What is the RECOVER Initiative?
RECOVER (Reassessment Campaign on Veterinary Resuscitation), is the first and only evidence-based veterinary CPR guideline in the industry. Created in 2012 through the collaboration of over 100 veterinary criticalists from around the world, RECOVER has played a crucial role in improving CPR performance and outcomes since it was started.
In human medicine, prior to the development of evidence-based CPR guidelines, their CPA outcomes were close to what the veterinary field has historically been. This yielded less than a 10% chance of survival to discharge. With the implementation of evidence-based guidelines, they have improved CPA (cardiopulmonary arrest) outcomes to over 20% survival to discharge.
With that in mind, the goal of the RECOVER initiative is the same. By globalizing these guidelines and increasing the training of veterinary professionals, we hope that we will begin to see a similar improvement in our CPA patient outcomes as it becomes common practice.
How Can Your Hospital Benefit from being RECOVER Certified?
On average, a busy ER and ICU in a veterinary hospital will experience an average of 3-5 CPA events in a single week, sometimes more. When untrained, many experience a feeling of panic and chaos often ensues. During this time it is common for people to “scramble” to gather supplies, get help, and work to save the patient from the grips of the impending irreversible death.
But what if I told you that it didn’t have to be this way?
What if I told you CPR can be not only be organized and less stressful, but also coordinated and less futile? RECOVER focuses on an algorithm that was created using evidence-based information.
increased rate of survival to discharge
In human medicine, before evidence-based CPR guidelines were created, the successful outcome of CPA cases was near where veterinary medicine currently stands: only a 10% survival rate. Since then, they have increased the rate of survival to discharge to an average of 32%. This outcome set the veterinary profession on the path to follow by example and create our own set of guidelines with the intent of improving our CPA outcomes as well. Because successful CPA outcomes are defined as “survival to discharge” and the immediate increase of ROSC in these cases is seen (70%), the percentage of survival only depicts the patients who were successfully discharged from the hospital.
In the veterinary profession, the results can be more complicated. This is due to a combination of variables related not only to the nature of why our patients can experience CPA, but also the financial implications for the owner, and the option of euthanasia. Therefore, our survival rates may not reach that of human medicine. But we are seeing a significant increase in achieving ROSC which is sometimes just as valuable for the owner.
focuses on “preparedness & prevention” through education and training
With this training, we dive into a deeper understanding of effective and efficient basic life support, advanced life support, effective monitoring, and post-resuscitation care. Because of this, when properly trained and educated, staff members quickly become more efficient. They know exactly what to do and how to do it efficiently.
With this knowledge and coordinated effort, rescuers can work as a team. We can improve effective communication through “closed-loop communication.” And we can reduce the stress of the situation by following a simple algorithm readily available within view as a visual aid when needed. RECOVER promotes the idea of teamwork by constantly supporting each other with feedback aimed at helping the patient survive.
As An Instructor, I’m Often Asked “Why bother becoming certified when the chances of sending the patient home are still not very high?”
For me, I have a few reasons for this. As previously mentioned, since becoming certified, CPR is no longer a stressful event for me. I know exactly what needs to be done and how to direct others in order to give our patients the best possible chance of surviving.
RECOVER in Action: Hemoabdomen
With that said, another reason comes to mind. When I was working at a previous hospital, after becoming RECOVER certified, I quickly found myself leading a CPA case that had experienced CPA on its way into the building; the patient had a hemoabdomen. I began to lead the CPR and had begun training others already on what I had learned. Everyone fell right into place, they all began working with me and performing CPR on this patient. Not only was everyone calm, everyone was effective and efficient and we were able to revive the patient.
The owner was informed that the pet had been revived, but had a large mass in the abdomen and would need surgery. They were devastated but felt that it was unfair to put him through the surgery given the likelihood of it being cancer and the possibility of it spreading. They came back to say their goodbyes and the patient, a black lab, began wagging his tail and licking them in the face. The family thanked us all repeatedly and said “if you hadn’t revived him, we would not have gotten to say goodbye to him, our last memory of him would have been awful, thank you so much for giving us the chance to say goodbye”.
To me, this moment made every bit of training and hard work I had done to become an instructor more than worthwhile. This is a moment many of us in the emergency field live for.
For me this is my “why”.
RECOVER Initiative Has Landed in Hawaii
Veterinary Emergency and Referral Center of Hawaii (VERC) was recently able to bring the RECOVER initiative to the state of Hawaii. This has been made possible thanks to the co-instruction of our Ethos Technician Clinical Educator Patty Pate and myself, who are both RECOVER certified instructors and Veterinary Technician Specialists in Emergency and Critical Care (VTS-ECC). Over 3 days of training, we were able to certify 26 members of the veterinary staff at VERC, including DVMs, technicians, and assistants.
Having this training had an immediate impact on the trained staff members who performed CPR on several patients. It has not only reduced stress on the participants performing CPR, but has already improved the success of the return of spontaneous circulation (ROSC) in patients experiencing CPA. The training class was also an amazing team-building experience and helped improve communication and teamwork for everyone who participated.
To learn more about the RECOVER initiative and to see how you and your team can become trained and certified in evidence-based veterinary CPR, please visit: www.RECOVERinitiative.org.
Written by: Heather Ann Scott RVT, LVT, VTSECC | Technician Learning and Development Specialist