Page 374 - ATP-P 11th Ed

(c) Cutting the end off of a 3–5mL syringe tube casing and securing over the
upper and lower canine teeth.
(d) Placing a portion of a kong between the MWD’s teeth to open the mouth
c. Conscious MWD with airway obstruction or impending airway obstruction:
i. Clinical Signs:
(a) Pawing at mouth, gagging,
(b) Excessive drooling,
(c) Frequent swallowing motions,
(d) Extended head and neck,
(e) Elbows and upper legs held out from the chest (e.g., “tripod position”),
(f) Reluctant to lie down,
(g) Noisy breathing (stertor or stridor),
(h) Cyanosis (bluish gums); late sign.
ii. Allow the MWD to assume the ‘position of comfort’ or the position that best
allows the MWD to breath with minimal restriction of air flow and that protects
the airway, to include sitting or standing.
iii. Palpate throat (pharyngeal area, larynx, and trachea to identify any abnormal
mass or foreign material.
iv. Open mouth to examine oropharyngeal area:
(a) Avoid placing hands or fingers directly in MWD’s mouth.
(b) Consider using a leash, rope or roll gauze looped behind the upper and
lower canine teeth in attempts to pry and hold the MWD’s mouth open.
SECTION 4 v. (c) Consider sedating the MWD (see number 10 below).
Use suction if available, appropriate and feasible based upon MWD disposition/
mental status.
d. If attempts to clear or remove the airway obstruction have failed or the MWD col-
lapses or becomes unconscious consider one of the following techniques:
i. Orotracheal Intubation (OTI)/Endotracheal Intubation (ETI):
(a) Preferred first-line technique for gaining airway access in MWDs and with
training this can be accomplished in field conditions.
(b) Use of a laryngoscope, although helpful, is not often required for MWD
ETI; if available, a #4–5 Miller (straight) blade is recommended for MWD
>25 kg (55 lb).
(c) Use a 8.0–10.0mm internal diameter ET tube (ETT) for MWD weighing
> 25 kg (55 lb).
(d) ETI is considered the first-line option for advanced airway management in
an unconscious or anesthetized MWDs. Canines possess a proportionally
larger tracheal lumen diameter as compared to people. In order to achieve
an airtight seal, it is recommended to select an ETT that is 70% of the
canine’s internal tracheal lumen diameter. Digital palpation of the trachea

364 SECTION 4 CANINE/K9 TACTICAL COMBAT CASUALTY CARE GUIDELINES (C-TCCC)