Cardio-pulmonary resuscitation (CPR) has been trending on the internet since the shocking scenes in the Denmark/Finland Euro 2020 match last week, when Danish footballer Christian Eriksen collapsed. In full view of global live television, CPR was carried out. This prompt and effective action saved his life. Now everyone is talking about CPR. I’ve even had owners asking me if they should know how to use this on their pets. So what’s the truth? Should this be a standard pet owner skill?
First, some background on what CPR really means. Essentially, it’s the physical treatment that’s given in an attempt to save the life of a person or animal who has suffered cardiopulmonary arrest (in other words, their heart has stopped beating and they have stopped breathing). The aim of CPR is to provide physical compression of the chest, along with ventilation of the lungs, to restart the heart, and stimulate sufficient blood flow and oxygen to the brain and other vital organs. The idea is to keep the patient alive until more advanced medical therapy can be given.
When the heart stops beating, repetitive physical pressure can nudge it to start beating again, while forced compression (then relaxation) of the lungs forces out air, then allows air in, mimicking breathing, removing carbon dioxide and introducing fresh oxygen. Without intervention, if the heart stops beating, a patient is only minutes away from irreversible brain injury.
Even in humans, the success rate of CPR is low. Although around 40% of patients are brought back from cardiac arrest, only 10 – 20% live long enough to be discharged from hospital. So while it’s well worth carrying out CPR, expectations need to be realistic. Eriksen was one of the lucky ones.
In pets, the bad news is that success rate is far lower again. Even when carried out as perfectly as possible, in a veterinary hospital environment, with experienced professional staff using optimal resuscitation equipment, only around 5% of pets survive. In other words, around 95% don’t make it. And in a non-hospital, public space, where there’s no experienced assistance, no oxygen, and no equipment, it’s likely that over 99% of cases don’t survive.
Why are these figures so poor compared to humans? First, it’s exceptionally rare for animals to suffer cardiac arrest from a heart attack, which is a common human issue. It’s far more likely that if a pet’s heart stops, it’s due to some other serious underlying illness. Pets are better at hiding illnesses than humans: they can’t complain about feeling odd, and they tend to just carry on until they can’t carry on any more because the disease is so advanced. So even if a collapsed pet is brought back from the brink, it’s very likely that they will still be a very sick pet with other issues going on.
So is it worth doing CPR for pets at all? As long as expectations are realistic, I believe that yes, there is a place for CPR. After all, miracles do happen, and even if only one in a thousand animals are saved, that is still one animal and they might mean a great deal to their owner. But it’s important to do the right type of intervention.
My simple starting tip is to remember the mnemonic ABC: Airway, Breathing, Circulation. If you encounter a collapsed pet, check your ABC.
open their mouth and look inside. Is there something causing a physical obstruction? I have seen dogs collapse after the ball they grabbed in a game has lodged at the back of the throat, obstructing their breathing. Food and fluids (such as vomit) can also act like this, and simple removal of the obstruction may be all that you need to do to save the animal’s life.
if the collapsed animal is still breathing, you can relax. Of course you still need to take the animal to the vet, but there is no point in carrying out CPR, as the basic heart and lung function is still happening.
look at the colour of the gums. They should be pink: a grey, purple or blue colour indicates oxygen deficiency due to circulation failure, and urgent action is needed. Also, feel for a heartbeat, simply by placing your hand on the chest (taking a pet’s pulse is not easy for the inexperienced). If you can feel a heart beat, chest compressions are not needed.
A prompt ABC assessment will save lives, as well as saving many animals from unnecessary CPR interventions.
So if the airway is clear, the breathing has stopped, and the circulation has failed, it’s time for CPR for the collapsed animal.
CPR has two aspects: rescue breathing and chest compressions.
Rescue breathing is performed by covering the pet’s nose with your mouth and forcefully blowing your breath into the lungs until you see the chest expand. Do ten breaths per minute if the heart is beating until spontaneous breathing recommences.
Chest compressions are needed if the heart has stopped: this means squeezing the chest, aiming to restart it. Use both hands around the chest in cats and small dogs, or both hands on one side of the chest in large dogs. Aim at 120 compressions per minute (2 per second). In this situation, you’d do a rescue breath every 30 seconds, in between the compressions (the compressions themselves will be forcing some air flow). Continue until the heart restarts.
So that’s the basics: and remember, whatever happens, rushing the animal to your local vet is essential. Professional help saved Eriksen, and it’s the most likely way to save the life of a collapsed pet.