9.1.4. Do Not Resuscitate Clauses

In high-volume veterinary settings, simplicity and consistency are critical. The most efficient clinics use a single, standardized approach for all patients. Adding individual steps—such as case-by-case CPR decisions—slows workflow, increases error risk, and can create legal exposure.

For example, asking staff to review custom CPR instructions for each patient takes extra time, increases the chance of missed details, and prevents bulk processing of consent forms. This creates friction for admin teams, technicians, client partners, and—most importantly—patient care.

Balancing Speed and Client Autonomy

It’s natural to want pet owners involved in every decision, but emergencies don’t allow for delays. When values conflict— speed vs. owner control —the best safeguard is a clear, standardized policy written directly into your consent forms. This empowers staff to act quickly and confidently.

Recommended consent language:

“In the unlikely event that your pet experiences cardiac or respiratory arrest while under anesthesia, our team will immediately begin CPR and continue for a reasonable amount of time. If there is no response, we will attempt to contact you to determine whether to continue efforts.”

This approach ensures:

• CPR is never delayed when it could save a life.
• Prolonged efforts without recovery are avoided.
• Owners are re-engaged for decisions at the appropriate time.

Not initiating CPR on a healthy animal in arrest is generally below the standard of care. At the same time, endless resuscitation attempts can cause suffering. That’s why internal guidelines are essential—e.g., defining how long to continue CPR before reassessment or contacting the owner.

Why a Standard CPR Protocol Matters

A default protocol ensures fast, effective action in emergencies. In practice, this typically means:

1. Start CPR immediately if an animal arrests under anesthesia.
2. Reassess after a set timeframe.
3. If no improvement, call the owner using the phone number on file.

Why collect a phone number on consent forms? This is how your team reaches the owner during time-sensitive decisions once CPR is underway.

Real-World Examples

• Kitten case: A kitten was found unconscious in their carrier before surgery. The team began CPR immediately. Fifteen minutes later, they reached the owner, who chose to stop.
• Puppy case: A puppy arrested right after induction. The team revived the pup, but it could not breathe without assistance. The owner was contacted and decided when to stop efforts.

In both cases, early CPR saved valuable time, and a clear policy allowed the decision-making responsibility to shift back to the owner when appropriate.

Bottom Line

To protect your team, clients, and patients:

• Use one standard CPR protocol.
• Train staff to follow it without hesitation.
• Involve the owner after initial CPR efforts—not before.
• Document your policy in the consent form.

Consistency reduces risk, speeds care, and ensures every patient is treated with the same high standard—especially when seconds count.