Hunting emergencies: equine and human injuries and dangers and how to deal with them *H&H Plus*

THE unpredictable demands of hunting can unfortunately result in injury to both horse and rider, so knowing the risks and how to deal with situations when they arise will put you in a better position should the worst happen. Three Counties Equine Hospital vet Andrew Harrison MRCVS outlines the most common horse injuries and how to deal with them. Horse emergencies Blackthorns JUMPING hedges can result in blackthorns penetrating joints and tendon sheaths. Action: if you have had a big jumping day, always thoroughly check joints after hunting, particularly the knees, for thorns. Often you can easily pull them out, but if a thorn is stuck in, don’t try to remove it as it might break – the tip then breaks off and remains in the joint (or tendon sheath). Even after removal, if you suspect that the joint has been penetrated, it will need immediate veterinary intervention. [subscriber-content]Quite commonly, horses with blackthorns will pull up sound from hunting and load sound thanks to adrenaline, but an hour or two later will be hopping lame. There will be heat and swelling around the joint and the horse will markedly resent joint flexion. With blackthorn penetrations, time is of the essence as an aggressive septic arthritis develops rapidly, requiring urgent arthroscopic flush and debridement (removal) of any foreign material. Get your vet out immediately or take your horse straight to the vets. Strike injuries and overreaches GALLOPING with the rest of the field can run the risk of strike injuries from other horses to your horse’s legs, or of your horse overreaching and striking into himself. There are many structures at the back of the leg that can be affected, including tendons, tendon sheaths and ligaments. Action: because of the location of most overreach and strike injuries, bleeding can be quite severe, so the first port of call is to stem any bleeding with pressure. Once home, clean the wound and bandage the leg. If the wound is deep and requires stitching, or your horse is showing a significant level of lameness, call your vet – don’t leave it overnight. Tendon injuries [caption id="attachment_743524" align="alignnone" width="1400"] Ultrasound of suspensory ligament[/caption] GALLOPING and jumping over uneven and holding going can result in damage to the tendons and ligaments that can take months to heal. Action: ensure your horse is fit enough for hunting with a suitable fitness programme before the season starts. If you suspect your horse has injured a tendon out hunting, keep them as immobile as possible, transport them home immediately and call the vet. Tendon injuries require box rest, non-steroidal anti-inflammatory drugs such as phenylbutazone (bute) and regular ice therapy. Prevention is better than cure, so don’t gallop through really deep ground and be wary of jumping out of heavy ground. Flesh wounds PASSING through gates or by trees at speed or getting kicked by another horse can result in flesh wounds. Action: some wounds may bleed and look bad, but be of no serious concern and may just require cleaning and bandaging or possibly a stitch or two by a vet. It’s the small, seemingly innocuous wounds close to joints and tendon sheaths that cause the biggest problems. If you are concerned, call your vet. For wounds that are bleeding profusely, the key is stemming the flow. Remove your stock or tie and wrap it just above the bleeding to help stem the flow. Keep layering up with the bandaging and eventually it will stop. Always seek veterinary advice if your horse has lost a lot of blood or you can’t stop the bleeding. It’s also worth checking that your horse’s tetanus vaccination is up to date. Some kick injuries aren’t obvious, particularly if they affect the bone where there is little or no covering tissue. If your horse is very lame, he may require an X-ray to rule out a fracture. Getting stuck IT’S not uncommon to hear of horses getting stuck while out hunting, such as when jumping hanging gates but not quite making it all the way over, or falling into a ditch after jumping a hedge with a ditch behind, or when riding through a deep bog. Action: working safely around horses that are recumbent or entrapped is very important. Avoid the “kick zone” or “head-butting zone” – never approach a horse from the leg side if they are lying on their side; approach from the spine side. If a horse is properly trapped, they tend not to struggle, but once they sense a bit of freedom they are likely to scramble to escape, so keep out of the way at that point. People are keen to get stuck in to such situations but it can be very dangerous. It’s better to wait for the emergency services, who are trained and have the equipment to deal with trapped horses. They will request the attendance of a vet to sedate the horse to protect themselves and their staff. First-aid essentials As part of your first-aid bag, consider including a major bleed control kit, which includes a tourniquet plus advanced ChitoGauze