RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support

Authors

  • Kate Hopper BVSc, PhD, DACVECC,

    Corresponding author
    • School of Veterinary Medicine, Department of Veterinary Surgical and Radiological Sciences, University of California at Davis, Davis, CA
    Search for more papers by this author
  • Steven E. Epstein DVM, DACVECC,

    1. School of Veterinary Medicine, Department of Veterinary Surgical and Radiological Sciences, University of California at Davis, Davis, CA
    Search for more papers by this author
  • Daniel J. Fletcher PhD, DVM, DACVECC,

    1. College of Veterinary Medicine, Department of Clinical Sciences, Cornell University, Ithaca, NY
    Search for more papers by this author
  • Manuel Boller Dr. med. vet., MTR, DACVECC,

    1. Department of Clinical Studies, School of Veterinary Medicine, and the Department of Emergency Medicine, School of Medicine, Center for Resuscitation Science University of Pennsylvania, Philadelphia, PA
    Search for more papers by this author
  • the RECOVER Basic Life Support Domain Worksheet Authors

    Search for more papers by this author
    • RECOVER Basic Life Support Domain Worksheet Authors are listed in the Appendix.


  • The authors and collaborators declare no conflicts of interests.

Address correspondence and reprint requests to

Dr. Kate Hopper, Department of Veterinary Surgical and Radiological Sciences, Room 2112 Tupper Hall, University of California at Davis, Davis, CA 95616, USA

Email: khopper@ucdavis.edu

Abstract

Objective

To systematically examine the evidence on basic life support (BLS) in veterinary CPR and to determine knowledge gaps.

Design

Standardized, systematic evaluation of the literature, categorization of relevant articles according to level of evidence and quality, and development of consensus on conclusions for application of the concepts to clinical practice. Relevant questions were answered on a worksheet template and reviewed by the Reassessment Campaign on Veterinary Resuscitation (RECOVER) BLS domain members, by the RECOVER committee and opened for comments by veterinary professionals for 30 days.

Setting

Academia, referral practice, and general practice.

Results

Sixteen worksheets were prepared to evaluate techniques for chest compression and ventilation strategies as well as identification of cardiopulmonary arrest (CPA). Major recommendations arising from this evidence review include performing chest compressions at a rate of at least 100/min at a compression depth of one-third to half the width of the chest with minimal pauses, and early instigation of ventilation at a rate of 8–10 breaths/min in intubated patients, or using a 30:2 compression/ventilation ratio in nonintubated patients.

Conclusions

Although veterinary clinical trials are lacking, much of the experimental literature on BLS utilized canine models. The major conclusions from this analysis of the literature are the importance of early identification of CPA, and immediate initiation of BLS in these patients. Many knowledge gaps exist, most importantly in our understanding of the optimal hand placement and technique for chest compressions, warranting coordinated future studies targeted at questions of relevance to differences between veterinary species and humans.

Ancillary