Lucy Brock BVSc MRCVS gave an informative talk to the staff at Whitsbury Manor Stud on the process of resuscitating the foal. Below, she outlines the necessary equipment and steps to follow:
• Face mask and pump
• Oxygen cylinder
• Naso-tracheal Tube
• Adrenaline (1ml vials x 5)
• Needles and syringes
• IV catheter x 2
• Fluids + administration set
• Pen torch
• Scrub/Methylated spirit
1. Clear the mouth and nostrils of membranes while vigorously towel drying.
2. If after 20 seconds the foal is not breathing – CALL THE VET
3. Place mask over the mouth and nostrils and attach the resuscitator. If there is no resuscitator available, mouth to nostril can be attempted. Place your mouth over one nostril, close the opposite nostril and breath out. If possible, get someone else to pinch the foal’s throat to block off the oesophagus and direct the air into the lungs.
4. Give10-20 pumps/breaths per minute. Observe chest inflating.
5. The oxygen supply can be inserted into the opposite nostril.
6. If, after 30-60 seconds, there is no heartbeat, or the rate is very slow (<40bpm): Start chest compressions: To do this, place the foal on its side on a hard surface. Place hands on the highest part of the chest. Keep hands flat and arms straight. Aim to compress chest by 3-5cm.
7. Give 90-120 compressions per minute. (If alone: give 15 compressions followed by 2 breaths).
8. Thoracic compressions can stop when a heartrate of >60bpm is achieved.
9. Ventilation can stop when a spontaneous respiratory rate of >15 bpm is reached.
10. If the foal fails to breathe spontaneously and the heart rate is still slow or absent continue CPR until Veterinary intervention is possible.
11. Veterinary Intervention: The vet may change the mask for a cuffed ET tube that directs oxygenated air into the lungs. They may need you to continue giving breaths via an Ambubag attached to the tube and may also need you to continue chest compressions while they administer drugs and fluids.
12. If after 15 minutes of continued CPR there is no response CPR should be halted.