Triage of the polytrauma dog: what to stabilise first
4-year-old 18 kg crossbreed hit by a car 20 minutes ago. Rapid, shallow breathing with abdominal effort, pale mucous membranes, weak femoral pulse and an open tibial fracture with minor bleeding.
What should you do first?
chevron_right Show answer and explanation
A. Two-view thoracic radiographs to confirm a possible pneumothorax before intervening
Positioning a dyspnoeic patient for radiographs can cause decompensation and arrest. Stabilise first; point-of-care thoracic ultrasound (TFAST) and thoracocentesis are safer and also therapeutic.
B. Lavage, dress and splint the open fracture to prevent contamination
The open fracture should be covered with a sterile dressing as soon as possible, but it is not immediately life-threatening. It comes after breathing and circulation.
C. Oxygen with minimal handling, assess the cause of the dyspnoea (TFAST, thoracocentesis if pneumothorax) and place an intravenous catheter
Correct. Triage follows airway–breathing–circulation (ABC): dyspnoea is the most immediate threat. While oxygen is given and the chest assessed, another team member places a catheter to treat shock.
D. Rapid crystalloid bolus at 90 mL/kg (the "shock dose") in the first hour
Giving the full shock dose at once is no longer recommended: small boluses are given and the patient reassessed. In a dog with possible pulmonary contusions, excess fluid worsens gas exchange.
lightbulb Key takeaway
At triage, assess the three major body systems in seconds: respiratory, cardiovascular and neurological. Treat what kills first (ABC) and leave dramatic but non-life-threatening injuries until after stabilisation.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.