Handling and restraint



Handling and restraint


Victoria Aspinall



INTRODUCTION


No matter which procedure is to be performed, correct restraint of the patient is essential for the safety and welfare of both the animal and the handler. An animal that is securely and comfortably restrained will suffer less stress and will be less inclined to struggle and escape.


Most animals brought into a veterinary practice are used to being handled, but you may encounter stray dogs and feral cats which are wary of human contact. Their reaction to restraint may be unpredictable and even dangerous and you must be mindful of your own safety.


It is important when handling any species of animal that you approach quietly and confidently and perform the technique correctly at the first attempt, not at the third or fourth attempt – nothing upsets an animal more than clumsy, inept handling. You must know how to carry out the procedure, have all the equipment ready to hand and organize assistance if you think you are going to need it. It is also important to feel confidence in yourself. Animals are very sensitive to your mood and may detect your fear and bite you.


(For the purposes of description, the veterinary nurse restrains the patient, while the veterinary surgeon performs the task. In many cases two nurses or a nurse and the animal’s owner can perform the task.)



DOGS




Procedure: Tying a tape muzzle (Fig. 1.1)

This prevents the dog from biting the handler and diverts its attention away from the procedure being carried out.


image
Figure 1.1 Tying a tape muzzle. Adapted, with permission, from Masters and Bowden (2001), Butterworth Heinemann.


1. Action: Place the dog in a sitting position on the floor.


    Rationale: In this position the dog is less likely to wriggle or bite. If the dog is small, it may be easier to place it on a table – avoid being bitten while you lift it on to the table.


2. Action: Ask an assistant to stand astride the dog and grasp the scruff on either side of the head just behind the ears.


    Rationale: If the dog moves its head around, the muzzle cannot be tied quickly. Be careful when scruffing a brachycephalic breed as there is a risk of prolapsing the eyes.


3. Action: Using a length of cotton tape or bandage, tie a loop in it.


    Rationale: Any long strip of material can be used, e.g. a tie or even a stocking, but it must be strong enough to hold the jaws together.


4. Action: Approach the dog slowly and deliberately, crouching down to its level.


    Rationale: Crouching low helps to prevent fear aggression; standing over the dog may provoke it to jump up and bite.


5. Action: Place the looped tape over the nose and tighten quickly and firmly with the knot over the nose.


    Rationale: Any delay in tightening the loop may allow the dog to shake its head free.


6. Action: Bring the long ends of the tape down and cross over under the chin.


    Rationale: Further throws around the nose before finally crossing over will strengthen the muzzle.


7. Action: Take the two ends of the tape backwards and tie them in a bow behind the ears.


    Rationale: A bow allows a quick release if the dog becomes distressed.


8. Action: Ask the assistant holding the dog to keep the head pressed downwards.


    Rationale: This position prevents the dog from lifting its forefeet to pull off the muzzle.


9. Action: If the dog is a brachycephalic or short-nosed breed, insert another piece of tape under the loop over the nose and under the piece at the back of the head.


    Rationale: This prevents the muzzle from slipping off over the short nose.


10. Action: Bring the two ends of this piece together and tie into a bow on the bridge of the nose.


    Rationale: The dog must be carefully observed as pressure over the nose may lead to respiratory distress.


11. Action: Never leave a muzzled animal unattended.


    Rationale: There is a risk of asphyxiation by vomit or saliva.



Procedure: Lifting dogs up to 15 kg bodyweight

(For example, cocker spaniels, beagles, etc.)




Procedure: Lifting dogs over 20 kg bodyweight (Fig. 1.2)

(For example, labradors, springer spaniels, etc.)


image
Figure 1.2 Lifting a large dog. Redrawn from Lane and Cooper (1994), Butterworth-Heinemann.


1. Action: Arrange for another person to assist you.


    Rationale: Never attempt to lift a heavy dog by yourself. You may do permanent damage to your back!


2. Action: Both people stand on the same side of the dog.


3. Action: Keep your back straight and, with your legs slightly apart, bend your knees.


    Rationale: This ensures that the weight of the dog is borne by your spine and your pelvic girdle.


4. Action: You take the head end by placing one hand under the chest and the other under the neck.


    Rationale: If possible, the person lifting the head should be familiar to the dog, e.g. the owner. This reduces the risk of anyone being bitten.


