VETERINARY SUPPORT ASSISTANT

DIPLOMA COURSE

ASSIGNMENT TEN

SMALL ANIMAL EMERGENCY NURSING – PART TWO

Overview and learning outcomes

Overview

• Fractures
• Bites and stings
• Wounds and burns
• Poisoning and fitting
• Diarrhoea and vomiting
• Hyperthermia and hypothermia

Outcomes

• Understand the different types of fractures and their first aid treatment
• Learn what to do if an animal gets bitten or stung by an insect or adder
• Learn how to stop haemorrhage and treat wounds and burns in a first aid situation
• Understand how to treat diarrhoea and vomiting
• Have a basic understanding of the signs of hyperthermia and hypothermia and their treatment

FRACTURES

A fracture is a break or crack in a bone. There are several different types, and each type has different
issues and treatments.

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Fracture and other skeletal injury types:

• Closed fracture
o Is a break or crack in the bone where there is no related external wound.

• Open or compound fracture

o Is a break or crack in the bone that is associated directly with open wounds (you may
or may not see the bone poking out of the wound).

• Dislocation
o Is a displacement of a bone at the joint caused by an injury to the connective tissues
holding a joint in position.

• Sprain
o Involves partial tearing or stretching of joint structures, without dislocation or
fracture. Can involve a ligament, tendon or both.

The above types may be suspected when the animal suddenly appears lame on a leg or following any
fall or injury. Common signs are an unusual angle of the fractured area and swelling. The vet will
make their diagnosis using x-rays.

First aid of a suspected fracture

• Stop any bleeding with pressure. Do not flush the wound with saline or water, as this should
be carried out at the vets, and could start bleeding.

• If possible, the pet should be prevented from moving around.

• Splinting the fracture at home can make the fracture worse, and without pain relief for the
animal you are likely to be bitten. Never attempt to try to push a protruding bone back into
position.

• Keep the animal quiet and calm, and protect yourself.

• Open fractures should be covered with a sterile gauze dressing if possible. If this is not
available, use a clean cloth applied over the opening and bone.

• Do not give any medications to the animal unless directed to do so by a vet.

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Treatment at the vets

Types of treatment include:

• Reduction of the fracture

o Placing the broken ends together.

• Fixation of the fracture

o Fixing any fragments in place.

• Immobilisation
o Keeping the area motionless to allow healing.

BITES AND STINGS

Insect stings are painful, and can cause secondary issues such as hot spots and infections. They can
generally be treated at home unless the animal is stung in the mouth. If this is the case, a visit to the
vets is very important, as it can be life-threatening if the area swells and causes the animal’s airway
to block. Also, some animals may have an allergy to the sting; if so, their symptoms will be a lot
worse and a visit to the vets may also be necessary.

Signs

At the time of the bite, the animal may yelp or cry out and start to rub or scratch at the affected area.

Within between ten minutes and twenty-four hours of the bite, you may notice swelling of the area;
usually the eyelids, ear flaps, lips, feet, and sometimes the entire face will swell. The animal may
also develop hives, difficulty breathing, fast heart rate, trembling, wheezing, diarrhoea, collapse and
shock.

Treatment

First of all, examine the area for a stinger. If you find one then remove it carefully.

To reduce the pain and itching you can apply one of the following:

Wasp sting venom is alkaline and so its effects can be neutralised with vinegar.

Bee sting venom is acidic and so its effects can be neutralised with bicarbonate of soda (baking
powder).

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Then, I would apply an ice pack or cold compress to the area to help with the swelling. If the animal
doesn’t improve then call the vets.

In a severe reaction, the vet may give IV fluids, antihistamines and corticosteroids.

Adder Bites

Adders are the only venomous snake in the United Kingdom, and can be identified by looking for an
X or V shape on the back of their head. They also have a dark zigzag pattern on their backs. They are
not aggressive creatures, but they will bite if disturbed. Adders are more active in the spring and
summer, so most bites occur then.

The area around the bite mark will swell, and other signs may include lethargy, vomiting, diarrhoea,
fever, fast heart rate and low blood pressure. In some cases, the animal can start to fit or become
comatose. Adder bites can be fatal, so it is important to call a vet immediately.

