CPR & Placing an airway

Year 1 - Normal Animal

assessing a patient

1. Call for help

2. Shake and shout patient

3. Assess breathing - watch for rise and fall of chest

4. Primary survey - check pulse by placing fingers inside thigh to palpate femoral artery (don't use thumb as it has its own pulse) or metatarsal pulse at top of thigh

5. Check airway - firmly hold muzzle and tongue and move mandible down to check airway for obstructions

6. Start chest compressions

dog CPR procedure

1. place hands on top of each other with straight elbows and compress chest 1/3 of the way down

2. perform 30 compressions and allow full recoil of chest between compressions without losing contact with patient

3. perform 2 ventilations via ventilation or mouth-to-snout

CPR on a round chested dog

position yourself at the dorsal aspect of patient in lateral recumbency, compress widest portion of chest

CPR of a barrel chested dog

position yourself at side of patient in dorsal recumbency and perform compressions on front of chest

technique to place an ET tube

1. Open mouth of patient

2. Displace soft palate dorsally and epiglottis ventrally

3. Slide tube in between vocal folds

4. Inflate cuff if necessary to ensure appropriate fit

5. Tie ET tube over patient's snout if large dog and behind ears for a cat or brachycephalic dog

cardiac pump theory

cardiac ventricles are directly compressed which increases pressure in the ventricles, forcing blood out of the heart to the lungs and tissues and between compressions the ventricles relax to allow blood to return to the heart

thoracic pump theory

chest compressions increase intrathoracic pressure which forces blood out of the thorax, the elastic recoil of the chest between compressions leads to reduced intrathoracic pressure and draws blood back into the thorax and lungs from the periphery

What is A?

murphy eye

What is B?

cuff

What is C?

pilot balloon and valve

What is D?

inflating tube

What is E?

connector

what size ET tube is typically used for a medium sized dog?

7.0-8.0

What size ET tube is typically used for a cat?

4.0

how to prepare an ET tube

1. select appropriate size tube

2. tie a bandage around the tube

3. ensure the cuff is deflated, empty by connecting an empty syringe to pilot baloon and pulling air out

which pump theory is used in round chested dogs?

thoracic

which pump theory is used in narrow chested dogs?

cardiac

which pump theory is used in barrel chested dogs?

cardiac

which pump theory is used in small dogs and cats?

cardiac

How long should assessment of the unconscious patient take?

10-15 seconds

What causes an animal to need CPR?

respiratory arrest, cardiac arrest, patient is close to death

How should the patient be positioned to ensure the airway is open?

snout aligned with spine

What is the aim of CPR?

to achieve the return of spontaneous circulation

What are the 2 main components of CPR?

chest compressions and ventilation

What are the different ways to perform ventilation on a patient?

ET tube intubation followed by intermittent positive pressure ventilation or blowing down the tube or mouth-to-snouth ventilation

What rate should chest compressions be performed at?

100-120 bpm

What rate should intubated patients be ventilated at?

10 breaths per minute with an inspiratory time of 1 second