>
> This is posted for those of you who have at some stage been faced with
> an injured tortoise/turtle, in the hope that it may help you to
> stabilize your patient. If a vet is available and can be reached do not
> attempt treatment on your own unless you are qualified to do so.
> However, there are many times when you will be faced with such an
> emergency and no vet will be within reach, and I hope this will help
> you.
> Again, I have tried to keep technical jargon to a minimum for laymen
> amongst us.
>
> EMERGENCY FIRST AID FOR THE WOUNDED TORTOISE/TURTLE:
>
> Always use the A, B, C approach to treatment, and provide warmth as soon
> as possible. I keep a heatpad with a folded towel over it for this sort
> of emergency and find it works well. Failing that you can use a lamp or
> heater, ensuring they are not a fire hazard.
>
> A is for airway, ensure the tortoise can breathe and look for signs of
> repiratory distress (i.e. gasping, gaping). Are there any facial
> fractures which may impede breathing, any blood from nose or mouth. Are
> there any wounds to the chest region? Any problems here need immediate
> attention as they are life threatening. If there is an obstruction in
> the mouth preventing proper breathing, remove it with forceps/tweezers.
> If congealed blood is hampering breathing use a sterile cotton bud and
> gently clear the area. For more serious complications oxygen will be
> required. If no problems here go to B.
>
> B is for bleeding, are there any signs of major blood loss? Stop any serious
> bleeding immediately by pressure or tying off/cauterizing bleeders.
> Minor bleeding can often be stopped by the application of a little
> bicarbonate soda powder. If any major loss has occurred the tortoise/turtle
> will need IV/SC/IC fluid replacement, get veterinary assistance as soon
> as possible. If no serious bleeding go to C.
>
> C is for consciousness, a reminder to examine briefly but thoroughly the
> nervous system before any drugs are given. Is the patient conscious,
> alert and responsive? A badly injured animal will often be in shock,
> though in some cases this can be delayed. With drugs for shock always use
> the minimum dose necessary. Unless you are qualified, leave treatment
> to your vet.
>
> A, B and C are the areas of immediate concern as problems here are life
> threatening , but do not forget:
>
> D and E are for digestive and excretory system, trauma here can cause
> death at a later stage through peritonitis. Check for any obvious
> puncture wounds. Is there any bleeding from the cloaca? Any blood in
> urine? If so an x-ray will be imperitive to locate the cause.
>
> F is for fractures, these must be repaired once life threatening
> conditions have been stabilized. Temporary splinting or immobilization
> can be done and will suffice until your patient is not in danger of
> immediate death. The dangerous fractures are those that you cannot see -
> ribs, pelvis etc. Any fractures will need an x-ray as soon as the
> tortoise is stabilized.
>
> S is for stress. Never under estimate the stress your patient is under.
> Stress from the injury, stress from handling/treatment. Keep all
> interference to a minimum. Once the animal is stabilized place in a warm,
> darkish area with no traffic going past and allow him time to recover.
>
> WOUNDS:
>
> Wounds can be classified into three categories: clean ( surgical wounds
> made under aseptic conditions), contaminated (all fresh traumatic
> wounds) and dirty (old traumatic wounds and those where pus is
> encountered).
>
> 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 (remember that sutures are foreign bodies), necrotic
> tissue (the wound will only start healing once debridement or removal of
> dead tissue is almost complete). Stress and cortisone therapy decrease
> resistance to infection.
>
> Stimulating wound healing: The administration of vitamin A will promote
> healing - especially in animals receiving cortisone and those that have
> infected ulcers. 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.
> Antibiotics can be given to prevent septicemia but will have very little
> effect on the wound itself.
>
> Bite wounds: If infected 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 to
> limbs are seldom, if ever, sutured. If fresh, clean thoroughly and apply
> a good antiseptic ointment such as Betadine/flammazine. Clean and
> re-apply daily. Keep the wounds covered, jelonet and micropore work
> well.
>
> Abscess: These are often caused by tick bites. Initially it will be hard
> and warm, and should be allowed to ripen before any attempt is made to
> lance it. This can be hastened by hot dressings or an ointment designed
> to draw. Once ripe, you can locate a soft spot fairly low down make a
> small incision and drain as much as you can by gentle but firm massage.
> The cavity can be rinsed and drained repeatedly using a mixture of
> diluted betadine and peroxide (half/half) introduced with a syringe. If
> drainage is inadequate a tube drain can be installed. Antibiotic therapy
> should be given. If the abscess reoccurs the presence of a foreign body
> should be suspected. Never suture an abscess. Unless qualified this
> procedure should be left to your vet.
>
> Traumatic wounds: Evaluate the wound as to depth, damage to surrounding
> organs and contamination. Large skin flaps can be tested for viability
> by making a small incision in it (necrotic skin will not bleed). If
> removing debris protect the wound with K-Y jelly (it is water soluble
> and can be easily rinsed off afterwards).
> Flood the wound with water (tap water is fine) or you can use ringers lactate.
> 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. Skin edges without capillary
> oozing should be removed using a scalpel blade.
>
> As a rough guide, wounds less than three hours old can be closed with
> minimal debridement unless there is tissue bruising and contamination.
> Where large flaps of skin are involved subcutaneous sutures will reduce
> the chances of "dead space". Wounds presented some time after injury are
> usually heavily contaminated and may show evidence of infection and
> contain necrotic tissue. In these cases infection should be controlled
> first. When healthy granulation tissue is formed, closure can be
> undertaken to facilitate healing of the wound. If no granulation has
> taken place do not close the wound, healing will take place by second
> intention.
>
> Wound drains: a drain will be necessary when there is fluid collecting in
> the wound and if massive contamination has occurred. The drain should be
> a short piece of tubing with multiple perforations. It should be placed
> with one end at the site to be drained and the other end exiting through
> a separate incision below the wound - never exiting through the wound
> itself. The drain can be anchored to the skin with a single suture, and
> is easily removed once draining stops and the wound heals. Unless you
> are qualified, inserting a drain is best left to your vet.
>
> Wound dressings: These should keep the wound moist and allow for
> drainage in infected wounds, and it should not contain irritating
> substances. Jelonet is ideal, or failing that gauze with plain Vaseline.
> Change dressings often while wound is in the debridement stage, then
> leave dressings on longer when wound starts healing.
>
> Once your patient is stable, try and locate a vet as soon as possible
> and explain to him all emergency measures you have taken. With most
> serious injuries, the time lapse between the injury and receiving
> treatment is critical. Do NOT attempt any veterinary procedure unless
> you are qualified to do so, do only what is absolutely necessary to
> stabilise your patient till you can reach a qualified vet.
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