ABC’s Of Trauma


  • 4. ABC’s Of Trauma
  • 4.1 A Is For Airway

The chest wall and lungs are damaged to some extent most of the time when an animal is hit by a car. This damage may cause blood or air to leak from the lungs into the chest causing a collapsed lung. It may bruise or fracture the ribs reducing the breathing or changing the way a pet takes in air. There is little a person can do to help with these problems outside a veterinary hospital.

Common sense should tell us that bandages around the chest should be avoided to prevent breathing, oxygen, if available, can be administered by bag as described above. Sucking chest wounds are covered with ointment and plastic. Blood loss is a reason for shock and the lungs of a pet hit by a car are a source for bruising and blood loss that may not be apparent from outside.

It is helpful to try to determine if a pet that is having difficulty breathing is having difficulty inhaling or exhaling.

  • 4.2 B Is For Bleeding
  • A. Superficial Bleeding – External
    • 1. Wash your hands thoroughly before attending to the animals wound.
    • 2. Clean the wound by carefully flushing away the superficial dirt, hair, or other debris.
    • 3. Use warm tap water in a gentle stream for cleansing the wound.
    • 4. DO NOT use Hydrogen Peroxide as it will cause tissue damage and prevent healing.
    • 5. Blot the wound dry with a sterile dry clean cloth. DO NOT use kleenex or tissue paper. Apply a small amount of an antimicrobial ointment. Then apply a sterile bandage.
  • B. Minor Bleeding – External
    Minor bleeding from scrapes, scratches, small bites, etc. The bleeding can be controlled by applying pressure directly over the wound for 5 minutes by the clock with no interruptions. DO NOT attempt to pull at or cut tissue or remove debris if the wound is deep.
    Follow the cleaning procedures as outlined above.
    Arrows, knives, sticks, and bullets should never be removed. Only a trained veterinarian should care for these types of wounds. Instead, secure the object so that it does not move about. The object also may be acting in a splinting fashion and if removed, mass bleeding may occur.
  • C. Impaled Objects
    Arrows, knives, sticks, and bullets should never be removed. Only a trained veterinarian should care for these types of wounds. Instead, secure the object so that it does not move about. The object also may be acting in a splinting fashion and if removed, mass bleeding may occur.
  • D. Severe Bleeding – Hemorrhage – External
    Arterial Blood – Is bright red and pulsates or spurts out of the wound with every heartbeat. Early in the incident, the heart rate will be increased – therefore a larger volume will be lost quickly.
    Venous Blood – Is dark in color and oozes out of the wound.

    Techniques To Slow Or Stop Severe Bleeding Before Transport

    • 1. Direct pressure: Apply direct pressure by hand or with a dressing over the entire bleeding area for 5 to 10 minutes by the clock. You can use a gauze pad or clean cloth. If this is applied, do not remove. Also, if blood soaks through the dressing, do not remove.
    • 2. Elevation: Unless there is evidence of a fracture, a severely bleeding wound or paw can be elevated above the level of the heart. Elevation uses the force of gravity to help reduce the blood flow by decreasing the blood pressure to the area.
    • 3. Pressure on the supplying artery: If external bleeding continues after the use of direct pressure and elevation, application of digital pressure over the main artery supplying the wound may be helpful. Apply pressure to the femoral artery in the groin for severe bleeding of the rear leg; the brachial artery inside the upper front leg for wounds to the front leg.
    • 4. Pressure above and below the bleeding wound: This can be used in conjunction with direct pressure to control venous bleeding.
    • 5. Tourniquet: Use of a tourniquet is DANGEROUS and should only be used on a limb that you do not expect to save.
  • E. Internal Bleeding
    • 1. Open Body Cavity Bleeding – Internal to External Bleeding may occur from any body cavity or orifice with an opening to the outside, such as: the mouth, the vagina, the ears, the nose, the rectum, the urethra, and the eye. Bleeding from any of these body cavities needs the immediate attention of a veterinarian.
      • a. You may place dressings over the outer orifice to absorb blood.
      • b. Keep the animals activity limited to a cage or crate during transport and while at home.
      • c. Bring samples of any blood discharge from the rectum, vagina, or vomitus with you to the veterinarian. Please note the color, odor, amount and how long the bleeding is known to have occurred.
      • d. Hypovolemic Shock – Rapid transport to the veterinarian is essential. Please refer to the section on Shock for more information.
    • 2. Closed Body Cavity Bleeding
      Traumatic injury from abuse, poisonings, falls, and motor vehicles can also occur. They may involve the head, chest, abdomen, and extremities. Traumatic injury can cause a rapid rate of internal bleeding into the brain, lungs, heart, liver, GI tract, and other vital organs and tissue. Certain medications can also cause these types of bleeding. If the injury is not witnessed, the only signs that something is wrong are the signs of shock, respiratory difficulty, neurological changes, or abdominal changes. There is little that you can do to stop this kind of bleeding. TREAT FOR SHOCK if the signs exist. Transport as quickly as possible. DO NOT allow the animal to run or walk. Carry the pet on a board if necessary.
      There is no more severe emergent problem (Except the need for CPR) than having uncontrollable bleeding from either an internal or external wound.

