I feel a little uncomfortable with this recommendation as there may be some degree of "practicing veterinary medicine" with according to some state and their veterinary laws. I think that it would be defendable in that it is an emergency situation, but the administration of drugs to a patient may be frowned upon unless it is ordered by a DVM. With that being said, there is no evidence that physicians do a better job anyway so I am not sure outcome would change anyway.
Post by Manu Boller on Sept 7, 2011 8:58:44 GMT -5
Good point Jimmy. I think we wrote the recommendation mostly upon the evidence and did not consider the legal ramifications. Maybe we should add a statement that state law needs to be considered? What do others think?
Legally the patient must be under the care of a veterinarian. As long as this is fulfilled, there can be pre-set CPR protocols, approved by the veterinarian. An order can be listed (advanced directive) to either perform CPR or DNR. In this case, veterinary technicians initiating a CPR (or not) are simply fulfilling a veterinarian's order, following a pre-set algorithm. This is similar to listing an order to adjust fluid therapy based on urine output and serum electrolyte results; the veterinary technician takes objective data and follows an algorithm approved by the veterinarian to adjust therapy. Ultimately, it is the veterinarian who is giving the order to change therapy, or conduct CPR. This of course will depend on the skill level of the technicians, which will vary clinic to clinic. Individual clinics will need to decide if technicians can perform these types of tasks. I don't believe there is a legal issue, as long as the veterinarian is giving the CPR order either in person or via protocol.
I think this statement requires some re-wording. Perhaps something to the effect of: "Veterinarians or trained technicians can be considered as leaders of a CPR team." Is there a definition as to what a "leader" is responsible for? Could the "leader" be defined as a veterinarian or technician who has received formal training?
Is this something that is defined in the human guidelines? I wonder if this is not something we should include in our guidelines, but rather leave it to the discretion of each veterinary clinic and veterinarian who is primarily responsible for the patient.