Plus-Hex CLINICAL
Obtaining consent and shared decision-making
Discussions and related decision-making with a patient ' s owners must take place on admission, along with the signing of consent forms outlining what interventions the veterinary professionals are approved to carry out and to what extent the owners want to proceed in the event of an emergency. If a patient is assigned‘ do not resuscitate’( DNR) status, this should be made clear to all relevant staff within the hospital or practice and a DNR sign should be placed on their kennel( Figure 1).
Date: Patient name: Case number:
DNR DO NOT RESUSCITATE
Table 2. Types of roles for people involved in a crash / resuscitation event. CPR, cardiopulmonary resuscitation.
Role Scribe
Floater / runner
Rotation on CPR
Description
The person who records details about the event: when the intervention was started, the drugs administered, actions taken, people involved, clinical findings following actions taken, and so on
The team member who is guided on what drugs to draw up and what equipment may be needed and set up; follows instructions given by the lead for the help required
All the members involved who will rotate on completing cycles of compressions to avoid fatigue
Figure 1. An example of a simple DNR sign for a kennel.
Having informed consent and an acknowledged level of patient intervention provides the veterinary team with clear instructions for emergency assistance. It also reduces time spent obtaining authorisation during a time-sensitive event.
Lead
Debriefing
The veterinary professional guiding the CPR and instructing the team members on how to respond to the patient and the results of the interventions given
Training
The veterinary team should be equipped with the knowledge and tools to tackle various emergency scenarios, and be able to reflect on ways to react to many different events with diverse causative factors that could have led to a crash event. Leadership and team-building are increasingly being recognised as fundamental elements that impact on the team ' s experience and clinical outcomes [ 14 ].
Undertaking training can also allow individuals to feel more confident in their abilities and make everyone feel valued within the team, including veterinary care assistants, student veterinary nurses, interns, clinicians and any other attending staff. Practise and education are both key in relation to CPR events; each individual can adopt a role and understand its importance( Table 2). Planning these in-house CPD events not only provides clarity for all individuals on their specific roles but also increases confidence, enhances their skill set, develops knowledge within the team through constructive feedback and improves psychological safety through open and honest discussions.
As highlighted earlier, debriefing plays an important role in psychological safety, and can also help to improve future patient outcomes [ 14 ]. Following an emergency event involving CPR intervention or a case resulting in an unfavourable or negative outcome, it is recommended that the team takes 5 – 10 minutes to reflect and discuss what happened. This can help to outline the strengths of the team, along with identifying areas for improvement.
During this reflection( debriefing) period, it is important that a no-blame approach is used. A study by Gilmartin et al. [ 15 ] highlighted that 90 % of staff felt that debriefing helped with their mental wellbeing. During an already traumatic and emotional time, team members should feel supported and comfortable with openly sharing their thoughts during the discussion period.
Debriefing can also act as a great tool for highlighting whether further investigation is required with the practice management or change is needed to avoid‘ near misses’ of incidents that could be logged on the VetSafe confidential incident-reporting system.
Volume 41( 5) • October 2026
25