014   Volume 200, Issue 1 109-115 doi: 10.1016/j.tvjl.2014.01.003
van Loon JP, Jonckheer-Sheehy VS, Back W, van Weeren PR, Hellebrekers LJ.Recognition and management of equine pain have been studied extensively in recent decades and this has led to significant advances. However, there is still room for improvement in the ability to identify and treat pain in horses that have undergone emergency gastrointestinal surgery. This study assessed the validity and clinical application of the composite pain scale (CPS) in horses after emergency gastrointestinal surgery. Composite pain scores were determined every 4h over 3 days following emergency gastrointestinal surgery in 48 horses. Inter-observer reliability was determined and another...
Helicopter emergency medical services response to equestrian accidents.
European journal of emergency medicine : official journal of the European Society for Emergency Medicine    January 5, 2014   Volume 22, Issue 2 103-106 doi: 10.1097/MEJ.0000000000000105
Lyon RM, Macauley B, Richardson S, de Coverly R, Russell M.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 journal of trauma and acute care surgery    December 26, 2013   Volume 76, Issue 1 205-212 doi: 10.1097/TA.0b013e3182a9007e
Lang J, Sathivelu M, Tetsworth K, Pollard C, Harvey K, Bellamy N.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-related injuries in pediatric and adolescent age: analysis and outcomes in a level 1 pediatric trauma center in Austria.
Pediatric emergency care    November 10, 2013   Volume 29, Issue 9 1053-1054 doi: 10.1097/01.pec.0000434939.82050.c6
Zoetsch S, Saxena AK.No abstract available
Equine-associated maxillofacial injuries: retrospective 5-year analysis.
The British journal of oral & maxillofacial surgery    October 26, 2013   Volume 52, Issue 2 124-127 doi: 10.1016/j.bjoms.2013.09.019
Islam S, Gupta B, Taylor CJ, Chow J, Hoffman GR.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.
The Canadian veterinary journal = La revue veterinaire canadienne    October 25, 2013   Volume 54, Issue 6 599-601 
Tirosh-Levy S, Tatz A, Kelmer G.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.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    September 12, 2013   Volume 23, Issue 5 504-516 doi: 10.1111/vec.12095
Epstein KL, Brainard BM, Giguere S, Vrono Z, Moore JN.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...
Tornado takes toll on horses: Oklahoma response reflects preparedness.
Journal of the American Veterinary Medical Association    August 29, 2013   Volume 243, Issue 2 181-182 
Kahler SC.No abstract available
Peri-anaesthetic mortality in horses - the need for CEPEF-4.
Veterinary anaesthesia and analgesia    July 22, 2013   Volume 40, Issue 6 e1-e2 doi: 10.1111/vaa.12070
Gent TC, Bettschart-Wolfensberger R.No abstract available
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.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    July 16, 2013   Volume 23, Issue 4 408-415 doi: 10.1111/vec.12072
Hug SA, Riond B, Schwarzwald CC.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...
Crisis communication. Horse industry working on better response to disease outbreaks.
Journal of the American Veterinary Medical Association    July 5, 2013   Volume 242, Issue 11 1461-1462 
Larkin M.No abstract available
Princess Royal draws attention to growing horse crisis.
The Veterinary record    June 26, 2013   Volume 172, Issue 25 649 doi: 10.1136/vr.f3918
No abstract available
Hospitalization due to horse-related injuries: has anything changed? A 25 year survey.
The Israel Medical Association journal : IMAJ    June 21, 2013   Volume 15, Issue 4 169-172 
Abu-Kishk I, Klin B, Gilady-Doron N, Jeroukhimov I, Eshel G.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.
JRSM short reports    April 22, 2013   Volume 4, Issue 5 2042533313476688 doi: 10.1177/2042533313476688
Sandiford N, Buckle C, Alao U, Davidson J, Ritchie J.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.
Compendium (Yardley, PA)    March 28, 2013   Volume 35, Issue 1 E5 
Burba DJ.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.
The Journal of emergency medicine    March 20, 2013   Volume 45, Issue 2 206-209 doi: 10.1016/j.jemermed.2012.11.088
Kamali MF, Wilson AC, Acquisto NM, Spillane L, Schneider SM.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.
The Veterinary clinics of North America. Equine practice    January 18, 2013   Volume 29, Issue 1 193-214 doi: 10.1016/j.cveq.2012.11.005
Boesch JM.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.
The American surgeon    January 16, 2013   Volume 79, Issue 1 76-83 
Guyton K, Houchen-Wise E, Peck E, Mayberry J.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].
Der Unfallchirurg    January 12, 2013   Volume 117, Issue 2 123-127 doi: 10.1007/s00113-012-2275-z
Hessler C, Eckert V, Meiners J, Jürgens C, Reicke B, Matthes G, Ekkernkamp A, Püschel K.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.
Transboundary and emerging diseases    December 28, 2012   Volume 61, Issue 5 449-463 doi: 10.1111/tbed.12046
Schemann K, Gillespie JA, Toribio JA, Ward MP, Dhand NK.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.
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)    December 12, 2012   Volume 22, Issue 6 661-665 doi: 10.1111/j.1476-4431.2012.00817.x
Nolen-Walston RD.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...
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