First aid for adder bites:

• Confine the animal; the more it moves about the more the venom will spread.
• Do not touch the wound, as this too could spread the venom.
• At the vets, treatment may include anti-venom, anti-inflammatory drugs, IV fluids and
antibiotics.

WOUNDS AND BURNS

Bleeding

The techniques below are listed in order of preference to do. The animal should be taken to a vets as
soon as possible, but try to stop the bleeding first or on the way.

• Direct Pressure

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 Gently press a pad of clean cloth, feminine sanitary product, cotton wool or gauze over the
bleeding area. You want it to absorb the blood and allow the blood to clot. Whatever you do,
don’t disturb blood clots. If blood soaks through your cloth etc., do not remove the pad, just
add more layers to the top and continue to apply pressure. The cloth etc. can be fixed in place
using bandage material, which can free up your hands. If you don’t have any absorbent
materials, then just use your hands.

• Elevation

If a wound is bleeding on the foot or leg, gently lift the leg so that the wound is above the
level of the animal’s heart. This technique uses the force of gravity to reduce blood pressure
in that limb and therefore slow the bleeding. Elevation is more effective in larger animals
with longer limbs, because you can lift them much higher than the animal’s heart. Elevation
and direct pressure at the same time is an effective way to stop bleeding.

• Pressure on the Supplying Artery

If the bleeding continues after you have used direct pressure and elevation, then try using
your finger or thumb to place pressure over the main artery to the wound. For example, apply
pressure to the femoral artery on the inside of the thigh for severe bleeding of a rear leg, to
the brachial artery in the inside part of the upper front leg for bleeding of a front leg, or to the
caudal artery at the base of the tail if the wound is on the tail. Continue application of direct
pressure. Seek veterinary attention immediately.

• Tourniquet

Using a tourniquet can potentially cause injury to the animal, so it should only be used for
very severe, life-threatening haemorrhages (bleeding) of a limb, for example, a deep wound
to the leg where you expect the leg would not be saved by any veterinary help, or where you
see blood spurting or pumping from the wound. This is a rare sight, but it may be necessary
in these cases to use a tourniquet.

• Procedure

Use a wide cloth or bandage that is two inches wide or more and wrap it around the leg twice,
above the wound, and tie a knot in it. Then, take a short stick or pen, for example, and tie it
into the knot as well. Now, as you twist the stick, this will tighten the tourniquet. You need to
keep twisting until the bleeding stops. It is very important that you then time how long the
tourniquet is working for. You have to loosen the tourniquet every fifteen minutes for thirty
seconds. If you don’t do this, it may result in the animal having to have the leg amputated.
The tourniquet should only be used as a last resort, a life-saving measure.

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 WOUNDS

A wound is any break in the continuity of tissues in the body. Many wounds will require pain relief,
and then sedation or anaesthesia for cleaning and suturing the wound. Please remember that animals
in pain can be unpredictable, so you need to think of your own safety and protect yourself from being
bitten. Below I will discuss several different types of wounds and how to treat them.

• Deep wounds

Deep wounds are generally bleeding and have exposed muscle, fat, or bone. Firstly you need
to stop the bleeding by using direct pressure. You should not attempt to clean the wound
unless instructed to do so by your vet. It is a good idea to protect the wound from any
contamination by applying a saline-soaked swab, or if one isn’t available, a wet cloth to the
wound. Try to mobilise the wound, as this will prevent further damage to it. Monitor the
animal for shock and provide first aid for it, if necessary. Seek the advice of a vet as soon as
possible. When transporting the animal, make sure that the wound is face-up.

• Superficial wounds

These are wounds that do not penetrate all the way through the skin. Firstly make sure your
hands are clean. Then, flush the wound with saline or sterile water until you have removed all
the dirt and debris from the wound. Then, wrap a bandage or large dressing around the wound
to protect it. If the wound is only a very small one, then just apply some wound powder to
protect it. Veterinary advice should only be sought if you are concerned about the wound or if
it increases in size, looks red, is inflamed or infected, or if the animal is behaving unusually.
If the animal has a bandage, then this should be checked frequently for any signs of swelling,
discolouration, odour, whether it feels wet or damp, or if the animal seems very
uncomfortable with the bandage. If any of these things are spotted, the bandage should be
changed immediately.

