The clinical practice of small animal CPR and compliance with RECOVER guidelines in Switzerland: an internet-based survey

Objective: In 2012, the Reassessment Campaign on Veterinary Resuscitation (RECOVER) published the first evidence-based small animal CPR guidelines. Even though a RECOVER-based CPR approach has been shown to improve patient outcomes, guideline awareness and compliance is necessary to see such benefits. Our study aimed to characterize Swiss small animal veterinary CPR practices and assess their compliance with RECOVER guidelines. Methods: A nationwide, internet-based survey was conducted, and invitations distributed via Swiss veterinary society mailing lists. Questions covered respondents' demographics, CPR preparedness, Basic Life Support (BLS) and Advanced Life Support (ALS) techniques, and awareness of RECOVER guidelines. Percentages of group total (95% confidence interval) were calculated. Results: One-hundred and fifty respondents were grouped by level of expertise into board-certified specialists (BCS, n = 19), veterinarians with additional post-graduate training (PGT, n = 27), and general practitioners with (GPE, n = 30), and without emergency duties (GPG, n = 74). Of BCS respondents, 58% (36-77%) were familiar with the RECOVER guidelines, compared to 8% (4-17%) of GPG. Large disparities in preparedness, BLS, and ALS techniques emerged among the levels of expertise. Incompliance with preparedness measures varied from 89% (69-98%) in BCS to 100% (95-100%) in GPG and was predominantly due to failure to attend regular CPR training. BLS compliance ranged from 26% (12-49%) in BCS to 5% (2-13%) in GPG, and incompliance was mostly characterized by targeting lower than recommended chest compression rates. ALS compliance varied from 21% (9-43%) in BCS to 0% (0-5%) in GPG and was compromised by limitations in the resuscitation environment such as lacking access to a defibrillator, monitoring equipment, and rescue drugs. Conclusion: Awareness of RECOVER guidelines in Switzerland is acceptable in specialists, but inadequate among general practitioners and CPR practices are largely not in agreement with RECOVER guidelines. An educational strategy is needed to improve Swiss small animal CPR knowledge and performance.