Page 263 - ATP-P 11th Ed

5. Circulation
a. Be sure that there are no major (pooling/spurting blood) points of bleeding. Control
as necessary.
b. Hemorrhagic Shock Fluid Resuscitation (Administration Routes):
i. Preferred route is IV
ii. Secondary route is IO (Tibia or Humerus) on a sedate or unconscious dog only.
c. Incorporate crystalloids and colloids as
needed.
i. Bolus of crystalloid, 10–20mL/kg,
reassess and repeat a maximum of
2 times SECTION 2
ii. Bolus of colloid, 5–10mL/kg given
once over 20–30 minutes.
iii. The targeted endpoint for resuscita-
tion should be to achieve and main-
tain permissive hypotension. IO Access Site Proximomedial
d. Blood transfusion (dog-to-dog), if available.
i. For the first transfusion in a trauma/field situation it is generally safe to give any
type of blood without typing or cross-matching.
ii. Collect no more than 20% blood volume (collect 1 unit/450mL from typical
size working dog). Perform a sterile prep and use the jugular vein for collection.
iii. In a trauma/field situation you will usually administer the whole unit. Human
blood transfusion guidelines apply for rate and monitoring requirements.
6. Hypothermia/Head Injury:
a. Hypothermia: Prevent loss of body heat. Dry the fur. Use a hypothermia blanket.
Watch for overheating.
b. Head Injury: Head trauma from blunt or penetrating injury can cause rises in intra-
cranial pressure (ICP) in most patients with CNS trauma usually as a result of braid
edema and intracranial hemorrhage. Signs of shock, hypoxia, seizures, and other
neurologic signs (i.e. ataxia, altered mentation, loss of consciousness, pupil asym-
metry) may also be seen.
i. Elevate head 30° and avoid jugular occlusion, maintain head neutral neck
position.
ii. Supplemental oxygen, if available. Intubation and hyperventilation may be nec-
essary in cases of hypoxia.
iii. Mannitol 0.5–1.0g/kg IV over 20 minutes, repeat q4–8 hours based on neuro-
logic status, limit to 3 doses in a 24 hour period
iv. IV fluids: goal is to maintain cerebral perfusion by optimizing MAP without
causing increased ICP

252 SECTION 2 TACTICAL MEDICAL EMERGENCY PROTOCOLS (TMEPs) ATP-P Handbook 11th Edition 253