Page 392 - ATP-P 11th Ed

(a) Lactated Ringer’s, Normosol R or Plasma-Lyte A
(b) Reassess the MWD after each 500mL IV/IO bolus.
(c) Continue resuscitation until a palpable femoral pulse, improved mental sta-
tus, or systolic BP of 80-90mmHg is present.
(d) Discontinue fluid administration when one or more of the above end points
has been achieved.
vi. If a MWD with an altered mental status due to suspected TBI has a weak or
absent femoral pulse, resuscitate as necessary to restore and maintain a normal
femoral pulse. If BP monitoring is available, maintain a target systolic BP of at
least 90mmHg.
vii. Reassess the MWD frequently to check for recurrence of shock. If shock recurs,
re-check all external hemorrhage control measures to ensure that they are still
effective and repeat the fluid resuscitation as outlined above.
e. Refractory Shock
i. If a MWD in shock is refractory to fluid resuscitation and canine blood products
are not available, consider:
ii. The use of synthetic colloids (Hextend® and/or Hespan®) – 150–200mL bolus
IV/IO. Can repeat if shock state is not resolved.
iii. Untreated tension pneumothorax as a possible cause of refractory shock. Tho-
racic trauma, persistent respiratory distress, absent breath sounds, and hemoglo-
bin oxygen saturation < 90% support this diagnosis. Treat as indicated above
with repeated NDC or finger thoracostomy/chest tube insertion.
SECTION 4 7. Hypothermia Prevention
a. Minimize MWD’s exposure to the elements.
b. Remove any wet outer wear (e.g., vests, harnesses, booties, etc.). GENTLY pat dry
any wet tissues or hair coat.
c. Get the MWD onto an insulated surface as soon as possible.
d. Apply the Ready-Heat Blanket from the Hypothermia Prevention and Management
Kit (HPMK) to the MWD’s torso (not directly on the skin) and cover the MWD with
the Heat-Reflective Shell (HRS).
e. If an HRS is not available, the previously recommended combination of the Blizzard
Survival Blanket and the Ready Heat blanket may also be used.
f. If the items mentioned above are not available, use dry blankets, poncho liners,
sleeping bags, or anything that will retain heat and keep the MWD dry.
g. Warm fluids are preferred if IV fluids are required.
8. Penetrating Eye Trauma
a. If a penetrating eye injury is noted or suspected:
i. Place muzzle if practical before examining the eye
ii. Do NOT attempt to bandage or cover the eye. Make every effort to prevent
MWD from scratching at the eye. Consider sedation as outlined in number 10.

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