Emergency First Aid for Traumatic Injuries
When approaching an injured horse, the first thing to do is STOP!
Take a moment to assess the horse's mental state.
A frightened or traumatized horse may not respond in the expected manner. The horse's response to frightening or painful situations is to flee. If this response is prevented, panic and additional self-induced trauma are potential consequences. APPROACH WITH CAUTION! Be calm and deliberate; panic on your part may make the situation worse. Try to calm and reassure the horse. Above all else, do not put yourself in a position that creates a human emergency to compound the existing equine emergency. ALWAYS HAVE AN ESCAPE ROUTE! Do not tranquilize an injured horse unless directed by a veterinarian. Acepromazine should not be given to an animal with severe trauma, bleeding, or signs of shock. "Ace" will lower blood pressure, worsen shock, and may result in the collapse of the animal.
The next step is to assess the horse's physical condition.
Apply the principles of first aid: check Airway, Breathing, and Cardiovascular system. Stop hemorrhage and evaluate for shock. Direct pressure is the most effective method to stop bleeding. This can be a simple as holding a clean towel over the wound. Bandage material such as an Ace bandage or Vetrap can be used to construct a compression bandage for the lower extremities. If blood begins to seep through your bandage, add another layer and wrap tightly. Never remove the old bandage to apply a new one. Shock can accompany severe internal injuries or extensive blood loss. Depression, pale gums, rapid heart rate (>50 bpm), cold extremities, and decreased pulse amplitude are typical signs of shock. Keep the horse quiet and warm until the veterinarian arrives.
Following assessment of the horse in general, attention can be directed to the wounds.
Evaluate the extent of the damage and determine whether the wounds are opened or closed. Closed wounds do not penetrate all the skin layers. They are not life threatening and heal with a minimum of complications. Abrasions result when only the superficial layers of skin are removed. The wound oozes serum, but bleeding is minimal or absent. Treatment consists of gentle cleansing to remove dirt and protecting the area from further trauma. Abrasions can be very painful, and often heal more slowly than anticipated. Contusions and hematomas are traumatic bruises under the skin. Initial treatment consists of cold water or ice packs, phenylbutazone (1-2 grams/1000 lb. once or twice daily), and topical DMSO. Veterinary assistance should be sought to evaluate for other soft tissue damage (especially contusions over point of the hock or elbow). Very large hematomas require a tetanus booster and antibiotic therapy. If the fluid does not resorb by 7 to 10 days, the hematoma can be drained by a veterinarian.
Lacerations result from tearing of the skin, are often irregular in shape, and associated with extensive soft tissue damage. If bleeding is not severe, cleanse the wound. Sterile saline is the fluid of choice for cleansing wounds, but water can be used if saline is not available. The wound is flushed until visible dirt is removed. Finally the wound is bandaged to prevent further damage and contamination. Do not apply ointments, sprays, or powers to wounds that are to be sutured. If the wound is to be closed, suturing must be done within the first 6-8 hours of injury. Wounds greater than 8 hours old are considered to be infected, and attempts to suture infected wounds usually fail. No matter how small, any wound over a joint or tendon should be evaluated by a veterinarian.
Puncture wounds can be very serious because the visible damage is minimal, but the internal damage can be extensive. Puncture wounds provide an ideal environment for the bacteria that causes tetanus. If your horse has not had a tetanus vaccination in the past 6 months, a tetanus toxoid booster must be administered. Punctures can be very serious if they are located over joints, tendon sheaths, the chest, or abdomen. These punctures should be evaluated by your veterinarian. Puncture into the abdomen can lead to evisceration, while an open wound into the chest can result in the aspiration of outside air and the collapse of both lungs, resulting in death. If air movement is heard from a wound over the horses chest, seal the hole with an occlusive bandage until veterinary care is provided. If a foreign object is present in a puncture, it is best to leave it in place until your veterinarian arrives.
Lacerations usually look worse than they are, and punctures are usually worse than they look. Always have your emergency numbers on hand. Be calm, evaluate the situation, and apply the general principles of first aid.