RECOVER Guidelines: First Aid in Dogs and Cats. Evidence and Knowledge Gap Analysis With Treatment Recommendations

To systematically review the evidence on, to devise clinical recommendations for, and to identify critical knowledge gaps regarding the provision of first aid in dogs and cats.

Standardized, systematic evaluation of literature pertinent to first aid following Grading of Recommendations, Assessment, Development, and Evaluation methodology. Identified literature regarding prioritized questions in the Population-Intervention-Comparator-Outcome (PICO) format was reviewed independently by Evidence Evaluators, and findings were reconciled by Domain Chairs and Reassessment Campaign on Veterinary Resuscitation Co-Chairs to arrive at treatment recommendations commensurate with the quality of evidence and feasibility. This process was implemented using an evidence profile worksheet for each PICO question, including an introduction, consensus on science, treatment recommendations, justification of recommendations, and knowledge gaps. Treatment recommendations underwent a 4-week comment period among international veterinary stakeholders prior to finalization.

Transdisciplinary, international collaboration in university, specialty, emergency, and general practice.

Sixteen PICO questions pertaining to first aid were addressed in this project. We separated 10 general first aid scenario PICO questions from those pertaining to allergy and anaphylaxis, reported elsewhere. These main first aid PICO questions resulted in 38 treatment recommendations regarding a variety of conditions for which prehospital care may improve morbidity and mortality in dogs and cats. Many recommendations are supported by low or very low quality of evidence (15) or based on expert opinion (18).

Uncertainty remains regarding optimal ways for bystanders to recognize specific conditions and provide first aid in the prehospital setting to dogs and cats. However, through comprehensive evidence evaluation and a consensus process that included considerations of safety and feasibility, the resulting treatment recommendations lay the foundation for clear, actionable guidance in small animal first aid. Additionally, a list of high-priority knowledge gaps was identified to guide collaborative clinical research to overcome a significant deficit in veterinary literature.