p.1

EVIDENCE-BASED CPR: THE RECOVER GUIDELINES
Kenichiro Yagi MS, RVT, VTS (ECC, SAIM)

p.2

Video of a dog receiving CPR

p.3

CPR being performed at a practice

p.4

DO IT ALL NOW!!
How much epi?
Hook up the ECG!
Get a tube in!
Do we have an IV yet!?

p.5

How much epi?
What does the ECG show us?
What should we do first?

p.6

RECOVER
Reassessment Campaign on Veterinary Resuscitation

p.7

CRP Algorithm
Unresponsive, Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Support
1 full cycle = 2 minutes
uninterrupted compressions/ventilation
1: Chest Compressions
100-120/min
- Lateral recumbency
- 1/3-1/2 chest width
2: Ventilation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
- Interpose compressions
Advanced Life Support
3 Initiate Monitoring
- Electrocardiogram(ECG)
- End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
5 Administer Reversals
-Opioids - Naloxone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
Evaluate Patient Check ECG
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131, 2012

p.8

CRP Algorithm
Unresponsive,Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Spport
1 full cycle = 2 minutes
uninterrupted compressions/ventailation
1 Chest Compressions
100-120/min
-Lateral recumbency
-1/3-1/2 chest width
2 Ventailation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
-Interpose compressions
Advanced Life Support
3 Initiate Monitoring
-Electrocardiogram(ECG)
-End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
5 Administer Reversals
-Opioids - Nalocone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
decreased
Evaluate Patient Check ECG -->ROSC -->Post-CPA Algorithm
VF / Pulseless VT
Asystole / PEA
-Continue BLS,charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT,consider
-Amiodarone or Lidocaine
-Epinepherine / Vasopressin every other cycle
-Increase defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin
every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10min,consider
-High dose Epinephrine
-Bicarbonate therapy
decreased
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131,2012

p.9

Compression Technique
- Start immediately
- Rate: 100-120bpm
- Depth: 1/3-1/2 of chest
- Allow full recoil
- 2 min uninterrupted
- Compression Point

p.10

Round Chested
As wide as deep Highest point of chest Thoracic pump theory
Keel Chested
Deeper than wide Over the heart Cardiac pump theory
Flat Chested
Wider than deep Over the sternum Cardiac pump theory
This is a rare case!!

p.11

Round-Chested Dog
Focus compressions on the widest portion of the chest

p.12

Narrow-Chested Dog
Focus compressions over the heart

p.13

Video of Bulldog try turnover

p.14

Chest Compressions
- Recumbency
- No significant difference
- Physical Tips
- Hand over hand
- Shoulder over hands
- Lock Elbows, use back

p.15

Demonstration of how to keep your arms while performing CPR

p.16

Image of a dummy dog to practice CPR

p.17

THE ORIGINAL MOVIE SOUNDTRACK
SATURDAY NIGHT FEVER

p.18

OUEEN
Another One Bites the Dust

p.19

100 BPM HITS
ARTIST
ABBA
All American Rejects
Arrested Development
Backstreet Boys
Bangles
Beastie Boys
Beastie Boys
Beastie Boys
Black Crowes
Black Eyed Peas
Bon Jovi
Cyndi Lauper
Diana Ross
Fall Out Boy
Guns N' Roses
Hanson
John
Denver
Justin Timberlake
KT Tunstall
Lily Allen
Linkin Park
Ludacris
Madonna
SONG
Dancing Queen
Gives You Hell
Tennessee
Quit Playing Games (With My Heart)
Walk Like An Egyptian
Body Movin' [Fatboy Slim Remix]
Heart Attack Man
Root Down
Hard To Handle
Hey Mama
Lay Your Hands On Me
Girls Just Want To Have Fun
Ain't No Mountain High Enough
This Ain't A Scene, It's An Arms Race
Paradise City
Mmmbop
Thank God I'm A Country Boy
Rock Your Body
Suddenly I See
LDN
Breaking the Habit
The Potion
Who's That Girl

p.20

Linkin Park
Ludacris
Madonna
Mariah Carey
Marvin Gaye
Michael Jackson
Missy Elliott
Motley Crue
Notorious B.I.G.
Patty Loveless
Paul Oakenfold
Phil Collins
Ricky Martin
Rod Stewart
Shakira
Simon & Garfunkel
Soul II Soul
Stray Cats
Sugar Ray
Tracy Chapman
U2
Breaking the Habit
The Potion
Who's That Girl
Heartbreaker
What's Going On
Man In The Mirror
Work It
Kickstart My Heart
Notorious B.I.G. [Featuring Lil' Kim and Puff Daddy]
Strong Heart
Starry Eyed Surprise
You Can't Hurry Love
Shake Your Bon Bon
You're In My Heart
Hips Don't Lie [Featuring Wyclef Jean]
Cecilia
Back To Life
Rock This Town
Fly
Fast Car
I Still Haven't Found What I'm Looking For
bethebeat.heart.org
2009 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited.

