Andersen LW, Holmberg MJ, Berg KM, Donnino MW, Granfeldt A In-hospital cardiac arrest: a review. JAMA. 2019; 321:(12)1200-1210

Armstrong P, Peckler B, Pilkinton-Ching J, McQuade D, Rogan A Effect of simulation training on nurse leadership in a shared leadership model for cardiopulmonary resuscitation in the emergency department. Emerg Med Australas. 2021; 33:(2)255-261

Boller M, Kellett-Gregory L, Shofer FS, Rishniw M The clinical practice of CPCR in small animals: an internet-based survey. J Vet Emerg Crit Care (San Antonio). 2010; 20:(6)558-570

Cooper S, Wakelam A Leadership of resuscitation teams: “Lighthouse Leadership’. Resuscitation. 1999; 42:(1)27-45

Dazio VER, Gay JM, Hoehne SN Cardiopulmonary resuscitation outcomes of dogs and cats at a veterinary teaching hospital before and after publication of the RECOVER guidelines. J Small Anim Pract. 2023; 64:(4)270-279

Fernandez Castelao E, Boos M, Ringer C, Eich C, Russo SG Effect of CRM team leader training on team performance and leadership behavior in simulated cardiac arrest scenarios: a prospective, randomized, controlled study. BMC Med Educ. 2015; 15

Fletcher DJ, Boller M, Brainard BM RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 7: Clinical guidelines. J Vet Emerg Crit Care (San Antonio). 2012; 22:(Suppl 1)S102-S131

Ford K, Menchine M, Burner E Leadership and teamwork in trauma and resuscitation. West J Emerg Med. 2016; 17:(5)549-556

Fore AM, Sculli GL A concept analysis of situational awareness in nursing. J Adv Nurs. 2013; 69:(12)2613-2621

Gabr AK The importance of nontechnical skills in leading cardiopulmonary resuscitation teams. J R Coll Physicians Edinb. 2019; 49:(2)112-116

Härgestam M, Lindkvist M, Brulin C, Jacobsson M, Hultin M Communication in interdisciplinary teams: exploring closed-loop communication during in situ trauma team training. BMJ Open. 2013; 3:(10)

Haskey E CPCR: basic life support. The Veterinary Nurse. 2016; 7:(3)170-173

Hoehne SN, Balakrishnan A, Silverstein DC Reassessment campaign on veterinary resuscitation (RECOVER) initiative small animal CPR registry report 2016–2021. J Vet Emerg Crit Care (San Antonio). 2023; 33:(2)143-155

Hunziker S, Tschan F, Semmer NK, Howell MD, Marsch S Human factors in resuscitation: Lessons learned from simulator studies. J Emerg Trauma Shock. 2010; 3:(4)389-394

Jones C How debriefing post cardiopulmonary arrest and resuscitation can be used to improve training. The Veterinary Nurse. 2021; 12:(5)211-214

Kinnison T, Lumbis R, Orpet H, Welsh P, Gregory S, Baillie S Piloting interprofessional education interventions with veterinary and veterinary nursing students. J Vet Med Educ. 2011; 38:(3)311-318

Manthous CA, Hollingshead AB Team science and critical care. Am J Respir Crit Care Med. 2011; 184:(1)17-25

McCulloch P, Mishra A, Handa A, Dale T, Hirst G, Catchpole K The effects of aviation-style non-technical skills training on technical performance and outcome in the operating theatre. Qual Saf Health Care. 2009; 18:(2)109-115

McIntyre RL, Hopper K, Epstein SE Assessment of cardiopulmonary resuscitation in 121 dogs and 30 cats at a university teaching hospital (2009-2012). J Vet Emerg Crit Care (San Antonio). 2014; 24:(6)693-704

McMichael M, Herring J, Fletcher DJ, Boller M RECOVER evidence and knowledge gap analysis on veterinary CPR. Part 2: Preparedness and prevention. J Vet Emerg Crit Care (San Antonio). 2012; 22:(Suppl 1)S13-S25

Oxtoby C, Ferguson E, White K, Mossop L We need to talk about error: causes and types of error in veterinary practice. Vet Rec. 2015; 177:(17)

Rajeswaran L, Cox M, Moeng S, Tsima BM Assessment of nurses' cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana. Afr J Prim Health Care Fam Med. 2018; 10:(1)e1-e6

Timothy CL, Brown AJ, Thomas EK Implementation of a postarrest debriefing tool in a veterinary university hospital. J Vet Emerg Crit Care (San Antonio). 2021; 31:(6)718-726

Wolfe H, Zebuhr C, Topjian AA Interdisciplinary ICU cardiac arrest debriefing improves survival outcomes. Crit Care Med. 2014; 42:(7)1688-1695

The importance of the team in small animal CPR

02 April 2024
9 mins read
Volume 15 · Issue 3


This review draws on evidence from human medicine to assess the team factors most relevant to small animal cardiopulmonary resuscitation (CPR). It is increasingly being recognised that leadership, team building, communication and situational awareness all impact both the team's experience and clinical outcomes. Leadership training, nurse-led teams, debriefing, closed-loop communication and cognitive aids have all been shown to improve CPR performance and thus deserve consideration alongside the practical elements of arrest and resuscitation. There is limited primary evidence to support this claim in veterinary medicine. However, the mental models underpinning clinical human factors are largely seen as transferable, with veterinary governing bodies supporting their inclusion in practice culture and training.

Cardiopulmonary arrest results in death without immediate intervention (Hoehne et al, 2023). Cardiopulmonary resuscitation (CPR) promotes a return of spontaneous circulation for the patient (Dazio et al, 2023). It has been shown that survival to discharge in small animals is approximately 5% (McIntyre et al, 2014). In contrast, human hospitals are believed to discharge around 25% of patients following in-hospital cardiac arrest (Andersen et al, 2019). The reasons for this difference are multifaceted; however, it may be sensible to look to the human medical field when suggesting improvements to current CPR training. CPR human factors are an emergent focus in human CPR, and include leadership, psychological safety, situational awareness, debriefing and communication. It is believed that if these principles are examined within the veterinary field, small animal CPR can improve both in patient outcomes and team experience.

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.