CPR without intubation: mouth-to-snout ventilation 30:2
15 kg crossbred dog that arrests in the waiting room. You are alone with a nurse and the intubation equipment is not yet ready.
How should you combine compressions and breaths until you can intubate?
chevron_right Show answer and explanation
A. Compressions only, without ventilation, until the equipment arrives
Compression-only CPR is an option if ventilation is impossible, but many arrests in dogs and cats are asphyxial and mouth-to-snout ventilation is recommended if possible.
B. Cycles of 30 compressions followed by 2 brief mouth-to-snout breaths, with the mouth closed and the neck extended
Correct. Without a secured airway, breaths cannot coincide with compressions: RECOVER recommends a 30:2 ratio, blowing into the nostrils with the mouth closed and the neck extended.
C. Mouth-to-snout breaths simultaneous with compressions, at 10 per minute
Without intubation, blowing during a compression is ineffective and increases air entry into the stomach. Simultaneous ventilation is only for intubated patients.
D. 15 compressions and 2 breaths, as in two-rescuer paediatric CPR
This is the human two-rescuer paediatric protocol; in veterinary medicine RECOVER recommends 30:2 to maximise compression time.
lightbulb Key takeaway
Non-intubated patient: 30 compressions and 2 mouth-to-snout breaths, in 2-minute cycles. As soon as it is intubated (without stopping compressions to do so), switch to continuous compressions with 10 simultaneous breaths per minute.
References: RECOVER clinical guidelines for veterinary CPR (2012)
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.