p.21

Participants of a CPR workshop in Japan

p.22

Video of a CPR workshop in Japan

p.23

Doraemon - A famous character in Japan

p.24

Video of a woman performing chest compressions

p.25

Chest Compressions
- Cycle
- Interruption = Bad
- Less perfusion during pauses
- Blood flow build-up takes time
- Recommendations
- Limit rhythm checks to q2min
- <10 sec pauses
- Switch every 2 minutes

p.26

CRP Algorithm
Unresponsive, Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Support
1 full cycle = 2 minutes
uninterrupted compressions/ventilation
1 Chest Compressions
100-120/min
-Lateral recumbency
-1/3-1/2 chest width
2 Ventilation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
-Interpose compressions
Advanced Life Support
3 Initiate Monitoring
-Electrocardiogram(ECG)
-End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
5 Administer Reversals
-Opioids - Naloxone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
decreased
Evaluate Patient Check ECG -->ROSC -->Post-CPA Algorithm
VF / Pulseless VT
Asystole / PEA
-Continue BLS, charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT, consider
-Amiodarone or Lidocaine
-Epinephrine / Vasopressin every other cycle
-Increase the defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin
every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10min,consider
-High dose Epinephrine
-Bicarbonate therapy
decreased
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131, 2012

p.27

Ventilation Timing
The "ABCs" of CPR?
Airway
Breathing
Circulation
Prioritize compressions
Do not stop compressions to intubate!

p.28

The Evidence
Requirement Reduced Oxygen
Low oxygen pulmonary uptake
Oxygen Supply without Ventilation
Compression Induced Ventilation
Detrimental Effects
Interrupted chest compressions

p.29

Ventilation Technique
- Single Rescuer/No tube
- Mouth-to-snout
- Close mouth, blow in
- Keep neck straight
- Brisk breaths
- 30:2 ratio
- In veterinary practice
- Intubate
- Ambu-bag / Anesthetic machine

p.30

10 breaths per minute
1s inspiration

p.31

CRP Algorithm
Unresponsive, Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Support
1 full cycle = 2 minutes
uninterrupted compressions/ventilation
1 Chest Compressions
100-120/min
-Lateral recumbency
-1/3-1/2 chest width
2 Ventilation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
-Interpose compressions
Advanced Life Support
Monitoring
3 Initiate Monitoring
-Electrocardiogram(ECG)
-End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
5 Administer Reversals
-Opioids - Naloxone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
decreased
Evaluate Patient Check ECG -->ROSC -->Post-CPA Algorithm
VF / Pulseless VT
Asystole / PEA
-Continue BLS, charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT, consider
-Amiodarone or Lidocaine
-Epinephrine / Vasopressin every other cycle
-Increase the defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin
every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10min,consider
-High dose Epinephrine
-Bicarbonate therapy
decreased
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131,2012

p.32

Monitoring
- Which of the following is the best measure for effective perfusion in CPR?
A. Palpable pulses
B. EtCO2
C. Doppler
D. ECG
E. Lactate

p.33

Useful Monitors
- ETCO2
- ECG

p.34

Capnography
Ventilation
Perfusion
ETCO2
Blood In
Alveoli
Co2 Out
O2 In
Blood Out

p.35

Capnography
- Confirms Intubation
- Predictor of ROSC
- 15mmHg
- Indicator of ROSC
- Sudden increase

p.36

Video

p.37

Readings on the monitor

p.38

Other
- Doppler/Oscillometric
- Pulse palpation
- Venous pulsation
- Pulse Oximetry
- Vasoconstriction
- Motion

p.39

CRP Algorithm
Unresponsive,Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Spport
1 full cycle = 2 minutes
uninterrupted compressions/ventailation
1 Chest Compressions
100-120/min
-Lateral recumbency
-1/3-1/2 chest width
2 Ventailation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
-Interpose compressions
Advanced Life Support
3 Initiate Monitoring
-Electrocardiogram(ECG)
-End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
Vascular Access
5 Administer Reversals
Reversals
-Opioids - Naloxone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
decreased
Evaluate Patient Check ECG -->ROSC -->Post-CPA Algorithm
VF / Pulseless VT
Asystole / PEA
-Continue BLS, charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT, consider
-Amiodarone or Lidocaine
-Epinepherine / Vasopressin every other cycle
-Increase defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin
every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10min,consider
-High dose Epinephrine
-Bicarbonate therapy
decreased
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131,2012

