Page 380 - ATP-P 11th Ed

preference: tongue, non-pigmented area of lip, ear pinna, prepuce (male) or
vulva (female). Recent data demonstrated the use of a human-designed neonatal
pulse oximetry adhesive sensor attached to the base of a canine’s tail may pro-
vide an alternative site for accurate and feasible pulse oximetry measurement
in canines.
NOTE: Accurate pulse oximetry measurement is often only achievable in an
unconscious or adequately sedated/anesthetized MWD.
ii. Capnography for MWDs is the same as for humans. An ETCO monitor can be
2
attached to an intubated MWD. ETCO levels should be the same as for humans
2
(35–45mmHg).
f. Always remember that the MWD’s airway status may change over time and requires
frequent reassessment.
NOTES:
i. Similar to a human casualty that can speak clearly without any respiratory dis-
tress, consider a MWD that is barking, growling, or whining without any clini-
cal signs of respiratory distress has a patent airway.
ii. Consider monitoring the MWD’s rectal temperature. Canines rely on panting to
dissipate body heat, therefore any upper airway obstruction increases their risk
for potential of a heat-related illness.
iii. Due to anatomical/conformational differences, the tongue is not a major source
of upper airway obstructions in canines as it is in human casualties.
iv. In MWDs experiencing respiratory fatigue from prolonged or strenuous in-
SECTION 4 creased work of breathing, even mild sedation may increase the risk of immi-
nent respiratory failure/arrest. Therefore, have resources prepared to perform
rapid ETI or CTT/TT before administering any sedative or analgesia.
v. ETI is considered the first-line option for advanced airway management in an
unconscious or anesthetized MWDs. Canines possess a proportionally larger tra-
cheal 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 in the cervical neck region is
the most reliable method for estimating the canine’s tracheal diameter. In most
MWDs a size 8.0-10.0 endotracheal tube is appropriate. To avoid the risk of
one-lung intubation, determine the appropriate ET/CTT/TT length by measuring
from the front or the canine incisors to the thoracic inlet or point of shoulder.
vi. Surgical airways are not warranted in an unconscious or anesthetized MWD
that has no direct upper airway trauma unless the performance of basic airway
positioning maneuvers is unsuccessful in opening the airway and/or the pro-
vider is unable to successfully perform ETI.

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