Page 131 - PJ MED OPS Handbook 8th Ed

c. Incorporate crystalloids and colloids as needed.
i) Shock dose of fluids is 90mL/kg 10-20-10-20 rule.
ii) Give 1/4 shock dose every 10–20 minutes while continuously reassessing.
iii) Use hypertonic saline in cases that are refractory to crystolloids or in head trauma.
iv) 4–6mL/kg/bolus (max 2 boluses).
d. Blood transfusion (dog-to-dog), if available. Can collect a 450mL transfusion bag from a
healthy MWD to transfuse to another MWD. (Only use other MWDs with know health his-
tory as blood donors—no local canines with questionable disease status.) Cannot use human
blood products for K9s (e.g., FWB, FFP, FDP, etc.).
e. Monitor for circulatory overload
6. Hypothermia: Prevent loss of body heat, dry hair-coat if wet, wrap in blanket.
7. Antibiotic Therapy for Penetrating Wounds
a. Ertapenem (Invanz) 250mg IV/IM tid

K9 RDX (C-4) Ingestion
Signs and Symptoms:
1. Tonic – clonic convulsions
2. Coma
3. Lethargy
4. Confusion
5. Muscle spasms
6. Nausea/vomiting
7. Abdominal tenderness
8. Cardiac arrhythmias
Treatment:
1. Apomorphine is in all handler med bags. If recognized immediately after ingestion (prior to the
occurrence of clinical signs), use apomorphine in conjuctiva of eye. Vomiting will start in 10–20
minutes after application. Flush conjunctiva throughly after they begin vomiting.
2. Control seizures with midazolam (Versed), 5mg IV bolus for a 30kg dog. Repeat as necessary
to a maximum of 4 doses.

Ipecac is contraindicated in the treatment of K9 toxic ingestion.

3. If there is time during evacuation, initiate IV fluids.

DISPOSITION:
1. Evacuate to veterinarian immediately for follow up or supportive care.

Chapter 8. Tactical Medical Emergency Protocols (TMEPs) n 129