Recognising emergencies
Recognising emergencies
2
Differentiating emergencies
2
Emergency situations
3
Symptoms and treatment of emergencies
4
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© NSW DET 2007
Recognising emergencies
After a client and patient have arrived for a consultation or admission for a
surgical or medical procedure, the veterinarian involved needs to be
informed of their arrival. This can be done either via a paging system or in
person. Occasionally clients will arrive with animals that require urgent
attention, with or without an appointment.
As a veterinary nurse you’ll need to be able to identify the various clinical
signs that indicate an emergency, so that prompt treatment can be applied.
If the client does not have an appointment or there are other clients already
booked in, it will be necessary to explain the situation to the other waiting
clients who may then be delayed.
Differentiating emergencies
This table outlines a range of conditions you may encounter
Life threatening—
animal will die if not
treated immediately
Conditions requiring
immediate attention
Minor conditions

unconscious

conscious collapse

insect stings

conscious collapse
with breathing
trouble or cyanosis

difficulty breathing


fractures/
dislocations
severe
haemorrhage
minor wounds
(where the bleeding
is easily controlled
by bandaging)

haemorrhage


severe burns

gaping wounds
minor burns (only
slight discomfort)

poisoning


abscesses

difficulty giving
birth
snake bite

slight lameness


prolapsed eye
head injuries

hematuria


straining to urinate
vomiting and
diarrhoea

aural hematoma

seizures

Which category do you think this animal would fit into if it arrived without
an appointment?
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Emergency situations
The table below lists veterinary emergencies that you may encounter in a
clinic. Emergency situations must be reported to the veterinarian
immediately when they present at the veterinary hospital. Many clinics will
have a policies or procedure to follow when emergencies arrive.
Patient details must be obtained from the owner and provided to the
veterinarian either verbally, written or computer based. The patient must
then be presented to the veterinarian in an ethical and humane manner.
Veterinary emergencies

hit by a car (70% of veterinary
emergencies)

prolonged labour


gunshot wounds
ingestion of poisonous substance
eg snail bait, rat poisons, caustic
agents, aspirin, paracetamol,
human heart drugs etc

burns

dog attack

snakebite, suspected or confirmed

insect bite if has had a previous
allergic reaction

head trauma, falls etc

straining to urinate unsuccessfully.

dog administered DEC (daily
heartworm preventative) that has
not been blood tested beforehand
and that is showing signs of
dyspnoea or collapse

drug overdose

eye injuries, prolapsed globe

penetrating wounds or hernias to
abdomen or thorax
animal left inside a car in the sun,
or elsewhere in sun without water

