The Fundamentals of Basic and Advanced Life Support in Veterinary Care

Ensuring high-quality resuscitation in veterinary medicine is crucial for increasing the likelihood of return of spontaneous circulation (ROSC). The latest guidelines on Basic Life Support (BLS) and Advanced Life Support (ALS) highlight key interventions that can enhance survival in animals experiencing cardiopulmonary arrest (CPA).

Basic Life Support: Immediate Response to CPA

BLS encompasses four primary actions:

1. Recognition of CPA – If an animal is unresponsive and not breathing, CPR should begin immediately without delaying for pulse palpation or ECG confirmation.

2. Chest Compressions – Compressions should be initiated in lateral recumbency at a rate of 100–120 per minute, ensuring proper depth (about half the chest width) and allowing full recoil between compressions.

3. Ventilation & Airway Management – Simultaneous ventilation should be provided using a cuffed endotracheal tube, with a rate of 10 breaths per minute.

4. Compression Techniques for Different Breeds – Larger dogs benefit from thoracic pump theory-based compressions, while smaller dogs and cats respond better to cardiac pump theory-based compressions. Barrel-chested breeds may require sternal compressions.

Advanced Life Support: Enhancing Resuscitation Outcomes

ALS involves additional interventions beyond BLS, including:

• Vasopressor Therapy – Epinephrine is the primary vasopressor, administered every other cycle to increase vascular resistance and improve coronary blood flow. Vasopressin is an alternative option with mixed evidence supporting its effectiveness.

• Vagolytic Therapy – Atropine may be used for CPA cases related to vagal tone but has limited high-quality data supporting its routine use.

• Electrical Cardioversion – Defibrillation is recommended for animals experiencing ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT). The use of biphasic defibrillators and single-shock therapy helps improve resuscitation rates.

• Additional ALS Therapies – Some medications such as naloxone are recommended for opioid toxicity cases, while IV fluids, corticosteroids, and calcium are not routinely advised.

Optimizing CPR Success in Veterinary Patients

Timely and effective execution of BLS and ALS increases the likelihood of ROSC in veterinary patients. Providing uninterrupted chest compressions, delivering proper ventilation, and employing appropriate medications and defibrillation strategies are key components of resuscitation success. As research continues to evolve, adhering to established guidelines ensures the best possible outcomes for animals experiencing CPA.

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