Cardiopulmonary resuscitation (CPR) in a bird? While we have all heard about CPR for humans, and some of you may have actually taken a pet dog or cat CPR course, many bird owners are surprised that CPR can be performed on pet birds.
CPR can save a bird's life in the correct circumstances. CPR is much more likely to be effective if the bird has suffered from acute trauma, and conversely, it is unlikely to have a positive outcome if the bird is very debilitated and has been ill for a long period of time and the body finally gives out.
The basics of CPR are the same, whether dealing with a human, dog or bird. The three things that are evaluated before initiating CPR are: breathing, airway and pulse. When you come across an unconscious person, you get close to the person to listen and feel for breathing. You can use the old mirror trick by holding a small compact mirror up to the nose of a person to look for condensation on the surface.
You watch the chest for respirations and movement. Next, you open the mouth and look for any obstructions, and with a human (or dog) you can even sweep the mouth with your fingers to ensure that the airway is clear and nothing is blocking it.
To open the airway, the head is tilted back. Next, you feel for a pulse and listen for a heartbeat. You can even place your ear against the chest to listen for the heartbeat if no stethoscope is available.
If the patient is not breathing, and the airway is clear, rescue breathing is begun. If there is no respiration, the airway is clear and there is no pulse or heartbeat, then CPR is begun.
If a bird is found unconscious, the same parameters are evaluated: respiration (looking for the breast rising and falling, see if the abdomen is rising and falling, as well), airway (open the beak and examine the oral cavity, clear if necessary with a finger or cotton-tipped applicator, taking care to not have a finger bitten) and heartbeat (since it would be difficult to find and evaluate a pulse on a bird, listen to the chest on either side of the keel bone for heartbeat, or use a stethoscope, if available).
For those of you who need a brief anatomy lesson at this point, at the base of the tongue is the glottis, which is the opening of the airway. You may need to gently pull the tongue forward to visualize the opening of the windpipe. The heart is basically centrally located far beneath the breast muscles, and under the keel bone, almost midpoint along the length of the keelbone. There are nares (nostrils) at the base of the beak, either in the fleshy band called the cere or at the edge of the beak where feathers meet beak tissue.
Once you have evaluated the unconscious bird, check for respirations and clear the airway. Check for a heartbeat. If there is no breathing but the bird still has a heartbeat, begin rescue breathing. While holding the bird's head in one hand and supporting the body in the other, tilt the patient slightly away from you. With your head turned a quarter turn to the right or left, begin respirations. For small birds, you can seal your lips around the beak and nares, and for large birds, seal your lips around the beak only, while placing the index finger over the nares. Take a breath and blow five quick breaths into the bird's beak. The strength of each puff of breath should be determined by the size of the bird; for a little bird, just small puffs are needed, but for larger birds, you will need to use more force to breathe air into the lungs and airsacs. This takes practice and some skill, to learn how much force is necessary to adequately inflate the lungs.
Remember that birds breathe like a bellows, out and in, so look for a rising of the sternum with each breath. You can visualize this most easily where the sternum meets the abdomen. If the breast is not rising, then you are not getting enough air into the respiratory tract and you must recheck to ensure that the airway is open. If the breast is rising with each puff, then pause after five breaths and observe the bird to see if the bird has begun breathing on its own again. If it has not, then give two more puffs of breath and evaluate for breathing again. Don't forget to check periodically to ensure that the bird's heart is still beating. You will continue the two puffs, then checking to see if the bird is breathing and that the heart is still beating, either until the bird begins respiring on its own or until you can present the bird to your avian veterinarian or emergency clinic.
If there is no respiration, the airway is clear and there is no heartbeat, or if the bird's heart stops beating while performing rescue breathing, then you will begin CPR. You will continue providing puffs of breath into the beak and add chest compressions. Birds have a very rapid heart rate when compared to humans and dogs, so you will attempt to provide the bird with 40-60 compressions per minute, based on the size of the bird. Placing one to three fingers on the keelbone (depending on the size of the bird, one finger for budgies, three for macaws), begin applying finger pressure to the keel bone, depressing the keel, which will in turn, compress the heart, moving blood through the tissues. As with performing rescue breathing, the amount of pressure necessary to depress the sternum adequately can be adjusted, based on the depth of sternal compression.
The pattern will be five puffs of breath initially, followed by ten compressions, check the bird for heartbeat and breathing, then give two breaths, ten compressions, two breaths, ten more compressions, continuing in this manner for a minute. Have someone time this for you, if possible. At one minute, re-evaluate the bird for heartbeat and respiration. Continue providing CPR in this manner until the bird either recovers or is safely transferred to a veterinary clinic or emergency facility. If the bird begins breathing on its own it should be placed in a warm, quiet environment and you should then contact your avian veterinarian for instructions on what to do next.
If this column has piqued your interest, please investigate CPR classes in your area, or perhaps ask your avian veterinarian if he or she will teach a small class for interested bird owners. It is best if you can practice CPR on a human dummy, a dog dummy or even a stuffed bird before you ever need to perform this on a live patient. NEVER attempt to practice avian CPR on a live, healthy pet bird!!!
Once the bird has been delivered to the avian veterinarian, the bird will be re-evaluated and possibly intubated (meaning that a tube will be placed into the trachea or windpipe, or if necessary, an air sac breathing tube can be placed into an air sac, bypassing the windpipe, in certain situations). Once a breathing tube is in place, oxygen can be supplied to the bird via the tube. Certain medications can be administered to the bird either directly into the breathing tube or into a vein, if one is accessible, that can attempt to stimulate the heart, correct metabolic problems and stimulate breathing, as well. Your avian veterinarian will provide your best chance for stabilization and recovery.
Hopefully, you will never need to use CPR on a bird, but it is worth knowing.
Copyright © 2006 Margaret A. Wissman, D.V.M., D.A.B.V.P.
All Rights Reserved
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