packing and bandages. In partnership with the Daniel Baird Foundation, Midlands Air Ambulance Charity offers bleed control kits. Visit midlandsairambulance.com for contact details. Travelling home For horses with injuries on the hunting field, borrow a trailer or request a horse ambulance to get them home. The shallower ramp angle to that of a horsebox can help get them loaded more easily and they will have more support when travelling. Rider emergencies EQUESTRIAN-related incidents are sadly among the top four reasons the advanced clinical teams on board Midlands Air Ambulance Charity helicopters are called out. This is either because of the remote location of the incident or because of the traumatic nature of their injuries. It is imperative that those with the patient provide support before the pre-hospital emergency specialists even arrive on the scene. Dr Katie White is a pre-hospital emergency medicine specialist and flight doctor with Midlands Air Ambulance Charity. She provides some tips for assisting at an incident. Fractures of the forearm WRIST fractures are common following falls from horses. A person is likely to have a fracture if the area is tender, swelling or deformed in any way. Action: if a fracture is suspected, support the affected arm with a sling or improvise to make a splint to help keep the arm still until you can get it X-rayed. Remove any jewellery from the affected side as the fingers and hand may swell up. Consider paracetamol as a painkiller and note when any medication was given. An ice pack may help. Occasionally bones are badly broken – the arm may look to be obviously deformed, there may be bone sticking out and the injured person may complain of numbness or tingling, which could indicate serious injury. In this case, seek medical advice immediately and do not give the casualty anything to eat or drink as they may require an operation. Concussion THIS can result from being kicked by a horse or from a fall. Riding hats are important in helping to prevent head injuries, but they can still occur. Action: concussion is an injury to the brain that results in impairment of its function. Loss of consciousness doesn’t occur in the majority of concussions. Riders with concussion may appear dazed, may be slow to get up, show signs of poor balance or coordination and may be confused. Some of the symptoms they may complain of include headache, dizziness, fatigue and nausea. All concussions should be considered serious and medical advice should be sought. Open wounds AN open wound can result from contact with barbed wire or branches while jumping or following falls. Action: remove debris from the wound, then wash it with clean water and pat dry with a clean towel if available before covering it. Seek medical advice if the wound is large and might need stitches or gluing. Also, check the person’s tetanus vaccination is up to date as otherwise further treatment such as antibiotics may be required to prevent infection. In the following days, signs the wound is becoming infected include feeling feverish and unwell, and redness, swelling, worsening pain and pus from the wound. If this occurs, you should seek medical attention urgently. Major bleeding BLEEDING can be common from small wounds, however, occasionally major blood loss can occur. This can be life-threatening as a person can bleed out within minutes if a major artery is punctured, so get immediate help. Action: expose the wound so you can see the injury. If it is a bleed from the torso, use a clean cloth and put pressure on it. If it is a limb injury, use a tourniquet or alternative such as a belt or stock to help stem the bleeding, fixing the tourniquet tightly above the bleed. You then need to pack the wound with clean cloth before bandaging the packing into place. Calling for help If you or someone you are with needs medical attention and you require an ambulance, first call 999. Tell the ambulance service where you are using the What3words app location, as this makes it much easier for them to locate you quickly. The ambulance service will decide if the patient needs the rapid response and advanced care of air ambulance crews. If the air ambulance is on its way, ensure horses are cleared away from the area so they do not get spooked by the loud noise and downdraft of the helicopter landing. It is also important people keep clear of the area, and must not approach the helicopter while the rotors are still running. While waiting for help, reassure the patient that help is on its way, keep them talking and keep them warm. Being cold can cause shivering, which can increase pain from broken bones due to muscle movement. Also, hypothermia decreases the blood’s ability to clot, which can result in worsening haemorrhage in trauma patients. To find out more about Midlands Air Ambulance Charity, visit midlandsairambulance.com and follow the service on social media. [/subscriber-content] This feature is also available to read in this Thursday’s H&H magazine (22 April, 2021) You may also be interested in... [collection name="small"]