Trauma. Hollywood makes it look exciting, but reality is a different story. Unless you intentionally choose a career in trauma medicine, the chances of encountering and having to treat a real trauma case are rare. This should never overshadow the fact that you need to be prepared because a working dog and his or her handler are faced with the possibility of becoming a trauma case every single day.
To keep this article brief, let's summarize three broad categories of trauma: penetrating, blunt, and blast-related. We'll also cover some basic intervention after the trauma has occurred.
Penetrating trauma comes in the form of a projectile (bullet, shrapnel, etc.) or sharp object (knife, improvised blade, etc.) that penetrates the body. The severity of the injury depends on the location. Penetrating traumas to the legs of a dog are not nearly as life-threatening as a penetrating trauma to the abdomen or thorax (chest).
Blunt trauma occurs when a flat or wide object makes an impact with the dog at a high rate of speed. A couple examples include motor vehicle accidents and falls from elevation. As with penetrating traumas, blunt trauma to the abdomen or thorax is much more life-threatening because of proximity to vital organs. The effects of this type of trauma are sometimes not realized immediately because the damage can show up hours later as the internal organs try to recover from the impact.
Blast-related trauma is very complex and depends on the distance from the blast. If close enough, the dog experiences the overpressure waves (shock waves) of the blast. There is usually a deleterious effect on the brain and central nervous system, commonly known as traumatic brain injury. Other fluid and air-filled organs are also affected, such as the ears, eyes, and lungs. In addition to the shock waves, there is a combination of penetrating and blunt traumas from the debris and shrapnel. When a dog sustains multiple injuries of this magnitude, it can be referred to as polytrauma.
Regardless of the type of trauma, simple interventions en route to a veterinarian can mean the difference between life and death for a working dog. It may sound redundant or overused, but the ABC mnemonic of emergency medicine is the first step. Airway, breathing, and circulation. When a traumatic event happens, a lot of people lose their focus. That's why acronyms and mnemonics are helpful to keep people focused.
- A.) Airway. Does the dog have an open and clear airway?
- B.) Breathing. Is he or she breathing on their own?
- C.) Circulation. Can you feel a heartbeat when you place your hands on the chest near the elbows? Can you feel a pulse on the inside of the back legs?
After the airway, breathing, and circulation has been addressed, place a muzzle on the dog and examine the body for bleeding. Apply tourniquets as necessary. Feel the abdomen and thorax for signs of penetrating trauma, which sometimes doesn't bleed externally. Keep the dog warm because they can become hypothermic when they are in shock. Transport the dog immediately to a veterinarian for further evaluation. It may be easier to remember all of this additional information using another mnemonic that has gained popularity in the treatment of traumatic injuries: MARCH
- M.) Muzzle, massive hemorrhage
- A.) Airway
- R.) Respiratory support (the "B" of ABC)
- C.) Circulation
- H.) Hypothermia, check for head trauma (which can affect body temperature, breathing, and heart rate).
All of these steps can be implemented en route to a veterinary hospital where advanced life support, diagnostics, and surgical intervention are available for the working dog. Once in a hospital setting, the chances of survival significantly improve. Regardless of how you remember the steps to take in a trauma situation, rapid assessment and intervention is key to survival, so it’s your responsibility to get prepared and stay prepared.
About Dr. Dan
Dr. Dan Caldwell is the owner and lead veterinarian at MAC Animal Clinic in Auburn, Alabama. He has received numerous awards, including accolades for surgery, internal medicine, and public health. After graduating third in his class, he spent time in emergency medicine before transitioning to a position as the lead veterinarian at a clinic near Birmingham, Alabama. Dr. Caldwell and his family eventually decided they wanted to raise their family in Auburn, so they charted their course to opening MAC Animal Clinic in 2017.