      ANIMALS CAN LOSE CONSCIOUSNESS AND GO INTO SHOCK RAPIDLY BY LOOSING 15 cc OF BLOOD PER POUND OF BODY WEIGHT.

      Wounds

      A wound is a break in the continuity of the tissues of the body, either external or internal. Open wounds are those with a break in the skin or mucous membrane. Closed wounds involve injury to underlying tissues without a break in the skin or mucous tissue.

      Types of Open Wounds:

      • 1. Abrasions: Scraping injuries in which the top layer of skin is rubbed off
      • 2. Incisions: Superficial or deep cuts in which bleeding may be rapid and heavy
      • 3. Lacerations: Display jagged, irregular margins with greater tissue destruction
      • 4. Punctures: Produced by an object piercing the skin layers, creating a hole in the tissues
      • 5. Avulsions: Result when tissue is forcibly separated or torn from the body
      • 6. Bites: Frequently a combination of puncture and avulsion wounds
      • 7. Gunshot Wounds: Wounds caused by bullets ranging from a BB to a high powered rifle
      • 8. Impairments: Wounds in which a cylindrical object penetrates and lodges in the tissues. Wounds caused by arrows, long sharp sticks and knives are examples.
  • 4.3 C Is For Central Nervous System

Trauma to the brain or spinal cord is dealt with next. It is almost impossible to immobilize a dog that does not want to be restrained without drugs. It is best to try to access the damage so that you can prevent further damage. The most common injury is to the spine at the junction of the lumbar area to the ribs. This will cause loss of movement and sensation to the rear legs. The toes of a rear foot are pinched while watching for visible reaction of the pet. Do not interpret the foot being pulled away as a sign of spinal function. Spinal reflexes serve to pull the leg back from a pinch without the brain being aware of such an action. Watch for the dog to lick his lips, look at you or cry when you pinch his toes. If the pet does not respond then he may have a spinal injury. The pet should then be transported on a flat hard surface if possible. Do not try to tie the animal to a board as the struggle may be more harmful than good.

  • 4.4 D Is For Digestive

The digestive system includes the stomach, small and large intestines which are rarely injured in trauma. The liver is a part of the digestive system and it is commonly injured or fractured when an animal is hit by a car. It is commonly the source of bleeding. An animal that has recently been hit by a car and has a distended abdomen is likely to have bleeding from the liver. The liver bleeding will usually stop without intervention but if the pet is not responding, then other measures are taken. The abdomen may be bandaged as shown previously to force the blood into the more vital areas of the body for the treatment of shock. This abdominal compression may stop the hemorrhage from the internal organs of the abdomen.

  • 4.5 E Is For Excretory

Damage to the excretory system is damage to the kidneys or bladder or to the ureters that connect the kidneys to the bladder or the urethra which connects the bladder to the outside. These injuries may be serious or even life threatening but they are not essentially treated until the other concerns have been met. Kidney damage may result from shock or trauma directly to the kidney. Blood clots may obstruct the flow of urine or trauma may tear the ureters or the urethra. The bladder may
Rupture if it was full at the time of the trauma. These damages rarely are the cause for concern during the first few hours of first aid care.
It is expected to see bloody urine in a pet that has been hit by a car.