Page 373 - ATP-P 11th Ed

2. Triage
Triage casualties as required. Human casualties should always be given priority over
MWD casualties.
3. Massive Hemorrhage
a. Assess for unrecognized hemorrhage and control all sources of external bleeding
with manual or direct pressure via application of hemostatic agents, pressure band-
ages and/or wound packing as first line intervention.
b. Apply CoTCCC-recommended hemostatic dressings with at least 3 minutes of di-
rect pressure (optional for XStat). Each dressing works differently, so if one fails
to control bleeding, it may be removed and a fresh dressing of the same type or a
different type applied. (Note: XStat is not to be removed in the field, but additional
XStat, other hemostatic adjuncts, or trauma dressings may be applied over it.)
c. Junctional wounds should be treated with aggressive application and packing with
hemostatic, pressure dressings and direct pressure to control bleeding.
i. CoTCCC recommended windlass, limb tourniquets designed for humans (e.g.,
C-A-T, SOFTT-W) tend to slip distally and generally fail on MWDs due to
conformational differences and should not be used as first line therapy for hem-
orrhage control in MWDs.
ii. The only tourniquet that should be considered for use on a massive extremity
hemorrhage in a MWD is a stretchable and elastic tourniquet such as the SWAT-
T. This type of material allows it to mold to nearly any limb size and confor-
mation in conjunction with its wide design, allowing it to serve as an effective
circumferential pressure bandage on an MWD’s limb.
iii. Junctional tourniquets have not been evaluated in dogs and are not recom- SECTION 4
mended at this time.
4. Airway Management
a. Conscious MWD with no airway problems identified:
i. No airway interventions needed.
b. Unconscious casualty without airway obstruction:
i. Place unconscious MWD in a recovery position (sternal recumbency/ prone if
possible or allow MWD to remain in lateral recumbency).
ii. Perform basic airway maneuvers:
iii. Extend the head and neck into a straight in-line position.
iv. Grasp the tongue, gently extend out of the mouth, and pull it down over the
lower jaw.
v. Consider endotracheal intubation to achieve/maintain patent airway.
vi. Consider using a mouth gag to keep the MWD’s mouth open and prevent trauma
to endotracheal tube. Examples of a field expedient mouth gag may include:
(a) 1–2-inch roll of medical tape;
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(b) 2-inch-wide roll of self-adherent bandage (Coban /Vetrap ); or
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ATP-P Handbook 11th Edition 363