Chest compression techniques for small dogs and cats.
(A) For most cats and small dogs (<10 kg) with compliant chests, the use of a 1-handed technique to accomplish circumferential chest compressions with the hand wrapped around the sternum directly over the heart may be considered.
(B) An alternative chest compression method for cats and small dogs is the 2-handed technique directly over the heart to employ the cardiac pump mechanism. This method may be considered in larger cats and small dogs with lower thoracic compliance, or in situations in which the compressor is becoming fatigued while doing 1-handed compressions.
There is strong evidence, including an experimental study in dogs documenting increased rates of ROSC and 24-hour survival, supporting a recommendation for compression rates of 100–120/min in cats and dogs (I-A).[36] However, there is also some evidence that higher compression rates of up to 150/min may be even more advantageous, and further work in this area is needed.
There is also good evidence to support deep chest compressions of 1/3–1/2 the width of the thorax in most patients (IIa-A), with an experimental canine study showing a linear relationship between compression depth and mean arterial pressure, and multiple human clinical trials and experimental animal studies supporting these compression depths.[37-39] Finally, experimental studies in pigs have documented reduced coronary and cerebral perfusion when full elastic recoil between chest compressions is not permitted (ie, leaning).
Observational studies in people have shown a high prevalence of leaning during CPR. It is recommended that full chest wall recoil is allowed between compressions.