multiple fractures

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Symptoms and treatment of
emergencies
Broken bones
Symptoms
Some bone breaks show obvious symptoms: twisted or
distorted limbs, or in the case of a compound fracture, bone
fragments sticking through the skin. Less apparent breaks
cause great pain and discomfort.
The animal will cry or bite when the affected area is
touched; will lie around, often on the affected area; and will
usually not walk, although in some cases it will walk despite
the break, notably when the pelvis is broken. The fracture
will not bear weight. Swelling of the affected area with 24
hours can be expected from any sort of fracture.
Treatment
Treatment of compound fractures by a veterinarian should be
sought as soon as possible. Other breaks should be treated by
a veterinarian within 24 hours.
Apply an ice pack or cold wet compress to the affected area;
change regularly. Protect the animal from further injury by
confining it to a small room. Apply a temporary splint to
broken limbs to avoid further dislocation.
Burns
Symptoms
All burns are painful to the touch. Electrical burns are the
most serious and can cause heart attacks and death. The
burned area will show seared flesh, reddened skin, lesions,
and blisters.
The animal may suffer respiratory distress; paleness or
blueness, especially in lips, gums, and eyelid linings; rigidity
in limbs; glassy stare; collapse; and shock. Thermal burns
cause a singed or charred area; the exposed skin is reddened
or inflamed; the wound is warm or hot to the touch.
Friction burns are similar in appearance to thermal burns, but
the skin is chafed or scraped and has bare spots; bare skin is
rubbed raw, is reddish in colour, and is irritated or inflamed;
the trauma causing the burn may leave cuts, lacerations, or
embedded foreign matter.
Treatment
The animal should be taken to a veterinarian.
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Constipation
Symptoms
The animal struggles or strains during a bowel movement
without passing a stool; avoids food; becomes nervous or
irritated.
Diarrhoea
Symptoms
The animal passes liquid stool during bowel movement;
there may be abnormal coloration of the stool. Prolonged
diarrhoea can lead to severe dehydration and should be
treated as an emergency if persist for more than 24 hours, or
if blood is present.
Respiratory infections and conditions
Symptoms
Sneezing, coughing, runny eyes, swollen glands, difficulty
swallowing, laboured breathing, fever.
Treatment
If symptoms such as sneezing, coughing, and runny eyes are
present but the animal remains active and eats normally, the
condition is probably not as serious. A veterinarian should
examine the animal if symptoms continue for a while; if the
animal becomes lethargic and loses appetite; if there are
discharges of pus from its nose; if congestion becomes heavy
or laboured breathing is continued; or if fever of more than
40 degrees is present.
Skin problems
Symptoms
Localized skin conditions cause inflammation or irritation
and may cause bald spots of red, raw, or discoloured skin.
More serious disorders such as moist eczema, wet dermatitis,
or acute pruritus cause raw, oozing bald spots that may be
damp to the touch or oozing pus. A lump on the animal's
skin that does not go away within a few days may be a
tumour. Other skin problems can cause dry, flaky skin, or an
oily coat, and constant biting, licking, or scratching.
Symmetrical skin disorders affect both sides of an animal's
body equally; a generalized condition affects the animal's
whole body.
Treatment
Generally not an emergency unless the animal has caused or
inflicted self trauma. Bald patches of red or raw skin and
damp, oozing hot areas should be treated by a veterinarian.
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Any skin condition that does not go away or that reappears
after treatment should be treated by a veterinarian.
Sprains
Symptoms
Sprains usually occur in the joints of an animal's limbs,
causing rapid swelling. The affected area will be hot to the
touch. The animal will not walk normally, if it walks at all.
Treatment
Apply cold compresses or ice packs gently to the swollen
area; removing the compress or ice every 20 minutes. Wrap
the affected area snugly with cloth, gauze, or athletic
bandages; secure the wrapping to be sure the animal does not
scratch or bite it off. Keep the animal quiet; discourage
activity; avoid stairs. See a veterinarian.
Wounds
Symptoms
Cuts can be recognized by the presence of smoothly
separated tissue and possible bleeding. Lacerations result in
jaggedly torn skin, bleeding, swelling, irritation, and black or
blue discoloration of the skin. Abrasions rub or scrape away
the outer layers of skin, causing pain, swelling, redness, and
heat. Bruises or contusions leave black-and-blue tissue and
swelling.
Treatment
Any serious wound should be treated by a veterinarian
especially if bleeding will not stop, if blood is gushing out or
if shock is present. These are emergency situations- seek
veterinary advice right away.
Cuts that are bleeding can be dealt with by applying a
pressure bandage (clean gauze or cloth wrapped around
some non stick padding) pressed firmly but gently against
the wound and an ice bag, pressed firmly but gently on the
area. After the bleeding has been controlled, clean the wound
and then dry it; keep skin from wrinkling or bunching, then
apply an antiseptic or antibiotic to gauze square and wrap
snugly in place; change the dressing daily and keep the
animal from removing it.
Lacerations can be treated in the same way as cuts, but an ice
bag must be used to reduce swelling and prevent further
inflammation. Abrasions require the application of a
soothing cream, ointment, or lotion; a bandage is not
recommended, but the animal must be kept from licking the
treated area. Bruises and contusions are best treated with
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cold compresses or ice packs.
Bite wounds
Symptoms
Wounds caused by another dog or cat can be very
serious. Puncture wounds are often deeper than they
appear. Fight wounds also tend to become infected
easily. Seek Veterinary advice as soon as possible after a
fight wound has been sustained by your pet. Antibiotics
are often prescribed to prevent the formation of an
abscess.
An abscess is best described as a “pocket of pus”. They
cause the abscessed area to become very enlarged, hot
and painful to touch. Abscesses may cause your pet to
become dull and go off their food. They can also cause a
raging fever. Some pets become so sick with an abscess
that they can die from associated blood poisoning.
Treatment/action
Approach the pet carefully to avoid getting bitten.
Muzzle the animal. Check the wound for contamination
or debris. If significant debris is present, then clean the
wound with large amounts of saline. Wrap large open
wounds to keep them clean. Apply pressure to profusely
bleeding wounds. Do not use tourniquets.
Bite wounds often become infected and need
professional care. Wear gloves when possible.
Breathing stops
Treatment/action
Check to see if the animal is choking on a foreign
object. If an animal is not breathing, place it on a firm
surface with its left side up. Check for a heartbeat by
listening at the area where the elbow touches the chest.
If you find no heartbeat and no breathing, commence
CPR. If there is a heartbeat, but not respiration,
commence ‘breathing for the animal’ and continue to
check for heartbeat.
Please note: Even in the hands of well-trained
veterinary health professionals, success of resuscitation
is very low overall. Success may be slightly higher in
the cases of drowning or electrical shock. Call
veterinarian immediately. This is a major veterinary
emergency!
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Steps for Cardiopulmonary Resuscitation (CPR)
Check airway
1. Carefully pull the tongue out of the animal's mouth.
WARNING: even an unresponsive dog may bite by instinct!!
2. Make sure that the neck is reasonably straight; try to bring the head
in-line with the neck.
WARNING: Do not hyperextend in cases where neck trauma exists
3. Attempt two rescue breaths, by closing the mouth, and performing
mouth-to-nose ventilations. If they go in with no problems continue
to steps for Breathing.
Breathing
4. Reposition the neck and try step three again.
5. Visibly inspect the airway by looking into the mouth, and down the
throat for foreign objects occluding the airway. Unlike CPR for
humans, rescuers may reach into the airway and remove foreign
objects that are visible
6. After achieving a patent airway, one must determine whether the
animal is breathing, and whether this breathing is effective:
7. Carefully pull the tongue out of the animal’s mouth.
WARNING: even an unresponsive dog may bite by instinct!!
8. Make sure that the neck is reasonably straight; try to bring the head
in-line with the neck.
WARNING: Do not hyperextend in cases where neck trauma exists
9. Ventilate the animal by closing the mouth, and performing mouth-tonose ventilations. If they do not go in with ease go to A-Airway.
10. Ventilate at 20 breaths per minute If supplemental Oxygen is
available, and the animal is breathing on its own, use a high-flow
blowby.
WARNING: Do not attempt to intubate the animal, without prior
training, and properly sized ET tubes.
11. Proceed to C-Circulation, while continuing respiratory support as
necessary
Circulation
12. This is the final step of CPR and should only be initiated after the
airway and breathing steps have been completed:
13. Make sure that there are no major—pooling/spurting blood—points
of bleeding. Control as necessary.
14. Lay the animal on its right side.
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15. Locate your hands where its left elbow touches the chest.
Approximately the middle of the rib-cage
16. Compress the chest 15 times followed by two rescue breaths (three
compressions every two seconds)
Compress
a.1/2" - small dogs
b.1" - medium dogs <
c. 1.5" - large dogs
17. Repeat as necessary
Choking
Symptoms
Difficulty breathing, excessive pawing at the mouth,
blue lips and tongue. Be sure to protect yourself as well
since the pet will likely be frantic and may be more
likely to bite. If the pet can still partially breathe, it's
best to keep the animal calm and get to a veterinarian as
quickly as possible.
Treatment/action
If possible, look into the mouth to see if foreign object
in throat is visible. To avoid being bitten, use the handle
of a screw driver to wedge between the molar teeth on
one side of the mouth so the pet can not close its mouth.
Use your fingers to perform a “finger sweep” at the
opening of the throat. If you can, clear the airway by
removing the object with your fingers, being careful not
to push it farther down the throat.
If possible, encourage the pet to cough by gently
rubbing at the throat area or using a gentle “tinkling”
motion at the throat area while the pets head is slightly
extended back.
If it is lodged too deep or if the pet collapses, then place
your hands on both sides of the animal's rib cage and
apply firm, quick pressure. Or place the animal on its
side and strike the side of the rib cage firmly with the
palm of your hand three or four times. Repeat this
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procedure until the object is dislodged or you arrive at
the veterinarian's office. Call veterinarian immediately.
Warning- there is a structure deep in the throat (the
“Adams Apple”) that feels like a smooth bone. DO NOT
pull at this structure!!
Heatstroke
Symptoms
Rapid or difficulty breathing, vomiting, high body
temperature, collapse.
Treatment/action
Place animal in a tub and run cool water over it. Or,
gently soak animal with a garden hose or wrap in a cool,
wet towel. Do not overcool the animal. Stop cooling
when rectal temperature reaches 39 degrees. Call
veterinary immediately.
Seizures
Symptoms
Salivation, loss of control of urine or stool, violent
muscle twitching, loss of consciousness
Treatment/action
Move pet away from any objects that could be harmful.
Use a blanket for padding and protection. Do not put
yourself at risk by restraining the pet during the seizure.
Time the seizure. They usually last only 2 to 3 minutes.
Afterwards, keep the animal calm and quiet. Call
veterinarian immediately.
Shock
Symptoms
Early stages of shock

