RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 3: Basic life support.
OBJECTIVE
To systematically examine the evidence on basic life support (BLS) in veterinary CPR and to determine knowledge gaps.


METHODS
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.


METHODS
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.
School of Veterinary Medicine, Department of Veterinary Surgical and Radiological Sciences, University of California at Davis, Davis, CA 95616, USA. khopper@ucdavis.edu
Kate
K
Hopper
Steven E
SE
Epstein
Daniel J
DJ
Fletcher
Manuel
M
Boller
D000818:Animals; D016887:Cardiopulmonary Resuscitation / Q000662:veterinary*; D002415:Cats; D032921:Consensus; D004285:Dogs; D004632:Emergency Medical Services; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006323:Heart Arrest / Q000517:prevention & control / Q000628:therapy / Q000662:veterinary*; D006801:Humans; D017410:Practice Guidelines as Topic; D018634:Veterinarians / Q000523:psychology; D014730:Veterinary Medicine / Q000592:standards*