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Wednesday, June 12, 2013

What's in a first aid kit - Equine

I finally made it out to the stable AND remembered to photograph my first aid kit......

My Horse kit
Because my trailer gets even hotter than the place I keep my tack, and because I don't use my trailer more than a handful of times in a year, I keep my first aid kit in a box that travels between my tack area and to the trailer when I take a trip. 

In the box (which is a plastic file box) I have:
- various sizes of towels/dishcloths (in the blue bag/secondary container)
- Feminine pads for bandages
- Ziplock of cotton balls
- Bute tablets
- Betadine scrub (the alcohol based one)
- Surpass in a plastic bag (bag is needed for application)
- dosing syringes (not pictured)

 I keep all my leg wrapping supplies in a duffel bag that travels from the tack room to the trailer as needed too.  In this duffel I keep:
- polo wraps
- ice boots (I have the kind that I can insert any frozen pack into - ziplocks of ice, frozen peas etc.)
- quilts
- standing wraps
- etc

At the barn in a drawer lives additional supplies.  The 2 containers above that go to the trailer hang out with these additional supplies when we aren't traveling.  These are things that I think are worth having around, but I don't bring with me on trips.

In a secondary container I have 
- Big dosing syringes
- little syringes, some with needles, some without.  All syringes with needles are new in their packaging
- More feminine pads
- Gauze pads and bandaids
- a plastic bag for surpass application (I find it easier to have a ziplock bag on hand than gloves)
- antibiotic ointment


Other items in the first aid drawer are:
- rubbing alcohol
- betadine, soap based
- furasone
-Wound coat spray (tends to dry out wounds, while the antibiotic ointment tends to keep them moist.  Depending on location and type of wound, one may be better than the other)
- weight tape
- box with pen, paper, safetypins, marker

There are 2 things would greatly enhance the usability of my kit while not making it significantly more cumbersome or high maintenance
1. Flashlight
2. Clot pack

The situations that I designed my kit to cover are (along with my what changes I need to make):
1. Stabalize a major bleed (would need a clot pack, and possibly a roll of gauze cotton to complete this goal).
2. Provide care for a tendon injury
3. Manage mild musculoskeletal pain
4. Manage a colic until I get to the vet (would need to add Banamine to the kit to complete this goal)
5. Treat minor skin wounds and infections (would like to add tree tea oil so that I'm able to treat thrush)

Overall I have a very basic, very limited kit.  However, most things that happen outside of these scenerios I would not likely be able to address outside of a fully stocked vet hospital the focus remains on being able to treat the minor and stabalize the major.  When I'm a vet and if I have supply to additional medications, I would love to keep xylazine, banamine, and bute on hand. However, for now, I think what I have is sufficient. 

Feel free to stop reading here.....but just in case you wanted yet ANOTHER example of a very different type of first aid kit with different considerations, here is yet another example of a first aid kit currently in use. 

"another" horse kit
I thought it might be useful to see some of the stuff and considerations and reasons behind a kit beyond my own.  I'm not necessarily presenting any of this as "ideal" (in fact, none of these kits presented in this blog are "ideal"), but just more information for you to consider as you put together your own kit.

I'm helping some people put together a horse first aid kit for a group that will be going on a cross country trip to an event back east. There are multiple horses being served by the kit. The information below is based on email correspondence as we discussed what was currently in the kit, what should be added, and the reasoning behind each item.

Kit #1

Limitations: Limited space.  Likely the kit will be used by someone with limited skills in the field where nothing is going to be truly clean.  Kit is carried on horseback and is likely to get hot in the sun (bag is a black leather), and squished. 

Goals of the kit/scenarios addressed:
a. treat minor cuts on the legs and body
b. an emergency bandage for a major injury that is able to stabilize it until you can get to a vet hospital or make other decisions.
c. Stop a major bleed.  Maybe.  Horses have a lot of blood. :)

I was given the current contents of the kit, and asked what my thoughts were:

- Container of corona tubed ointment: good.  Can deal with a bunch of different bumps and scrapes

- Scarlex spray coating for skin: good, although if you want to eliminate something take this out.  I like corona for keeping dry wounds moist and I'll use sprays (they are all about the same) for wounds on the legs that need to stay drier, however bentadyne will do exactly the same job and will be more versitile.

