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Instructor to Student Ratio:  6:1

Time Required: condensed version shown below is 30min (standard version is 45-60min)

Station Objectives

Assessments:   

  • Safely and accurately assess all vitals included on the Base Line Trending
  • Articulate verbally and differentiate experientially the difference between normal and abnormal vitals findings.
  • Recognize importance and the skills of immediate rapid cooling.

Safety:

  • K9s:
    • This station includes live demo dog K9s which may be new to the program.  Follow all safe handling guidelines (taught in this module).  If you are unsure of any issue related to the K9, connect with the designated “K9 Safety” and/or “Lead Instructor”  contact for the day.
       
  • Weapons:
    • This station has no tactical simulation element (no sims, no blueguns, no bad guys, no threat responses).  Therefore, we do not require officers to download (put away in a safe location) their weapons. Regardless, always remain aware of the potential risk of weapons.
       
  • PPE (Personal Protection Equipment):
    • N/A  (*During COVID ensure students are able to clean hands after contact with K9s and follow all then-current COVID requriements)
  •  

Station Prep:

  • Demo Dog and Handler
    • Medical muzzle that fits demo dog
    • Dog rewards as applicable
    • Peanut butter pouches as applicable
  • Station Handling and Assessment Pouch
    • Baseline Vitals Card
    • Stethoscope (for medics)
    • Thermometer, alcohol wipes and gauze
       
  • Enough space for students to gather safely and comfortable around dog(s)
    without crowding other groups.   (chairs, sitting or standing on floor as applicable)

Introduction:

  1. If not already completed previously…
    Demo Dog and Handler Introductions (2 min)
    1. K9 Name, job, age
    2. Any injuries, known sensitive areas, behavioral notes
    3. Importance of deferring to Handler 

K9 MEDIC Medical Handling and Assessments

 Review “textbook” reference, but underscore the importance of knowing Your dog, because they are often outside the textbook

Assessment‘Normal’ Finding
Mentation (“LOC” / “Responsiveness)Alert and Oriented (A&O) x3
Respirations Quality:P (Panting) ?  / S (Sniffing) ? / Labored / Distress
Respirations Rate:10 – 40 Breaths/Min
Normal Pulse / Heart Rate:60 – 80 Beats/Min
Post-Exercise Pulse:up to 130 Beats/Min
Mucous Membrane (MM) Color:Medium Pink (black pigment is normal)
Capillary Refill Time (CRT):< 2 seconds
Hydration:Moist mouth and instant skin turgor/tent
Normal Rectal Temperature:100 – 102.5°F
Post-Exercise Rectal Temperature:103 – 106°F  (have seen 108°F and still safe)
Other:Posture, tongue length, drive, etc

LOC

  • Have the students look at the dog in front of them and describe their generation LOC/Mentation.
    • How alert? Responsive? Are they lethargic?  Are their eyes focused?
      Does their behavior match their environment/situation?
       
  • Demo or have a student demo Sobriety test
    • Do the dog’s eyes move from side to side without any (usually horizontal) jitters or stuttering?
       
  • You can do a PERRL (Pupils Equal, Round, Reactive to Light) test or explain it
    • When you shine a light in one eye, both pupils (black part) should get small in response.
      Test this on both sides.
       
  • A&O Level Test (looking for predictable responses)
    • Level 1:  Responsive to any word/sound/smell
      • tests basic responsiveness
      • Not just yes/no, but how well did they res
    • Level 2: A verbal only command (no corrections or hand gestures)
      • Assesses that the dog can hear, process, understand and perform the command.
      • Gives us lots of information
         
    • Level 3:  problem solving
      • Evaluation more comprehensive  brain function
         

Respirations

  • Ask is the dog breathing?  (everyone says yes) How do you know?
    • Look for chest expansion, incl beyond the last rib
    • Listen for breath sounds (can often hear a dog panting without even seeing them)
    • Feel for chest expansion or breath on your hand
       
  • Ask the students to evaluate the quality of the dog’s breathing?
    • Are they panting?  And if so why?  Is it expected in this situation/environment?
       