Over the years I have seen many bandages do more harm than good, if they are applied too
tightly, wrongly or not changed frequently enough. I have even seen this bad care result in
amputation of the bandaged foot. So please, be careful and vigilant, and if you’re not sure,
ask someone with more experience.

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 • Burns

A burn is an injury to the tissue caused by heat, flame, chemicals, or electricity. I would say
any burns should be examined by a vet. It is useful to know that burns often become worse
before they get better, and they can require several weeks of treatment. Burns are classified
into three different types depending on the severity of the burn:

1. First-degree Burns

These are the minor burns that involve only the top layer of skin and cause redness
and minor pain. These heal very quickly.

2. Second-degree Burns

These involve the deeper layers of skin, cause superficial blistering and are more
painful than first-degree burns.

3. Third-degree Burns

This is when the top layer of skin is lost completely and there is damage to the deeper
layers of skin. With this type of burn you can see charring and extreme damage to the
tissues. They take a long time to heal, are incredibly painful and may require skin
grafting. They will result in heavy scarring.

First Aid

It is very important that if you suspect the pet has been electrocuted, then you must turn off the
power before you touch or approach the animal. Remember your own safety first.

With any kind of burn it is important that you do not apply ointments or butter, as this will make the
burn worse, and never attempt to remove burnt hair or skin yourself.

Thermal or Electrical Burns

Immediately cool the area by applying cold water to the injury. You can apply cold water
compresses with a clean cloth to the injury, but this will need to be changed frequently to keep the
burn cool and wet. You need to continue this cooling process for at least thirty minutes. It is a good
idea to cover the area with petroleum jelly and wrap it in cling film if possible, as this will lock the
moisture in. Most of the damage caused to the tissues in a burn is caused by the tissue drying out.

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Chemical Burns

Be careful. It is likely that the chemical that burnt the animal may also be able to burn you.

Wash the area with large amounts of flowing, tepid water for at least fifteen minutes. If it is a dry
chemical, then brush it away, taking care to protect yourself and the animal from the powder. If the
chemical is in the animal’s eye, then flush the eye with large amounts of water or saline for fifteen
minutes. Get to a vets as soon as possible, but make sure the area is well ventilated, as some
chemicals can release toxic fumes.

POISONING AND FITTING

Poisoning

This is a condition that is caused by the ingestion, inhalation, injection, application or absorption of a
substance that causes damage or functional disturbances to the body and its tissues. A poison can
take the form of all sorts of substances, from a simple house plant, to an overdose of medication, or
the chemical you might find in a garage or under the sink in your house.

Initial first aid treatment for poisoning:

Do not give the animal any food or liquids, as this will increase the absorption of the poison into the
animal’s body. Contact the vets as soon as possible for advice. It’s important to get precise
information of what the animal has come in contact with, so keep any packets or packaging, or a
sample. If the pet vomits, it is also a good idea to keep that. The vet will use this to try to piece
together exactly what happened, and then they usually will contact an advisory poisons emergency
service, who will explain to the vet exactly what they need to do. It is important that the animal can
get to the vets as soon as possible, certainly within thirty minutes, as it may be possible to remove
the poison before the animal starts to absorb it.

Fitting

The proper name for a fit is a seizure or a convulsion. Basically, they are sudden, uncontrollable
movements of the animal’s body caused by abnormal brain activity. Seizures can be caused by a
multitude of different things, for example epilepsy, poisoning, low blood sugar, liver problems and
cancer. They can be very severe and affect the whole body, or quite mild, affecting small parts of the
body. Sometimes the animal may seem to be conscious during the seizure, and other times they will
be unresponsive and may urinate and defecate. If a seizure lasts any longer than five minutes it can
cause severe side effects. Veterinary treatment and advice is necessary with any seizures.

