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First Aid For the Injured

Misty Corton, The Care Centre, Natal, South Africa

So often I get frantic emails or phone calls from people who have picked up an injured tortoise. Emergency first aid can sometimes mean the difference between life and death to any injured animal. Adopting the ABC approach may help:

A: This is for airway - check that the animal is able to breathe freely, check mouth for any obstruction. Listen for gurgling or other signs of repiratory distress. Are there any facial fractures which may impede breathing, any blood from nose or mouth? Remove any obstruction if you can do so without harm to the tortoise. If the shell is broken and any lung tissue protruding, apply a sterile Jelonet (sterile parafin gauze)dressing and bandage closed until you can reach veterinary help. This will prevent further contamination of the wound.

B is for bleeding, are there any signs of major blood loss, stop any serious bleeding immediately using pressure. If any major loss has occurred the animal will need IV fluid replacement, get veterinary assistance as soon as possible. Keep the tortoise warm and quiet until you can get help.

C is for consciousness, is the patient alert and responsive? At this point you will more than likely need to mimimize shock. Place the animal in a box lined with any soft material - shredded newspaper is fine in an emergency. Keep him warm and quiet while you obtain help, this will minimize stress and prevent further shock.

WOUNDS: If it is going to be a while before you can get medical help, the immediate concern will be dehydration. Injuries permitting, soak the tortoise in shallow tepid water for twenty minutes. If available you can add electrolyte solution such as Reptimed or a similar product to the water. Ensure that the level of the water is not so deep that his nostrils are submerged. Try and observe if he drinks, as knowing this will help the vet when you get there. You can repeat this 2-4 times daily if necessary until you can reach help.

Wounds can be classified as: clean ( surgically made wounds made under aseptic conditions) and contaminated (all fresh traumatic wounds) and dirty (old traumatic wounds and those where pus is encountered). In all but minor wounds you will need veterinary help.

Factors likely to delay healing: bruising wound edges, tying sutures too tight, too tight bandages or casts (these interfere with blood supply, an important cause of delayed healing). Irritating antiseptics or topical drugs, skin dehydration and tissue destruction. The presence of foreign bodies, necrotic tissue (the wound will only start healing once all dead tissue has been removed). Stress can decrease resistance to infection.

Stimulating wound healing: Honey is bactericidal and contains enzymes and trace elements beneficial to healing and is great in an emergency. Bandaging is a good idea for several reasons: It prevents carbon dioxide and body heat loss from the exposed wound surface and it stabilizes the wound. It has been proved that the best wound healing takes place in a moist environment.

Bite wounds: these will usually be accompanied by a hard, warm and painful swelling around the affected area and can rapidly turn to septicemia. The correct antibiotic and an anti-inflammatory will be imperative as these wounds have a high infection rate. Bite wounds are seldom, if ever sutured. It will be essential to obtain veterinary help immediately.

Traumatic wounds: Evaluate the wound as to depth, damage to surrounding organs and contamination. Flood the wound with water (tap water is fine in an emergency) or you can use ringers lactate if available. Saline can cause tissue injury. Betadine can be used at a 1% solution or Chlorhexadine 0.05%. Higher concentrations of antiseptics can seriously affect wound healing. Any foreign bodies should be removed and or flushed out of the wound otherwise healing will not take place.

Wound dressings: These should keep the wound moist and allow for drainage in infected wounds, and should not contain irritating substances. Jelonet (sterile parafin gauze dressing)is ideal, or failing that gauze with plain parafin gauze. Change dressings often while wound is in the debridement stage, then leave dressings on longer when wound starts healing.

Please check our VETERINARY CONTACT INDEX to locate a veterinary surgeon in your area.