Emergency

Any swift, whose condition is estimated as instable or actually life-threatening doesnâ€™t allow the full clinical examination and can only undergo a fractionated examination, is considered as an emergency patient. Before finishing the complete examination life saving measures have priority.

These are:

- birds with shock symptoms and/or severe trauma,

- swifts with profuse bleeding,

- extremely emaciated and/or exsiccated adult swifts,

- extremely emaciated and/or exsiccated nestlings,

- swifts with severe dyspnoea,

- long term and extremely malnourished swifts with intense disorders of their

general condition,

- swifts with intense disorders of their general condition of unknown origin,

- swifts with damages of the plumage which have a direct and possibly life

threatening influence on the general condition.

First Aid Measures for Emergency Patients

Dispnoea:

The pharynx is controlled, potentially disturbing objects causing dyspnoea are removed (e.g. blood, saliva, slime, regurgitated food)

In case of noisy breathing (crepitating, slurping) : Furosernid in a dosage of 1 to max. 2 mg/kg p.o. or i.m.; if the symptoms start again the application can be continued for the next 2-3 days. Attention should be paid to the danger of a following exsiccose.

In case of breathing interruption Dimethylbutyramid is given in drops orally as a breathing stimulation. Never apply the drops directly into the pharynx (danger of aspiration pneumonia), prefer coating the ventral mucosa of the pharynx.

In case of an apnoea reanimation is tried with Doxapram either as drops orally, or in a dosage of 10 mg/kg as an intramuscularly injection.

In case of a high-grade dyspnoea (choking, wheezing, suffocation attacks), where no response is shown to the measures named above, the bird should be put to sleep without waiting longer.

Shock:
For large-volume fluid replacement in a stage of circulatory shock, good results have been achieved by injecting 0, 8 – 1 ml body-warm Ringerâ€™s lactate isotonic solution subcutaneously (in the bend of the knee). Furthermore shock patients receive a singular intramuscularly injection of corticosteroids (Prednisolon 5 mg/kg).

Subcutaneous infusion in the bend of the knee © I. Polaschek

Cachexia / Exsiccose:
For large-volume fluid replacement and circulatory stabilisation 0,8 – 1 ml Amynin or a mixture of Ringer™s lactate / Amynin at a ratio of 1:1 is injected body-warm and subcutaneously, if necessary two to three times after every 8 – 10 hours. Standard, warm coffee, given drop by drop after about 15 – 20 minutes after the infusion, has been proved as a gentle and effective circulatory stimulation method. In case of a circulatory collapse the medication of etilefrine hydrochloride (0,2 – 1 mg/kg i.m. or p.o.) and ouabain (g-strophantin, drop by drop, p.o.) is indicated. With a metabolic acidosis after long period of starvation it is advisable to give a single subcutaneous dose 15 ml/kg of sodium bicarbonate 4,2 %.

Hypothermie:
External heat (30 – 35° C) supplied by electric blankets, infrared light heat lamps or brooding lamps is essential for the intensive care patient. Feeding- or saturating the emergency patient is not indicated until the patient's condition is stabilised. Nourishment and fluids can be replaced by parenteral nutrition through subcutaneously injected roborants over the period of 12 – 24 hours.

Cramps and Convulsions:
The intramuscularly medication of Diazepam with a dosage of 5 mg / kg can be helpful. In case of a cranial trauma (Commotio cerebri) and disturbances of the central nervous system, a single dosage of a vitamin B complex (10 - 30 mg/kg i.m. or s.c.; the content of vitamin B1 shouldn't exceed 5 mg / kg) is recommended.

Bleeding, Haemorrhage:
Staunching a bleeding wound depends on its localisation and differs in its ways of treatment: finger pressure or a compression bandage, local (iron(III) chloride or silver-nitrate-pin given as topical medication) and/or systemic haemostatic agents (naphthionic acid 100 mg/kg i.m.).

Open Wounds / Fractures:
Unless an infaust prognosis is given: wound care / ostesynthesis under general anaesthesia. The same requirements as in surgical wound and fracture treatment for small pets have to be applied!!
If the patient can't be narcotised the wound care has to wait: sterile wound dressing / temporary fixation. Dehydration of tissue and bones has to be implicitly avoided. Analgetic agents to be administered!

Eye Injuries:
Analgetic agents systemically and locally. A specialist for ophthalmic examinations should be consulted immediately to find out as fast as possible if the eyesight can be recovered. If not: euthanasia.

Dirty Plumage:
With a highly contaminated plumage a treatment under general anaesthesia with body-warm water and a standard dish-washing detergent can be attempted for a first clean-up. This is especially important for preventing the bird on chocking or swallowing possible foreign objects or substances while trying to clean itself. It is also very important to determine the contaminating substance as fast as possible, so that a suitable detergent can be selected. Caution: many detergents are highly toxic for the patient!

Emergency

Business in responsibility