It’s very difficult to do compressions on a pug
Last night I went to an annual Christmas after-party at a close friend’s house. He’s graduating from vet school this year, so naturally our conversation turned to medicine. I was particularly interested in comparing the emergency care of animals and humans. Several things had plagued me on the windy drive up to his house.
Yes, they really did plague me. My nickname is “Nerd Alert” for a good reason.
“Hey D, you ever code a dog?”
“What do you mean?”
“Like…lethal cardiac arrhythmia, CPR, shock, intubate, epi, atropine, ya know?”
“Oh yeah. I wasn’t sure what you were asking because when an animal checks in we ask what code they are: DNR, CPR only, or Heroic CPR.”
“Heroic CPR? You have my attention…”
“Uh, that’s not what they actually call it. But basically we’re going to pull out all the stops – internal chest compression, everything you would do on a human, the whole 9 yards. Usually the animal is basically dead, so everything else is done for heroics.”
“Have you ever done CPR on a dog?”
“Yeah once on a pug in surgery. He was kind of round though, so he kept rolling as I was pushing and we’d have to stop and put him back in position.”
I whipped out my iPhone and show him my new favourite app. He is astonished that humans have all the same muscles. I ask him about anatomical differences between different animals.
“Meh, a mammal is pretty much a mammal. There’s really only some minor differences.”
Our conversation turns to interventions. IVs, IOs, intubation, ECGs – vets do it all too! Although, apparently IOs are pretty much reserved for birds. When a dog is intubated they’re placed prone with their chin on the table – which puts them in what we would call the sniffing position. From there it’s pretty much a straight shot down the trachea. Sometimes a laryngoscope with a large blade is used to manipulate the tongue, but about half the time it’s not necessary at all.
I forgot to ask about bag-valve-mask technique. Oh well, that will be good conversation at his graduation party.
We also talked about medication dosages. The meds are calculated the same as human ped doses. I told him about broslow tape and ped boxes. We may or may not have a million dollar idea in adapting broslow tape to veterinary medicine.
Luckily no one reads this blog, so our idea is safe.