5. Action: Hold the head close to your chest.


    Rationale: If the head is held close to you the dog cannot turn its head round to bite.


6. Action: Instruct your assistant to adopt the safe lifting position.


7. Action: Instruct your assistant to place one hand under the abdomen and the other around the back end over the tail.


8. Action: At the same time both people straighten their legs and lift the dog on to the table.



Procedure: Lifting small dogs with spinal damage (Fig. 1.3)

(This can also be used for cats.)


image
image
Figure 1.3 Lifting a small dog with spinal damage.



Procedure: Lifting large dogs with spinal damage (Fig. 1.4)


image
Figure 1.4 Lifting a large dog with spinal damage.


1. Action: Arrange for another person to assist you.


    Rationale: Do not attempt to lift a large injured dog by yourself. You may damage your back, get bitten or may cause the condition of the patient to deteriorate.


2. Action: Find something that can be used as a ‘stretcher’, such as a blanket or sheet, an ironing board or a solid plank of wood.


    Rationale: The dog must be supported on something that prevents compression of the spine. This would cause acute pain and further damage.


3. Action: Approach the animal quietly and with care.


    Rationale: It may be frightened and in extreme pain, leading to unpredictable behaviour.


4. Action: If appropriate, apply a tape muzzle.


    Rationale: This will prevent the dog biting you as you lift it.


5. Action: With the help of your assistant and adopting the correct lifting position, lift the dog on to the blanket or plank.


6. Action: If using a plank, tie the dog on to it using tapes or bandages.


    Rationale: This will prevent the dog from falling or jumping off the ‘stretcher’ as you lift it, with the risk of further injury.


7. Action: Gently carry the dog to the table and place it on the table, still on the blanket or plank.


    Rationale: The ‘stretcher’ can be removed from under the dog later on.



RESTRAINT FOR GENERAL EXAMINATION





Procedure: To examine the cranial end of the body




Procedure: To examine the caudal end of the body or take the rectal temperature

(Continuing from the previous procedure.)



1. Action: Keep one arm under the neck, pulling the head close to your chest.


    Rationale: If the head is held firmly against your chest, the dog cannot move to bite you.


2. Action: Move the other arm and place it under the abdomen, gently lifting the dog into a standing position.


3. Action: Pull the body close to your chest by bringing your forearm up under the abdomen.


    Rationale: This position holds the dog securely against you, reducing the risk of you being bitten and preventing it from moving during the examination.


4. Action: If you are required to restrain the dog for a long period of time, move your hand to lie over the spine, but be careful that the dog does not sit down again.


    Rationale: This position may be more comfy for you, while still maintaining control over the dog.


5. Action: If the dog starts to move or object to the examination, quickly return to the previous position.


    Rationale: You must be aware of the dog’s ‘mood’ and respond quickly to prevent anyone being bitten.



Procedure: To examine the dog on its side or to provide stronger control (Fig. 1.5)


image
Figure 1.5 Restraining a dog on its side.


1. Action: Apply a tape muzzle if appropriate.


    Rationale: This method is used to restrain more difficult dogs and you should be prepared for an aggressive response.


2. Action: Using the correct lifting procedure, lift the dog and place it on a stable table covered in a non-slip mat.


    Rationale: If the table does not shake and the dog’s paws do not slip, the dog will feel secure and be less inclined to struggle and escape.


3. Action: With the dog in a standing position, stand to one side of the dog.


4. Action: Reach over the dog and grasp the foreleg and hind leg furthest away from you at the level of the radius and tibia.


    Rationale: It may be difficult to reach over the back of larger dogs, especially if you are short or the table is high.


5. Action: As quickly and as firmly as possible, pull the legs away from you, supporting the dog’s spine against your chest.


    Rationale: This move must be done quickly before the dog begins to struggle and change position.


6. Action: Gently lower the body down to the table.


    Rationale: Avoid letting the body drop to the table as this may injure or frighten the animal.


7. Action: Place your arm across the chest and neck and apply firm pressure to keep the dog’s head on the table.


    Rationale: Most dogs will become submissive in this position, but some will try to stand up again and you must be prepared. With large dogs, you may have to lean quite heavily but you must always observe the condition of the animal.




RESTRAINT FOR THE ADMINISTRATION OF DRUGS





Procedure: Administering a tablet (Fig. 1.6)


image
Figure 1.6 Administering a tablet to a dog.


