Background

IINDICATIONS FOR CARDIOPULMONARY RESUSCITATION

Cardiopulmonary resuscitation (CPR) is indicated during cardiopulmonary arrest (CPA) when the tactical situation and available resources allow. CPR is the most appropriate therapeutic intervention for CPA, though other interventions and additional resources may be required for patient and personnel safety depending on the cause.

CAUSES OF CPA & GOALS FOR CPR

CPA is the abrupt cessation of spontaneous and effective ventilation and circulation. Causes of CPA include natural death as well as unexpected death due to illness, injury or iatrogenic factors.

The goal of CPR is to preserve myocardial and cerebral perfusion while attempting to reestablish spontaneous circulation. CPR should follow a strict algorithm (Figure 1) to reduce variability and optimize successful outcomes.

Return to spontaneous circulation (ROSC) rates range from 35-58%.1 Survival to hospital discharge ranges from 5-7% in dogs (all causes of CPA), but dogs with no underlying disease factors are more likely to survive.2,3

DIAGNOSIS OF CPA

Declare CPA in any unresponsive and apneic MWD that is not under general anesthesia or deep sedation. Agonal breathing may ensue. Precordial and femoral pulses are absent.

During general anesthesia, when responsiveness cannot be assessed, use a non-perfusing (arrest) ECG rhythm to confirm diagnosis. Arrest rhythms include asystole, pulseless electrical activity (PEA), ventricular fibrillation, and pulseless ventricular tachycardia.

Figure 1. CPR Algorithm for Military Working Dogs.