Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary resuscitation (CPR) is the treatment required to save an animal (or human) life when he or she has suffered respiratory and/or cardiac arrest. CPR consists of two parts:
Rescue breathing and chest compressions.
These two techniques combine to keep the lungs supplied with oxygen and keep blood circulating, carrying oxygen to the other parts of the body.
Basic CPR is CPR performed by trained bystanders at the scene of the arrest. Advanced CPR is CPR performed by trained teams of professionals.
Basic CPR is the most important, and will be described in this section.
All tissues require a steady source of oxygen. If the source is interrupted for only a few minutes, irreversible damage may be done. If an arrest occurs, basic CPR must be initiated at the scene.
Basic CPR: Rescue Breathing
Make Certain the Animal is Actually Arrested and Unconscious
Talk to the animal first. Gently touch and attempt to awaken the pet. You could be seriously injured should you attempt to perform CPR on a pet who was only sleeping heavily and was startled awake.
Ensure an Open Airway
Extend the head and neck and pull the tongue forward.
Look in the mouth and remove any saliva or vomitus. If it is too dark to see into the mouth, sweep your finger deep into the mouth and even into the throat to remove any vomitus or foreign body. Be aware of a hard, smooth, bone-like structure deep in the throat. This is likely to be the hyoid apparatus (Adam's apple). Serious injury could result if you pull on the hyoid apparatus.
Observe for Effective Breathing
Sometimes an animal will begin to breathe spontaneously when the head is put in the position discussed above (head and neck extended, tongue pulled forward). Watch for the rise and fall of the chest while listening closely for sounds of breathing. If no breathing is evident in 10 seconds, begin rescue breathing.
Begin Rescue Breathing
Rescue breathing is performed by covering the animal's nose with your mouth and forcefully blowing your breath into his lungs. In cats and small dogs, you must hold the corners of the mouth tightly closed while you force the air in.
In larger dogs, the tongue should be pulled forward and the mouth and lips held shut using both hands cupped around the muzzle. Force the air into the lungs until you see the chest expand. Take your mouth away when the chest has fully expended. The lungs will deflate on their own. Air should be forced into the animal's lungs until you see the chest expand.
Give 3 to 5 Full Breaths
After several breaths are given, stop for a few seconds to recheck for breathing and heart function. If the pet is still not breathing, continue rescue breathing 20-25 times per minute in cats or small dogs, or 12-20 times per minute in medium or large dogs. Push down on the stomach area every few seconds to help expel the air that may have blown into the stomach. If the stomach is allowed to distend with air, the pressure will make the rescue breathing efforts less effective.
If Breathing is Shallow or Non-existent
and the animal is still unconscious, continue rescue breathing 10 to 15 times per minute and transport the animal to the nearest veterinary facility.
Basic CPR: Chest Compressions
After Giving 3 to 5 Breaths, Check for a Pulse
If no pulse is detectable, begin chest compressions.
In Small Dogs or Cats
Squeeze the chest using one or both hands around the chest. Depress the rib cage circumferentially. Do this 100 to 150 times per minute.
In Large Dogs
Compress the chest wall with one or two hands, depending on the size of the dog (and the size of the rescuer). If the dog is on her side, place the hand(s) on the side of the chest wall where it is widest. If the dog is on her back, place the hand(s) on the sternum (breastbone). Depress the rib cage or sternum 1.5 to 4 inches, depending on the dog's size. Do this 80 to 120 times per minute.
Coordinate Rescue Breathing and Chest Compressions
Give breaths during the compressions, if possible. If it is not possible to give breaths during the compressions, give two breaths after every 12 compressions.
When Two or More Rescuers are Working Together
Rescue breathing should be given during every second or third heart compression. Continue CPR Until
** You become exhausted and can't continue.
** You get the animal transported to a veterinary facility and professionals can take over. The pulse is palpable or heartbeats are felt and they are strong and regular. In the vast majority of cases, artificial ventilations will continue to be required for a period of time, even though heart function has returned. This is due to nervous system depression secondary to the arrest.
All resuscitated animals should be transported to a veterinary facility for further examination and care!
Secondary Survey
The secondary survey is performed once resuscitation measures have been successfully performed or when it is decided that resuscitation measures are not required. In some circumstances (because of ongoing resuscitation), the secondary survey is never completed and the animal is transported directly to the veterinarian or emergency hospital during resuscitation.
A general examination (from the tip of the nose to the end of the tail) should be performed. Determine and record:
** pulse rate and character
** respiratory rate and character
** mucous membrane color
** capillary refill time
** rectal temperature.
Examine the eyes, ears, nose, neck, mouth (if possible), chest, abdomen, back, pelvis, legs, and tail. First aid treatment should be performed as necessary during transport to the veterinarian.
Taking and recording your pet's pulse is an important part of the secondary survey.