- 2 blue wraps: assuming vetwrap?  Good.  Realize that vet wrap tends to degrade in the heat so check it often. Also, it doesn't store well once it is out of it's nice plastic packaging.

- Scissors: assuming these are bandage sissors that have a blunt end?  If not (if they are pointy on both ends, discard them and replace them with bandage sisscors that can be used to cut bandages off without the risk of damaging tissue underneath.

- water and bentadyne mixed in a container: Would recommend carrying an bottle of undiluted bentadyne scrub (it's alcohol based, NOT the soap based stuff).  The water is taking up room and there's always water available to dilute.

- some weavy cotton for cuts (4x4): Good. This is what you will use with the betadine.  If there's a whole package in there, Put a handful into a ziplock to save room.  You won't need the whole package.

- one brown stretchy tape for leg or whatever: Assuming this is an ace bandage type bandage.  This will be a life saver if your vet wrap melts.

- rubber gloves: Good......but may or may not be a necessity if you are trying to save space.  Gloves tend to make people think that their hands are cleaner than they actually are.

- cotton wrap in package: Excellent.  Is this the rolled cotton that has a paper backing?  Or the thinner stuff that is on a roll? Both can make a good stabilization bandage.

- a few more cotton small pads: throw out and replace with a couple of feminine pads.  They stay cleaner, take up less room and are a lot more useful for dealing with wounds that need to stay clean, and the adhesive side will help keep it in place over a bandage material.

- nothing more will fit in the container taking the above into consideration, I had a couple of recommendations for what else might be squeezed into the container and provide substantial benefit for the effort and cost :)
1. A roll of gauze cotton (is used over the rolled cotton to compress it, and then vet wrap is placed over this layer to form a robert jones bandage or modified robert jones bandage or something like these).
2. A package of quickclot.  This doesn't necessary need to be kept on the pack but should at least be with the trailer, where major injuries tend to occur.  These packs are expensive - the human ones are good but kind of small, they make bigger horse sized ones.  They are the only way you are going to be able to stop an arterial bleed.  They have a shelf life of a couple of years, even in the heat.

Kit #2
A more general kit for the trailer

Specific concerns listed for the trip were:
- Tying up
- colic
- Sore muscles and joints (horses are older)
- Dehydration (horses come from a coastal climate and are performing in a hot, humid one.
- Foot soreness (horses are all barefoot)

What can be added to the first aid kit, to expand it to make it applicable to these scenarios (and is it even possible to expand your kit to address these scenerios)??????????

Specifically the common drugs and treatements that are first aid-related to these situations that were asked about are:
Bute, Banamine, electrolyte paste, asorbine rubs/linament, and boots. 
Good additions?  Maybe!!!!!!!! 

Bute: Good for lameness/musculoskeletal type pain.  Should it be kept in the field kit?  I personally wouldn't keep drugs in the field kit for 2 reasons.  #1 because the heat degrades the drugs.  #2 you can get a horse in SERIOUS trouble with administering bute to a dehydrated horse.  You can kill it.  So I would prefer to see these types of drugs kept in a place with limited access so that a person with both the knowledge and the accountability is the only one that gets to give stuff like that. Protect the well meaning person from their limited knowledge.

Banamine: Good for visceral pain (ie colics).  It's an NSAID and will cause the same issues as Bute if given to a dehydrated horse.  Also realize that adding this drug to your kit doesn't mean that you have necessarily expanded your kit to include a colic scenario.  You have expanded your kit to include pain management for a colic until you have gotten it to a vet

Elyte paste -Leaving the hydration discussion and how/what/when to administer elytes to support your hydration efforts aside....I'm not convinced the addition of a tube of electrolytes expands your kit to include the additional scenerios.

Some Absorbine rub for cooling and stiffness?
- Now I'm REALLY getting into personal opinion :).....IMO most of these products are more for the human than the horse - it's probably the massage that does more than anything else for the horse.  If you have limited space, it isn't a necessity.  But if you have the space, sometimes it's easier to do a massage when using these products.

An boot or two for hoof and sole injuries?
-Generally boots have different sizes, and if you are dealing with multiple horses and one kit, the boot you have probably won't be the right size and probably won't stay on.  The better bet for a hoof injury that needs attention is cotton padding and duct tape (ie a temporary boot that can be made from materials in your existing kit). 

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