p.40

Drugs and Venous Access

p.41

CPR Emergency Drugs and Doses
Weight (kg) 2.5 5 10 15 20 25 30 35 40 45 50
Weight (lb) 5 10 20 30 40 50 60 70 80 90 100
DRUG DOSE ml ml ml ml ml ml ml ml ml ml ml
Arrest
Epi Low (1:1000) 0.01 mg/kg 0.03 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45 0.5
Epi High (1:1000) 0.1 mg/kg 0.25 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Vasopressin (20 Umi) 0.8 U/kg 0.1 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8
Atropine (0.54 mg/m) 0.05 mg/kg 0.25 0.5 1 1.5 2 2.5 3 3.5 4 4.5
Anti - Arrhyth
Amiodarone (50 mg/ml) 5 mg/kg 0.25 0.5 1 1.5 2 2.5 3 3.5 4 4.5
Lidocaine (20 mg/ml) 2-8 mg/kg 0.25 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Reversal
Naloxone (0.4 mgml) 0.04 mg/kg 0.25 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Flumazenil (0.1 mg/m) 0.01 mg/kg 0.25 0.5 1 1.5 2 2.5 3 3.5 4 4.5 5
Atipamezole (5 mg/ml) 50 4g/kg 0.03 0.05 0.1 0.15 0.2 0.25 0.3 0.35 0.4 0.45 0.5Defib monophasic
External Defib (J) 2-10 J/kg 20 30 50 100 200 200 200 300 300 300 360
Internal Defib (w 0.2-1 J/kg 2 3 5 10 20 20 20 30 30 30 50

p.42

CRP Algorithm
Unresponsive, Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Support
1 full cycle = 2 minutes
uninterrupted compressions/ventilation
1 Chest Compressions
100-120/min
-Lateral recumbency
-1/3-1/2 chest width
2 Ventailation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
-Interpose compressions
Advanced Life Support
3 Initiate Monitoring
-Electrocardiogram(ECG)
-End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
5 Administer Reversals
-Opioids - Nalocone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
decreased
Evaluate Patient Check ECG -->ROSC -->Post-CPA Algorithm
VF / Pulseless VT
Asystole / PEA
-Continue BLS, charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT, consider
-Amiodarone or Lidocaine
-Epinepherine / Vasopressin every other cycle
-Increase the defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin
every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10min,consider
-High dose Epinephrine
-Bicarbonate therapy
decreased
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131,2012
Reversal
Naloxone(0.4mg/ml) 0.04mg/kg
Flumazenil(0.1mg/ml) 0.01mg/kg
Atipamezole(5mg/ml) 50ug/kg

p.43

CRP Algorithm
Unresponsive,Apneic Patient
decreased
Initiate CRP Immediately
Basic Life Support
1 full cycle = 2 minutes
uninterrupted compressions/ventilation
1 Chest Compressions
100-120/min
-Lateral recumbency
-1/3-1/2 chest width
2 Ventailation
10/min
Intubate in lateral
Simultaneous compressions
or
C:V 30:2
-Interpose compressions
Advanced Life Support
3 Initiate Monitoring
-Electrocardiogram(ECG)
-End Tidal CO2(ETCO2)
->15 mmHg = good compressions
4 Obtain Vascular Access
5 Administer Reversals
-Opioids - Naloxone
-2 agonists - Atipamezole
-Benzodiazepines - Flumazenil
decreased
Evaluate Patient Check ECG -->ROSC -->Post-CPA Algorithm
VF / Pulseless VT
Asystole / PEA
-Continue BLS, charge defibrillator
Defib
Anti-arrhythmics
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT, consider
-Amiodarone or Lidocaine
-Epinepherine / Vasopressin every other cycle
-Increase defibrillator dose by 50%
Epi/Atropine
-Low dose Epinephrine and/or Vasopressin
every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10min,consider
-High dose Epinephrine
-Bicarbonate therapy
decreased
Basic Life Support
Change compressor Perform 1 full cycle = 2minutes
Reprinted with permission from Fletcher et al., J Vet Emerg Crit Care,22(S1): S1022-S131,2012

