Ask The Vet: First Aid and Resuscitation

As in human health care, first responders for pets can do much good, or much harm.  While there are many situations where quick, thoughtful care by the pet owner or first responder will make a big difference, in most cases expeditious transport to the nearest source of veterinary emergency care will yield best outcome.

When in doubt, call and head towards your nearest emergency care provider, such as Exceptional Care for Animals (if you are in Dane County, Wisconsin)

So, what is First Aid?  What is resuscitation?  What can I do?

First Aid includes recognizing choking and other immediate life threatening problems, stopping bleeding, cooling an overheated pet, protecting fractures from further injury, and the like.  There are courses designed for pet owners and pet professionals that address many common problems. 

One such course is sponsored by our business and will be presented once monthly starting again in April.  Call  (877) 276-7184 for more information or to reserve a spot.  Classes are from 2-5 PM on April 24, May 15, June 19, July 10, August 7, Sept 4 and Oct 16.

Resuscitation is the act of reversing collapse, shock and cardiac arrest.   This is, for all intents and purposes, performed by trained emergency room veterinarians.  It involves protecting the airway, restoring circulation and mitigating damage.  It is an intense effort, followed by intense supportive after care.

The romantic idea that a bystander or owner can pump on a patient’s chest and breath down the nose or mouth and effectively resuscitate is not realistic.  If the pet is not apparently breathing, compress the chest rapidly (to circulate blood) and intermittently expel your breath into mouth or nose, while transporting him or her to the ER.

Who should be resuscitated?

Not everybody.  In some cases, the injuries are so severe that there is no hope for functional recovery or the economics are such that it is impractical.  If a patient has pre-existing age related disease, such as cancer or chronic renal failure, it may not be appropriate to resuscitate.  If they have been gradually deteriorating and now are dying, it is unlikely all of that can be reversed with the act of resuscitation. The intense efforts of CPCR are the exact opposite of the peaceful sleepy passing that one may have wished for their beloved pet.

On the other hand, very young animals with injuries and no known pre-existing problems, certain poisoning situations, and when there is a known and reversible problem (twisted stomach, foreign body obstruction, etc) it can make all the sense in the world to apply effort to the resuscitation.

What is CPR and what is CPCR?

CPR is cardiopulmonary resuscitation.  CPCR is more appropriate and stands for cardiopulmonary cerebral resuscitation.  The point is, if you fail to resuscitate the brain (cerebrum) you only achieve a living vegetative state.  CPR as taught to thousands of people over the years, emphasizes breathing but resulted in many alive patients with brain injury from lack of oxygen to the brain.  For this reason, recommendations have changed and focus much more on emphasizing circulation.  Pumping the chest is a means to improve circulation to the brain, protecting it.  Pumping the chest (the so called thoracic pump) moves blood up the one way valve controlled circulation to deliver oxygen to the brain and remove metabolic wastes.  In very small patients, such as cats, the pumping of the chest actually physically compresses the heart, the so called heart pump theory.  Either way, it is about moving the blood more than anything.  In dogs and cats, it is quite easy, with medications, to stimulate heart contractions and breathing.  To establish or maintain effective circulation absolutely requires intravenous fluid therapy, which can only be done in a hospital setting or by trained EMTs.  If circulation is not emphasized and supported, the result is a brain injured patient;  not quite a success. 

Common Emergencies are detailed elsewhere on this site.