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. 2022 Jul 14:9:919206.
doi: 10.3389/fvets.2022.919206. eCollection 2022.

Self-Reported Clinical Practice of Small Animal Cardiopulmonary Resuscitation and Compliance With RECOVER Guidelines Among Veterinarians in Eight Western European Regions

Simon P Hagley  1 , Anne Kruppert  2 , Rodolfo Oliveira Leal  3 , José Carlos Pizarro Del Valle  4 , Claudia Iannucci  5 , Imke Hennink  6 , Ludivine Boiron  7 , Sabrina N Hoehne  8
Affiliations

Self-Reported Clinical Practice of Small Animal Cardiopulmonary Resuscitation and Compliance With RECOVER Guidelines Among Veterinarians in Eight Western European Regions

Simon P Hagley et al. Front Vet Sci. .

Abstract

Introduction: The objective of this study was to assess whether small animal veterinarians across Western Europe are compliant with the 2012 cardiopulmonary resuscitation (CPR) guidelines by the Reassessment Campaign on Veterinary Resuscitation (RECOVER).

Methods: A previously published online questionnaire from Switzerland was adapted and translated into 7 languages, corresponding to national languages in Austria, France, Germany, Ireland, Italy, Liechtenstein, Netherlands, Portugal, Spain, and the United Kingdom. The survey was distributed via respective national veterinary organizations and social media outlets. A subset of questions was analyzed to evaluate respondent demographics, RECOVER guideline awareness, and to allocate composite compliance scores for CPR preparedness, basic life support (BLS) and advanced life support (ALS). Percentages of group total (95% confidence interval) were calculated. Multivariable logistic regression was used to evaluate the effects of region of practice, gender, age, specialty training, and guideline awareness on compliance. Odds ratios (95% confidence interval) were generated and significance set at P < 0.05.

Results: Nine-hundred and thirty respondents were included in analysis. Awareness of and compliance with RECOVER guidelines varied widely across regions. Compliance with all assessed RECOVER guideline recommendations was highest in Germany/Austria [14% (7- 27%)] and lowest in France and Portugal [0% (0-3%)]. CPR preparedness compliance was higher in participants aware of RECOVER guidelines [OR 10.1 (5.2-19.5)], those practicing in Germany/Austria [OR 4.1 (1.9-8.8)] or UK/Ireland [OR 2.2 (1.3-3.7)], and lower in those practicing in Portugal [OR 0.2 (0.1-0.9)]. Specialty training [OR 1.8 (1.1-2.9)], guideline awareness [OR 5.2 (3.2-8.6)], and practice in Germany/Austria [OR 3.1 (1.5-6.5)], UK/Ireland [OR 2.6 (1.7-4.1)], or the Netherlands [OR 5.3 (2.0-14.2)] were associated with increased BLS compliance. ALS compliance was higher in participants with guideline awareness [OR 7.0 (2.9-17.0)], specialty training [OR 6.8 (3.8-12.1)], those practicing in Germany/Austria [OR 3.5 (1.3-9.6)], UK/Ireland [OR 4.0 (1.9-8.3)], or Spain [OR 3.2 (1.2-8.3)] and in younger survey participants [OR 0.9 (0.9-1.0)].

Conclusions: Awareness and compliance with RECOVER guidelines varied widely among countries surveyed, however overall compliance scores in all countries were considered low. Further research may highlight factors surrounding poor guideline awareness and compliance so targeted efforts can be made to improve veterinary CPR in Europe.

Keywords: Europe; RECOVER; cardiopulmonary resuscitation; compliance; guidelines.

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Conflict of interest statement

SNH is a member of the RECOVER initiative research committee and served as an evidence evaluator for the RECOVER 2.0 guidelines. RECOVER is a not for profit organization and those services were provided on a volunteer basis. The author will not have any financial gain from increased distribution of CPR guidelines to small animal practitioners. SNH is a certified RECOVER CPR instructor and has led CPR certification workshops in exchange for an honorarium from course organizers such as the American College of Veterinary Emergency and Critical Care and the Veterinary Emergency and Critical Care Society. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram showing language of survey dissemination and number of survey respondents by European region, and reason for inclusion or exclusion in the final study. ESP, Spain; FRA, France; GER/AUS, Germany/Austria; ITA, Italy; LIECH, Liechtenstein; NLD, Netherlands; PRT, Portugal; SUI, Switzerland; UK/IE, England/Northern Ireland/Scotland/Wales/Ireland.
Figure 2
Figure 2
RECOVER guideline compliance and awareness of board-certified specialists or residency trainee respondents (n = 135) and respondents without residency training (n = 795) from 8 combined Western European regions. BLS, Basic Life Support; ALS, Advanced Life Support.
Figure 3
Figure 3
Percentage of respondents from 8 Western European regions incompliant with cardiopulmonary resuscitation (CPR) preparedness RECOVER guidelines and the associated factors for failed compliance. ESP, Spain; FRA, France; GER/AUS, Germany/Austria; ITA, Italy; NLD, Netherlands; PRT, Portugal; SUI, Switzerland; UK/IE, England/Northern Ireland/Scotland/Wales/Ireland.
Figure 4
Figure 4
Percentage of respondents from 8 Western European regions incompliant with basic life support RECOVER guidelines and the associated factors for failed compliance. ESP, Spain; FRA, France; GER/AUS, Germany/Austria; ITA, Italy; NLD, Netherlands; PRT, Portugal; SUI, Switzerland; UK/IE, England/Northern Ireland/Scotland/Wales/Ireland.
Figure 5
Figure 5
Percentage of respondents from 8 Western European regions incompliant with advanced life support RECOVER guidelines and the associated factors for failed compliance. ECG, Electrocardiogram; ESP, Spain; EtCO2, End-tidal carbon dioxide; FRA, France; GER/AUS, Germany/Austria; ITA, Italy; NaHCO3, sodium bicarbonate; NLD, Netherlands; PRT, Portugal; SUI, Switzerland; UK/IE, England/Northern Ireland/Scotland/Wales/Ireland; IV, Intravenous.
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