When you work in general practice, and do not have ready access to advanced imaging,…
On my very first day in practice, as we were preparing to place a bandage on a horse with a serious leg injury, my boss (an equine surgeon), pulled me aside and said, “Make sure you pay attention. If you are going to work in equine practice, you need to know how to place a good bandage. I have seen too many horses with potentially repairable fractures arrive at the hospital with their leg hanging by a thread, because the bandage was too flimsy and the owner (in their panic) drove too fast to get there.”
I am not sure how much of the abject horror I felt at that thought showed on my face, but her words had the desired effect, and I watched intently as she showed me exactly how a good bandage was applied. That bandage of course, was a Robert Jones, as demonstrated in this video by equine clinician Dr Sara Biasutti. And it was a good thing I paid attention because on my very first night on call, it was exactly what I had to reproduce.
It was an evening in February, during a summer rainstorm the likes of which only those living on the east coast of Australia are familiar with; where great heavy drops of rain pelt down from a dark grey sky, and land with a palpable thud, requiring only a dozen or so to thoroughly soak your person. The horse I had been called out to see had spooked in the storm, skidding across the mud, and was now non-weight bearing lame in one forelimb. There was marked swelling of the distal limb from the mid cannon down, and while I suspected a severe ligament injury, I was nervous about the possibility of a non-displaced fracture. Either injury called for a Robert Jones bandage to be placed – so that is what I did, by the light of the torch and under the owner’s large umbrella, in the least muddy part of the paddock.
There was nowhere to adequately confine the horse, so we made the decision to transport to the hospital for box rest and further workup. Under strict instructions, the owner drove at a crawl, and I breathed my first sigh of relief when the horse stepped off the trailer, leg intact. I was met at the hospital by most of the equine department, who had rather wonderfully showed up in support upon hearing me call the case in. I held my breath again when my boss came over to inspect my handiwork, giving it a couple of taps and simply saying, “That’s a good bandage” by way of praise, whereupon I breathed out my second sigh of relief.
Radiographs revealed no sign of fracture – more sighs of relief all round – and I finally retired to bed that night to contemplate that universal truth… that being a new graduate veterinarian is an emotional roller coaster and a series of big lessons in almost every case. Nervous anticipation about what you might be confronted with on a call out, hope that you know what to do, moments of panic, and then relief if the animal is OK. Learning how to place a good bandage. Realising that you should always work with good people who will support you and anticipate when you need help.
And that you should always remind panicked owners to drive slowly.
About the Presenter
Dr Sara Biasutti BVSc (Hons 1), MVetStud (Equine Surgery), MANZCVS (Equine Medicine), PhD, DACVS-LA, is an equine clinician with extensive experience in both medicine and surgery fields, as well as a background in mixed practice. She completed a doctoral thesis investigating the healing of tendon and cartilage in large animals, and works as a specialist surgeon and ambulatory veterinarian for the University of Sydney’s Camden Equine Centre. Sara was a classmate of mine in vet school, and it is wonderful to see her accomplish so much in her career since, while remaining so friendly and humble.
Need to know more?
Camden Equine Centre is a world-class equine hospital operated by The University of Sydney, which offers an ambulatory service as well as welcoming referrals for advanced imaging, surgery and performance, and complicated or intensive medical cases.
I would like to take this opportunity to thank the staff at The University of Sydney Veterinary Teaching Hospital in 2008 for their support during my internship, during which they taught me more than they could possibly realise, and became my friends in the process.