p.44

Shockable Rhythms
Evaluate Patient Check ECG
Non-shockable Rhythms
VF/Pulseless VT
Asystole/PEA
-Continue BLS,charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT,consider
-Amiodarone or Lidocaine
-Epinephrine / Vasopressin every other cycle
-Increase defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10 min,consider
-High dose Epinephrine
-Bicarbonate therapy

p.45

Simple CPR ECG Algorithm
RECOVER
recoverinitiative.org
Are there consistent, repeating complexes?
YES
Are pulses associated with the complexes?
NO
Rate > 200/min?
NO
PEA NO SHOCK!
YES
Perfusing Rhythm = ROSC
YES
Pulseless VT SHOCK!
NO
Is the ECG a flat line?
YES
Asystole NO SHOCK!
NO
VF SHOCK!

p.46

Simple CPR ECG Algorithm
RECOVER
recoverinitiative.org
Are there consistent, repeating complexes?
YES
Are pulses associated with the complexes?
NO
Rate > 200/min?
NO
PEA NO SHOCK!
YES
Perfusing Rhythm = ROSC
YES
Pulseless VT SHOCK!
NO
Is the ECG a flat line?
YES
Asystole NO SHOCK!
NO
VF SHOCK!

p.47

Simple CPR ECG Algorithm
RECOVER
recoverinitiative.org
Are there consistent, repeating complexes?
YES
Are pulses associated with the complexes?
NO
Rate > 200/min?
NO
PEA NO SHOCK!
YES
Perfusing Rhythm = ROSC
YES
Pulseless VT SHOCK!
NO
Is the ECG a flat line?
YES
Asystole NO SHOCK!
NO
VF SHOCK!

p.48

Simple CPR ECG Algorithm
RECOVER
recoverinitiative.org
Are there consistent, repeating complexes?
YES
Are pulses associated with the complexes?
NO
Rate > 200/min?
NO
PEA NO SHOCK!
YES
Perfusing Rhythm = ROSC
YES
Pulseless VT SHOCK!
NO
Is the ECG a flat line?
YES
Asystole NO SHOCK!
NO
VF SHOCK!

p.49

Simple CPR ECG Algorithm
RECOVER
recoverinitiative.org
Are there consistent, repeating complexes?
YES
Are pulses associated with the complexes?
NO
Rate > 200/min?
NO
PEA NO SHOCK!
YES
Perfusing Rhythm = ROSC
YES
Pulseless VT SHOCK!
NO
Is the ECG a flat line?
YES
Asystole NO SHOCK!
NO
VF SHOCK!

p.50

Shockable Rhythms
Evaluate Patient Check ECG
Non-shockable Rhythms
VF/Pulseless VT
Asystole/PEA
-Continue BLS, charge defibrillator
-Clear and give 1 shock or Precordial Thump if no defibrillator
-With prolonged VF/VT, consider
-Amiodarone or Lidocaine
-Epinephrine / Vasopressin every other cycle
-Increase defibrillator dose by 50%
-Low dose Epinephrine and/or Vasopressin every other BLS cycle
-Consider Atropine every other BLS cycle
-With prolonged CPA > 10 min,consider
-High dose Epinephrine
-Bicarbonate therapy

p.51

Non-shockable Rhythm
- Asystole (most common)
- Continue compressions
- Pulseless Electrical Activity
- Pulseless, <200 bpm
- Continue compressions
- Drugs

p.52

CPR Drugs
- Epinephrine
- Arterial Vasoconstrictor
- Increased aortic pressure -> Increased CPP
- Low Dose: 0.01mg/kg
- High Dose: 0.1mg/kg
- Vasopressin (0.4-0.8 U/kg)
- Smooth muscle vasoconstrictor
- Alternative to Epinephrine
- Half life longer (10-20 min)
- Atropine(0.05mg/kg)
- Blocks vagus nerve(Parasympathetic)
- Increases HR
- 0.05mg/kg or 1ml/10 lb
If non-shockable rhythm
After the first rhythm diagnosis
Every other cycle

p.53

Shockable Rhythms
- Ventricular Fibrillation
- Coarse vs Fine
- Pulseless Ventricular Tachycardia
- Pulseless, >200 bpm
- Shockable Rhythms
- Defibrillator

p.54

Demonstrating fibrillation

p.55

Shockable Rhythms
- Ventricular Fibrillation
- Coarse vs Fine
- Pulseless Ventricular Tachycardia
- Pulseless, >200 bpm
- Shockable Rhythms
- Defibrillator
- Mechanical Defib?

