Oxygen supplementation is often essential for MWDs experiencing respiratory distress. When available and until proven unnecessary, provide 100% oxygen to MWDs suffering major trauma and/or that are showing signs of respiratory distress.3 Oxygen cages (makeshift or manufactured) and oxygen tents are impractical as an effective modality for providing supplemental oxygen to MWDs and are not available in the typical deployed environment.
Use face mask or “blow by” technique (hold end of oxygen tubing or circuit 1-2 cm or as close to nose and mouth as possible or attach to muzzle) using high flow rates of 10-15 L/min.4 Use caution and ensure the handler always has control of the MWD. Agitated, distressed or dyspneic MWDs may bite causing serious injury to personnel. Figures 2 and 3 show simple yet effective techniques to safely provide “blow by” oxygen supplementation to muzzled MWDs. While not the ideal method, acceptable inspired oxygen concentrations of 40-70% are achieved with this technique, which may be lifesaving.4
Use tracheal insufflation, OTI/ETI, or surgical airways (CCT/TT). See Tables 1 through 4 for techniques. Bag-valve-mask (BVM) ventilation is a viable non-invasive airway management technique in MWDs for providing effective oxygenation and ventilation. Considering many UAOs are not completely occlusive, BVM ventilation may provide a stopgap until a more definitive airway can be obtained.