RECOVER’s 2024 CPR updates reshape small animal code response

Veterinary teams are getting a clearer, more evidence-based CPR playbook. The 2024 RECOVER guidelines, the first major revision since 2012, updated how clinicians should approach cardiopulmonary resuscitation in dogs and cats, and Clinician’s Brief’s discussion with University of Florida criticalist Dr. Jake Wolf highlights seven practice-facing changes most likely to affect the code cart. Among the biggest shifts: modified compression depth and positioning for wide-chested patients, more specific compression techniques for small dogs and cats, a higher ETCO2 target during CPR, new guidance for nonintubated ventilation, removal of high-dose epinephrine, and revised recommendations for defibrillation, vasopressors, and antiarrhythmics in shockable rhythms. The RECOVER initiative says the 2024 recommendations were built through a GRADE-based review process and published in June 2024, with input from more than 200 veterinary professionals across multiple domains. (recoverinitiative.org)

Why it matters: For veterinary professionals, the update is less about novelty than execution. CPR success in small animal practice still depends on speed, choreography, and consistency, but the revised guidance gives teams more precise targets during a code, including aiming for ETCO2 of at least 18 mm Hg, using 25% compression depth for wide-chested animals in dorsal recumbency, and prioritizing vasopressin over epinephrine for refractory shockable rhythms when available. Education remains a practical issue: prior survey data found awareness of RECOVER guidelines was associated with better compliance with preparedness, BLS, and ALS recommendations, underscoring why protocol refreshes, mock codes, and team training matter if clinics want the new guidance to change outcomes rather than sit on a shelf. (todaysveterinarynurse.com)

What to watch: Expect more hospitals to update CPR algorithms, crash carts, and staff training around the 2024 RECOVER materials as CE content and implementation tools continue to spread. (recoverinitiative.org)