p.56

Image

p.57

Communication
- Clear, direct, communication
- Closed-loop communication
- Situational awareness/cross-monitoring
- Debriefing

p.58

Post Resuscitative Care
- Respiratory Optimization
- Hemodynamic Support
- Neuroprotective therapy
D.J Fletcher et al.
Post-Cardiac Arrest Care Algorithm
ROSC
RESPIRATORY OPTIMIZATION
Spontaneous Breathing?
NO
PaCO2 or EtCO2 +5mm Hg
Dog = 32-43 mm Hg?
Cat = 26-36mm Hg?
No
IPPV
Titrate Suppiemental Oxygen
FiO2 >0.6
SpO2 > 98%
PaO2 > 100 mm Hg
Hyperoxemic
SpO2 > 94-98%
PaO2 > 80-100 mm Hg
Normoxemic
SpO2 < 94%
PaO2 > 80 mm Hg
Hypoxemic
SAP > 200 mm Hg
MAP > 120 mm Hg
Hypertensive
SAP = 100-200 mm Hg
MAP = 80-120 mm Hg
Normotensive
SAP < 100 mm Hg
MAP < 80 mm Hg
Hypotensive
1 Pressor
2 Treat Pain
3 Anti-hypertensive
ScvO2 > 70%?
Lactate < 2.5 mmol/L?
1 Hypovolemia?
YES
IV fluids
2 Vasodilation?
CRT, Injected MM?
Vasopressor
3 Contractility?
YES
Inotrope
4 PCV < 25%?
Transfuse
HEMODYNAMIC OPTIMIZATION
NEUROPROTECTION
ICU
Consider:
-Hypothermia if comatose
-Mannitol / HTS if neuro signs
-Seizure prophylaxis

p.59

RECOVER
Reassessment Campaign on Veterinary Resuscitation

p.60

Has your practice implemented the RECOVER guideline?

p.61

Adobe Animal Hospital
- 24hr General/Emergency Practice
- 27 Veterinarians
- 90 Technical (50 RVT, 3 VTS)
- Emergency, ICU, Surgery

p.62

Why implement?
- Standardizing of CPR
- No ""Official"" protocol beforehand
- Doctor/Tech/Shift dependent differences
- Helplessness and frustration
- Evidence-based guideline
- Best current practice
-""Smooth"", simplified CPR
- Patient outcome

p.63

Challenges
-Large Scale Training
-24/7 hospital
-Financial investment
-Some pushback

p.64

Image

p.65

Image

p.66

Image

p.67

Image

p.68

The Result
Number
Average Age
Average Length
ROSC
Discharged
2013-2014
54
8.90yr
11min
13 (24.1%)
2 (3.7%)
2014-2015
28
7.46yr
12.7min
12 (42.9%)
2 (7.1%)
2015-2016
21
8.13yr
6.47min
6 (28.6%)
3 (14.3%)
Total
103
8.35yr
10.5min
31 (30.1%)
7 (6.8%)

p.69

Was it worth it?
- Survival to discharge still low
- ROSC higher
- Gained perspective on performance
- Performance prior unknown

p.70

Other Intangible Gains
- Bring order to the chaos
- Less frustration
- Sense of control
- Happier staff

p.71

"I feel like things are so organized. We have very smooth CPR attempts."
"I can’t remember how we used to do this before the new protocol. It feels so calm going through the compression cycles. "
"We still have our chaotic sessions, but I like how everyone knows what should be happening. The debriefing helps a lot."
"With the new protocol, we are doing the best job possible. Our patients get the best chance."

p.72

It was totally worth it.
Adobe Animal Hospital
- Better efficiency
- Large scale training
- Better communication
- EBVM awareness
- Better teamwork
- Higher morale
- Better outcome(?)

p.73

ABOUT
HOW CERTIFICATION WORKS
COURSES/EDUCATION
GUIDELINES
RESEARCH
CERTIFICATION RESOURCES
CRP PACKAGE
Basic and Advanced Life Support for Veterinarians
CRP: Basic Life Support Course
CRP: Advanced Life Support Course
www.recoverinitiative.org

p.74

Future Directions
- ACVECC approved certification
- BLS
- ALS
- Certification Training
- Collaborative data collection
- 2020 Guidelines
- Laymen training?

p.75

RECOVER
PET CERTIFIED RESCUER

p.76

Video of CPR being performed on a squirrel

p.77

Questions?
Saving one dog will not change the world,
but surely for that one dog,
the world will change forever.

Kenichiro Yagi, MS, RVT, VTS (ECC, SAIM)
Email: kenyagirvt@gmail.com