1. Action: Place the dog in a sitting position or in sternal recumbency on a suitable non-slip surface.


    Rationale: If the dog feels secure it will be less inclined to attempt to escape. Select a surface of a suitable height for you. Bending over for long periods may injure your back – place small dogs on a table, but larger dogs can be dosed on the floor.


2. Action: If necessary ask an assistant to hold the tail end of the dog.


    Rationale: This will prevent the dog from standing up or moving backwards.


3. Action: Place one hand over the top of the muzzle and, using your fingers and thumb, gently raise the head and open the mouth.


    Rationale: Raising the head makes the lower jaw relax, making it easier to open.


4. Action: Hold the tablet in the fingers of your other hand and with your forefinger pull down the lower jaw.


5. Action: Place the tablet on the back of the tongue.


    Rationale: If the tablet is placed as far back on the tongue as possible, the swallowing reflex is initiated and the dog cannot spit the tablet out.


6. Action: Close the mouth and hold it closed with one hand.


    Rationale: This also prevents the dog from spitting the tablet out.


7. Action: Stroke the neck until you feel the dog swallow the tablet.


    Rationale: The dog may hold the tablet in the side of its mouth and spit it out as soon as you relax your grip. If swallowing has occurred, the tablet should be passing down the oesophagus!



Procedure: Administering a liquid feed or medication



1. Action: Place the dog in a sitting position or in sternal recumbency on a suitable non-slip surface.


    Rationale: If the dog feels secure it will be less inclined to attempt to escape. Select a surface of a suitable height for you. Bending over for long periods may injure your back – place small dogs on a table, but larger dogs can be dosed on the floor.


2. Action: If necessary ask an assistant to hold the tail end of the dog.


    Rationale: This will prevent the dog from standing up or moving backwards.


3. Action: Place one hand over the top of the muzzle and, using your fingers and thumb, gently tilt the head upwards and to one side.


    Rationale: This position restrains the head while encouraging the jaw to relax and open.


4. Action: Open the mouth slightly, creating a pocket at the angle of the jaw.


    Rationale: The pocket holds the liquid as it runs into the main part of the oral cavity.


5. Action: Using a syringe filled with the liquid, insert it into the side of the mouth.


    Rationale: Try to avoid scraping the syringe over the gums as you may damage the mucous membranes.


6. Action: Slowly depress the plunger so that the liquid trickles into the back of the mouth.


    Rationale: If you depress the plunger too quickly the liquid will squirt out over you and the dog.


7. Action: Continue until the syringe is empty and repeat as necessary.


8. Action: When the procedure is complete, wipe the mouth clean and wipe up any spillage on the dog’s coat.


    Rationale: Never leave the dog covered in liquid as it will become wet and cold and in summer dried food may attract flies.



Procedure: Applying ear medication



1. Action: Place the dog in a sitting position or in sternal recumbency on a suitable non-slip surface.


    Rationale: If the dog feels secure it will be less inclined to attempt to escape. Select a surface of a suitable height for you. Bending over for long periods may injure your back – place small dogs on a table, but larger dogs can be dosed on the floor.


2. Action: If necessary apply a tape muzzle.


    Rationale: Some dogs may object to the application of ear medication.


3. Action: Stand to one side of the dog.


4. Action: Place one arm under the dog’s neck and over the muzzle. Pull the head towards your chest.


    Rationale: This prevents the head from moving suddenly when the medication is applied. Avoid holding the head in the area of the ear as this will interfere with the treatment.


5. Action: Place the other arm over the dog’s back with your elbow pointing towards the far side.


    Rationale: If the dog starts to struggle you can apply extra pressure by pressing your elbow closer to your side.


6. Action: The veterinary surgeon will stand on the other side of the dog and apply the medication to the nearest ear.


    Rationale: The applicator is introduced down the vertical part of the ear canal and squeezed.


7. Action: The ear is gently massaged to disperse the drops or ointment.


8. Action: To treat the other ear exchange places.

Related posts:

  1. Administration of fluid therapy
  2. Measuring clinical parameters
  3. Anaesthetic procedures
  4. Diagnostic imaging

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Jan 8, 2017 | Posted by in NURSING & ANIMAL CARE | Comments Off on Handling and restraint

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