Horses have hard heads and when they make an unexpected movement that brings their head in to contact with ours, we can come off worse.

Nose bleeds

A blow to the face may cause tiny blood vessels within the nose to rupture, resulting in a nosebleed. This is not generally serious unless there is an excessive amount of blood loss, or the blood is thin and watery, which may indicate fluid from around the brain is leaking due to a fractured skull.

In non-serious circumstances, the casualty should sit down and pinch the soft part of the nose, tilting the head forwards to allow the blood to drain through the mouth. Do not tip the head back as this may cause the blood to run down the throat and result in vomiting.

Maintain the pressure for 10min, while keeping movement to a minimum. Talking, swallowing, spitting or coughing may disturb the forming clot. If the bleeding has not stopped, this procedure can be repeated twice more. Medical help should be sought for any nosebleed, which has continued for more than 30min.

Once the bleeding stops, the casualty should remain quiet for a few hours, taking care not to disturb any clots.

Bleeding from the mouth

Minor cuts to the lips, tongue and mouth nay bleed profusely and be alarming. There is a danger that blood may be inhaled into the lungs, causing breathing difficulties. The casualty should sit with their head forward and tilted slightly to the injured side to let the blood dribble from the mouth.

A gauze pad should be pressed on the wound for 10min to help the bleeding stop. If the bleeding has not stopped after this procedure has been repeated twice more, then medical help should be sought.

Once the bleeding has stopped hot drinks should be avoided for 12hr. Washing the mouth out may disturb a clot that is beginning to form, so should be avoided.

Lost teeth

If an adult tooth is knocked out, it should be replanted in its socket as soon as possible. Cleaning it off may cause tissue damage, so wearing disposable gloves, gently push the tooth into the socket and keep it in place by pressing a guaze pad between the top and bottom teeth.

If this is not possible and the casualty is conscious, they should keep the tooth inside their cheek while urgent help is sought. Alternatively the tooth can be placed in a small container of milk to prevent it from drying out.

Biting down on a thick gauze pad placed across he empty socket can help control any associated bleeding.

  • This article was originally published in the 7 August issue of Horse & Hound. The information is available in the eighth edition First Aid Manual, authorised by St John Ambulance.

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