Plus-Hex CLINICAL
ABSTRACT High-quality equine neonatal nursing care is essential to the recovery of a sick foal . Whether this care is carried out in a dedicated foal unit or an owner ' s yard , it is a labour-intensive endeavour and it provides many opportunities for equine veterinary nurses to use the array of specialist skills they have acquired .
This article provides an insight into the care of the recumbent neonatal foal and is aimed at veterinary nurses interested in equine neonatology .
The article includes guidance on the critical care checks needed to recognise areas of concern , prevent complications and provide ongoing assessment of the foal .
Keywords neonatal foal , recumbency , equine , nursing , care
Introduction
The care of the neonatal foal provides the equine nursing team with many opportunities to use their specialist skills . The provision of intravenous ( IV ) therapy and adequate nutrition , and the use of strict hygiene protocols , will support a positive outcome for the patient .
A systematic and thorough critical care check is vital to recognise any areas of concern , prevent complications and provide an ongoing , dynamic assessment of the critically sick foal .
Biosecurity and barrier nursing
Due to their compromised immune systems , sick foals are susceptible to hospital-acquired infections .
As the equine veterinary nurse is continually in close proximity to the sick foal in their care , they must adhere to biosecurity and barrier nursing guidelines at all times , including :
• Tying and removing full clinical waste bags from the foal unit immediately , to avoid contamination from overspill
• Keeping treatment rooms clean and organised
• Replacing disinfectant in and around the mats and removing organic material from the foot dip every 6 hours
• Ensuring all stethoscopes , thermometers , muckingout equipment , feed buckets , lead ropes , head collars and other utensils relating to patient care stay with the patient and are not used elsewhere .
Anyone unwilling to adhere to such biosecurity measures should not be admitted to the foal unit . Personnel working in the foal unit should be exempt from caring for adult patients in other areas of the hospital , to prevent the introduction of pathogens to an immunocompromised foal .
Recumbency
If weak and ill , the recumbent foal will prefer to rest in lateral recumbency . This adversely affects its blood oxygen levels and results in poor bilateral pulmonary perfusion . Foals maintained in sternal recumbency have better lung function and subsequently more stable blood oxygen levels [ 1 ] . Therefore , the foal should be supported at all times in a sternal position and maintained this way , preferably on an easy-to-clean surface that is impervious to moisture and faeces ( Figure 1 ). Gymnastic mats are ideal for this purpose as they provide cushioning and protect the foal from the cold floor ; they are also robust enough to support the foal if it attempts to stand when its condition has improved .
Foam wedges , vinyl-covered beanbags and customised U-shaped ‘ nests ’ work well in maintaining the foal in sternal recumbency . These can be used with fleece pet bedding , along with other washable blankets and duvets , to keep the foal warm and dry .
• Using the World Health Organization ( WHO ) handwashing technique ( https :// www . who . int / docs / default-source / patient-safety / how-to-handwashposter . pdf ) before and after handing foals
• Changing examination gloves before every treatment , examination or cleaning task
• Ensuring all clothing , including scrubs , overalls and shoes , is dedicated solely to that patient , and remains in the foal unit at all times to protect the foal from nosocomial infections
Figure 1 . A sick neonate being supported and maintained in sternal recumbency using a wedge .
Volume 39 ( 2 ) • April 2024
29