ZOMG! CPR in the ER

Garret Pachtinger, VMD, DACVECC, shared these urgent tips on how to stay calm during CPR-that's cardiopulmonary resuscitation (obviously)-at CVC San Diego: 

• Don't freak out! They're already dead, remember? So it really can't get much worse. Really. Can't. Get. Worse. 

• Use your jazz hands. The first rule is hands-first CPR. Try not to stop chest compressions to intubate your patient. It reduces the effectiveness of your CPR. Practice intubation in positions other than sternal recumbency, such as lateral recumbency, as many patients are in that position during CPR.

• Get high, and call in the cavalry. Jump up on the table with the patient. Or, if the stability of your table is questionable, perhaps just grab a stool for leverage. This avoids muscle fatigue: the higher you are, the less quickly you will tire out. Also try swapping out with other team members when you're feeling fatigued. No matter how many days a week you go to crossfit, effective chest compressions are tiring! The compressor should be switched every two minutes to prevent fatigue.

• Put some force into it-but don't fling your patient across the room! When performing chest compressions, the patient's spine should be against your legs so compressions won't push the patient off the table! Try to compress the chest width by one-third, or 33 percent. 

• Remember to breathe-but don't overdo it! The more breaths you give, the more you increase the intrathoracic pressure and the less effective your chest compressions are. Give 10 breaths per minute at 10 ml/kg tidal volume. 

• Embrace disco. It saves lives! Ah, ah, ah, ah, staying alive, staying alive … . The rate of your chest compressions should be in tune with the song, “Stayin' Alive” by the Bee Gees. Any more than that and you risk less effective compressions, because you're either not depressing the chest enough or not allowing time for full recoil of chest.

For more insights about what to do during a code blue, click here.

Hilal Dogan, BVSc, is an associate at At Home Animal Hospital in Maui, Hawaii. She started the Veterinary Confessionals Project as a senior veterinary student at Massey University in New Zealand.