Bright red gums

Very rapid capillary refill time (CRT) (1-2
seconds)

The pet may be either excited or subdued

Rapid heart rate

Pulse not difficult to find
Middle stages of shock

Gums appear pale or “muddy”

Abnormally long CRT (2-3 seconds)
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
The heart rate is frequently above normal

The pulse weakens and is often difficult to find

The pet will most likely be subdued and weak.

Respiration is often shallow and rapid (but may
be normal still)

Rectal temperature is often below normal
Late stages of shock
Treatment/action

Gums are extremely pale or show signs of a blue
discolouration

CRT is often quite long (3-4 seconds +)

Heart rate is elevated and irregular. If very
severe shock however, heart rate may be slowing
as the heart muscles begin to fail.

The pulse is very weak and difficult to locate

Respiration may be slow and rapid, shallow or
deep (but not normal!)

The eyes may take on a glazed appearance and
appear not to focus normally.

Mental condition deteriorates from subdued to
stupor or even coma.

Rectal temperature is below normal- often
critically so.
Successful treatment of a patient with shock involves
prompt recognition of the signs, immediate initiation of
first aid procedures and safe, rapid transport to a
veterinary facility for definitive treatment.
First aid includes:

providing adequate breathing

stopping blood loss

protecting obvious fractures from further injury

preventing loss of body heat by covering the
patient with blankets or clothing

immediately transporting the patient to a
veterinary facility.
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© NSW DET 2007