  • Ask the students to describe what they think the dog would look like after more exertion or heat?
    • Eyes squinting, tongue length, more open mouth, louder/faster sounds, posture, behavior, the whole picture
       
  • Ask the students to describe what they the dog would look like if the dog was in distress?
    • Frightened eyes, tripod position, nasal flaring, abnormal sounds, muscle exertion, sometimes shallow
       
  • Briefly discuss getting a rate
    • Very important for some injuries and illnesses
    • Less meaningful during work due to increased panting/sniffing rates

Circulation

Remind students that Circulation is “Oxygen That Moves”
 

  • Mucous Membrane Color

We can see that tissue has oxygen when it is pink
So where are some areas that you could find pink on your dog

  • Gums or inner lips/mucous membranes best location
    • Ideally a spot is visible when the dog is panting while working if possible
    • Or find a spot on the upper lip so you can easily “flip the lip” quickly while working
    • Use the same spot each time (since pigmentation causes some areas to be darker)
    • Don’t use LED lights at night (it make medium pink look pale pink and pale pink is dangerous)
       
  • Next best… Subconjuctiva (lower eye lid)
    • Place thumbs on fur below eyes and pull down to reveal color
       
  • For some dogs their ear will turn a slightly dark pink which matches mucous membrane changes, but you have to test each dog to see if its true for them.
     
  • Genitals and other areas also sometimes indicative, but less useful for field purposes.
     
  • Cap Refill Time
    Since Circulation is Oxygen that moves, now that we’ve found ‘pink’/oxygen we want to see how well it’s moving
     
    • Press down on the pink area in the mouth (gums or inner lips).  When we press, we away the blood and it goes white, when we let go the blood moves back into the tissue.  It should do so in less then 2seconds.
       
  • Pulse Rate or Heart Rate
    Sometimes we need more exact data than “less than 2 seconds”, so we can also get a heart rate or pulse rate.
    For our purposes these are 2 different ways to get the same info.  Try them both out with your dog and see which one you like better
     
    • Pulse rate
      • Slide your 4 fingers along the inside thigh (right up where the leg meets the torso) from the cranial aspect and slide caudal (towards the tail).  Go past the femur bone and you will typically feel the artery in the little valley just past the femur.  It should feel like a small hose with a strong pulse.
         
    • Heart rate
      • Place hand over the heart, close to the left ‘arm pit’.  The heart it technically centered, but it’s typically easier to feel on the left side of the heart.
         
    • Possible difficulties
      • If the dog is wagging their tail it can camoflage the pulse/heart rate.  Have another handler keep the tail still.
      • If the dog is panting the same camoflauge can occur.  If safe, gently close the dogs mouth to stop the panting while counting.
         
    • Getting the ‘rate’
      • We measure in beats per minute, but we don’t need to count for a full minute
        • 30sec x2
        • 15sec x4
  • For Handlers when evaluating their dogs during work:
    6sec x 10 à ‘quick look’ gives us a rough number to tell us where we are on the exertion curve
     (if we know the dog is in the 90s roughly, it should give us a good idea of where they are on their curve)  (and it’s something that they can’t fake/ignore/lie about due to be in drive)
     


Hydration

  • Ask the students “How do you know if my dog is thirsty”
    Most say offer water.  That’s the behavior method, but just because a dog doesn’t drink doesn’t mean he isn’t thirsty (especially when they are in drive).  So how can we can we ask them physiologically if they are thirsty?
    • Skin turgor (tent test)
      • The skin should snap back like an elastic into place.  If it’s slow, then the dog is dehydrated.  If it stays up, it’s severe!  Note:  many textbooks says this a “early sign”  that is relative to sick dogs in an emergency clinic.  Our context is keeping our high performance partner well supported, so for us it is a “late sign”.  So we want something that is earlier…
         
    • Cheek Check
      • Swipe inside the cheek (not the lip at the front of the mouth that gets dry too quickly, but the inside cheek pouch).  It should be wet.  (cuz wet plus wind equals cooling).   
         
      • This is such an important assessment tool, then we do a Cheek Check every 15-20min while we are working.
         

If students have already had the heat lecture, then remind them if I do a Cheek Check and it’s not wet, they they don’t have wet plus wind equals cooking, they have a dog that is not physiologically capable of cooling themselves!!

Temperature  (last but not least!)

  • We’ve been going from least invasive to most invasive, so we “end” lol with temp check.
     
  • Students often ask about other tools
    • SubQ Home Alone Chip
      • Does NOT have any studies showing accuracy
      • At best, it is a “maybe” useful IF I do the work to find out if my dog has any predictable trend compared to rectal temps.  So either way you are going to be doing a lot of rectal temps at first.  And by the time you do that many, then it’s not a big deal for the dog anyhow.
         
    • Similar for infrared ear/temp/’armpit’ etc.   Do we wish we had easier solutions, but right now no good data… yet!
       
  • Discuss how it’s important to slowly get a dog used to rectal temp, positive training.
  • Can’t have inaccurate high temps, only inaccurate low temps due to not going far enough, poop, or dead space.
  • For non-emergencies, comfort counts so use lube.
  • Keep the dog from sitting (your knee under the dog pressing back against their knees but not up into belly)
  • Don’t pull tail too high, just move enough to insert thermometer.
  • Demo either yourself or have students demo the temp check.