CPCR

Question 1

What are the 5 domains of the RECOVER guidelines?

Answer 1

Preparedness and prevention
Basic life support
Advanced life support
Monitoring
Post-cardiac arrest

Question 2

What does CPCR stand for?

Answer 2

CPCR = cardiopulmonary cerebral resuscitation

Question 3

How do we identify cardiopulmonary arrest in animals?

Answer 3

CPCR should be initiated if patient is unresponsive, apnoeic

During anaesthesia, CPCR should be initiated if you lose pulses/apex beat, apnoea

Question 4

What basic life support can we provide during CPCR?

Answer 4

Rapid recognition of CPA and rapid initiation of CPR
Immediate initiation of chest compression with intubation / ventilation simultaneously
Ventilation rate of 10 breaths/min
Chest compression 1/3rd-1/2 chest width in lateral recumbency, rate of at least 100 compressions/min
2-min cycles of chest compressions with alternation of compressors

Question 5

What roles should we establish between CPCR?

Answer 5

Lead
2 x cardiac compressors
Ventilation
Write/note-keeper
The runner

Question 6

List some top tips for cardiac compression.

Answer 6

Initiate immediately
Rate ~100bpm, allow full recoil of heart
Compress 1/3 to 1/2 of chest wall
Swap after 2 min cycles
Position patient back to your front, non-slip surface
Use a step, extend elbows
Large dogs = both hands, small dogs/cats = thumbs and forefingers

Question 7

List some top tips for ventilation during CPCR.

Answer 7

Gain airway security, i.e. ET tube
Use breathing system with oxygen or ambu-bag
Aim for 10 breaths/min (1 every 6 seconds)
Use capnography

Question 8

What else should we consider during CPCR?

Answer 8

Drug therapy
Monitoring
Recording
Additional care
IV catheters

Question 9

What should we do if a patient crashes during anaesthesia?

Answer 9

Call for help, notify surgeon
Note time
Start cardiac compressions
Ask someone to continue manual ventilation
Stop anaesthetic drugs
Consider adrenaline/drug therapy admin as per VS direction

Question 10

What should be included in the debrief after CPCR?

Answer 10

Staff can feel guilt/can blame others
Talk it through
What went well?
What could have gone better?
Does anyone need additional support?
Restocking/new equipment