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First aid treatment of seizures:

Firstly, remember your own safety, because the animal that is convulsing can suddenly bite or kick
out. Never place your hands near the animal’s mouth. So, you need to protect yourself. You also
need to protect the animal from injuring itself during its seizure. For example, move furniture out of
the way to prevent it from hitting its head. Do not try to pick up the animal and comfort it, as this
will only make the seizure worse. Keep the room very quiet and try to pull the curtains or turn off the
light so that the room is dimly lit. Remove any pets or children from the area for their own safety.
Make a record of the time the seizure begins and ends, and whether it started with a certain part of
the animal’s body. This will be useful information to the vet. Monitor the animal in case it stops
breathing, then begin ABC and CPR. You cannot shock an animal out of a seizure, so do not try to
startle it or throw water on it.

DIARRHOEA AND VOMITING

Diarrhoea is the frequent passing of watery faeces, and vomiting is the forceful passing of stomach
contents through the mouth. Both diarrhoea and vomiting can be caused by viruses, worms or a
sudden change in diet. It seems to be a lot more common in young animals.

First aid treatment

For dogs and cats, you can starve them for twelve to twenty-four hours. This will help settle
diarrhoea. Young and old animals that are not dogs and cats should not be starved without seeking a
vet’s advice first.

Feeding a bland food such as chicken and rice to cats and dogs, or removing fresh vegetables from a
rabbit or guinea pig’s diet can be very useful in treating vomiting and diarrhoea. This bland diet
should be continued until the faeces become normal. Don’t go straight back to the animal’s normal
diet, but gradually introduce the normal diet. A consultation with a veterinary surgeon is necessary if
any of the below symptoms are seen:

• Blood in faeces or vomit

• The animal vomits water
• The animal stops drinking
• The vomiting or diarrhoea does not resolve after twenty-four hours
• The animal vomits something that looks like coffee grounds (this is usually digestive blood)

Never remove the animal’s drinking water, but you will need to prevent the animal from drinking a
large quantity of water in one go. If you don’t, the animal will probably vomit it back up.

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Rabbits should never be starved, as their gut needs to be constantly working. If it stops working there
can be a build-up of harmful bacteria and gas.

Rodents, rabbits and horses do not have the ability to vomit, as they have a powerful barrier between
their oesophagus and stomach, and don’t have the muscle strength in their oesophagus to overcome
this barrier. Also, they don’t have the muscles needed in the diaphragm to be able to vomit.

HYPERTHERMIA AND HYPOTHERMIA

Hyperthermia is better known as heatstroke. It occurs when an animal’s body temperature rises high
above the normal. Hyperthermia can be fatal. It often occurs in summer and also unfortunately when
owners have left their pet in a car on a hot day. The signs of hyperthermia, other than a high body
temperature, can include a bright red tongue, rapid panting, red or pale mucus membranes, weakness,
vomiting, shock, diarrhoea and coma.

First aid treatment

Firstly, move them to a cooler area, then place wet towels over them. Put a fan on them if you have
one available. Check the animal’s temperature every five minutes, until the temperature becomes
normal, and then stop the cooling and cover them so they don’t lose too much heat. Encourage the
animal to drink little and often. Get the animal to a veterinary practice as soon as you can.

Hypothermia

Hypothermia is the opposite to hyperthermia. It occurs if an animal’s body temperature drops below
its normal temperature. It can also be fatal. It can be seen if an animal has been left out in the cold
with no form of shelter, or after a fall into an icy lake. The signs of hypothermia, other than a low
body temperature, can include violent shivering and shaking, slow and shallow breathing, pale
mucus membranes, weakness, shock and coma.

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First aid treatment

The animal needs to be warmed slowly.

First, place your animal in a warm room and then wrap them in warm blankets. To warm the
blankets, put them in a clothes dryer for a few minutes. You can use a hot water bottle, but only fill it
with warm water. Encourage the animal to drink warm water little and often. Warming a patient is
painful, so be careful the animal does not start to bite or scratch. Get the animal to a veterinary
practice as soon as you can.

TUTOR TALK: You have now come to the end of this assignment. Answer the questions
relating to the work that you have just covered and return them to the College for marking.

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STUDENT NOTES: Please use the space below for recording what you consider to be
any pertinent information or notes. You may find it helpful to refer back to it later on!

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