Four-Legged Patients: Can EMS Help the Dog?

“Ambulance 34, respond to 69 Valley Street for a reported structure fire. Stand by to assist the fire department at this time. Time out, 15:19.”

You and your partner head to the scene, getting yourselves mentally ready to provide for firefighter rehab, possible burn victims, heat exhaustion, and smoke inhalation. You arrive to find the first-arriving engine advancing a hose line into a house on fire, the first ladder company setting up an aerial truck out in front, and the second-due engine opening a hydrant and bringing in a water supply. You and your partner put the oxygen, airway kit, trauma bag, and monitor/defibrillator on your stretcher and stand by at the front of the house. You are close enough to be near the command post and see if there are any patients but not so close that you impede operations.

Suddenly there is a commotion at the front door, and two firefighters, breathing heavily even in their masks and air packs, emerge from the smoke with something in their arms. Is it a victim? As you and your partner start to move toward the rescuers, you notice two legs…then another two…and a tail. The firefighters have rescued the family dog, and it appears to be unconscious. The family is on the front lawn crying, “Do something!” and the news media on scene starts to take video. What do you do now?

In EMS there are very few, if any, protocols for treating dogs. If you opt to assist the family pet, this article will share some thoughts on how to best help the canine while keeping your crew safe, making sure no humans go unaided, and staying within your protocols and policies.

First Do No Harm

None of us want to see a family member be hurt or sick, even a family member is of the four-legged variety. But as EMS providers, our first priority must always be to humans above animals. In the scenario above, if you choose to render aid to the dog, your crew cannot be out of service for aiding injured firefighters or civilians. If you do not have active victims but have additional EMS support on scene, then you might consider assisting the dog. If a human is injured or sick, even less so than the dog appears, you must first treat the human. Certainly call your local animal control officer to the scene to assist.

Second, Scene Safety

Just as with humans, BSI and scene safety are still paramount. Make sure your scene is not a threat to your crew or your patient and that you’re wearing proper PPE, including a pair or two of gloves, eye protection, a mask, and perhaps a gown. Even if a dog is unconscious or seems passive, they may not stay that way. A panicked or altered dog may suddenly become aggressive. To that end, secure their snout with a muzzle. If one is not available, using a gauze/Kling wrap or a triangular bandage can work in a pinch.

Much like a human, you’ll have to conduct an assessment to see what medical problems you can fix.

Airway—A dog typically moves air in and out through its mouth. Is air passing through?

Breathing—The normal resting respiratory rate for dogs is 10–30 breaths per minute. To measure, observe the rib cage as it rises and falls during a 60-second period or put your hand lightly on the rib cage.

Pulse—Adult dogs over 30 lbs. have a normal heart rate of 80–100 beats per minute (smaller dogs have a faster rate).

There are four locations that can be used to measure your dog’s pulse or heart rate:

• On the ribs right behind the left or right elbow;
• On the inside of the hind leg where the leg meets the rest of the body;
• On the underside of either front paw, slightly above where the middle paw pad ends;
• On the back of either of the hind legs, just below the ankle.

Gums—Typically a dog’s gums are light-colored. Dark gums can be an indicator of shock.

Bleeding—A dog has far less blood than a human. Is the dog bleeding? Is it spurting (arterial) or oozing (venous)?

Deformity—Do any of the extremities or ribs appear to be deformed, angulated, or swollen?

Level of consciousness—As per the owners, is the dog’s level of consciousness less than its baseline?

Treatment

In EMS there are rarely treatment protocols for animals. The exception might be if your unit backs up a law enforcement agency with a canine unit. If so, be sure you’re familiar with these protocols and follow the instructions of the handler. Before your agency treats an animal, you should probably check with your medical director and/or agency attorney about liability. Clearly this should take place before you face an animal-treatment situation.

If you opt to treat a dog, there are several things you can do to assist.

Oxygen—If the dog’s not breathing normally or has inhaled smoke, you can give oxygen therapy. There are several brands of pet oxygen masks available designed to accommodate various dogs’ snouts. (There are also foundations that can provide them to your agency for free.) They hook up to your oxygen tank just as a nonrebreather mask would and passively deliver oxygen to the animal. You would deliver at a flow of 15 lpm. If you do not have a pet mask, a nonrebreather mask or oxygen tubing placed near the mouth will suffice.

CPR—If the animal is unconscious and does not have a pulse, you can give compressions where the dog’s elbow meets the chest. You will compress approximately one inch and try to establish a rate of 100–120 compressions per minute. Because of the risk of bite, infection, and a large snout, ventilations are not recommended—just give hands-only CPR with passive oxygenation. Bear in mind that the chance of successful resuscitation of animals without a pulse is very low.

Burns—Much like humans, your priority should be to cool the burn and wrap the burn with a dry, sterile dressing.

Transport—With the exception of Illinois, Mississippi, and New York, where you can transport injured police dogs, no other state has policies that allow for transport of a dog in the ambulance. In those three states a human patient cannot be in the ambulance at the same time, and crews may only transport the animal to a veterinarian. 

If a vet or animal control cannot come to the scene, other options can include having the family transport the dog to their vet or an emergency animal hospital, or law enforcement might be willing to transport in their vehicle to a vet.

Final Thoughts

While your crew would not complete a PCR for an animal patient, you should note what happened on an incident form that gets turned in to your supervisor. While it might be challenging not to treat a hurt or injured dog, especially under family or bystander pressure, humans must always come first. If you do opt to help a dog, make sure you’re not putting yourself or your crew at risk by doing so, and then do what you can to help our furry friends within your scope and knowledge.

Barry Bachenheimer, EdD, FF/EMT, is a frequent contributor to EMS World. He is a career educator and university professor with more than 34 years in EMS and fire suppression. He is currently an EMT with the South Orange (N.J.) Rescue Squad, a firefighter with the Roseland (N.J.) Fire Department, an instructor at the National Center for Homeland Security and Preparedness in New York, and owner of an amazing rescue dog. Reach him at bbachenheimer@albany.edu.