43
The Humane Society of the United States Euthanasia Reference Manual
Performing a Cardiac
Stick (‘Heart Stick’)
A cardiac stick involves the insertion of a needle
and syringe directly into the heart of the fully
unconscious animal (IMPORTANT NOTE: A
needle must never be inserted into the heart of
a conscious animal—the euthanasia technician
must be certain that the animal has no blink
or toe-pinch reflexes before the cardiac stick is
performed). Once the needle has pierced the
heart muscle, any movement of that muscle
will be transferred to the syringe, which will
then mimic the heartbeat extremely accurately.
Imagine that the animal’s heart is the base
weight of a metronome, and the syringe is
the metronome’s pendulum—when the heart
muscle moves the base of the metronome, the
syringe protruding from the base will swing
in response. If the syringe reflects zero move-
ment (assuming it was properly placed in the
heart muscle), it can be definitively determined
that the heart has ceased beating, and death
can be confirmed.
It is important to note that every movement
of the syringe does not necessarily mean the
animal is actually alive; an experienced eutha-
nasia technician can tell the dierence between
movement that indicates a true heartbeat,
meaning the heart is still circulating blood
through the body, and mere fibrillation. If
the syringe is moving in a circular fashion, the
heart is beating and circulating blood, and
the animal is still technically alive; in this case,
either the technician should wait a few minutes
longer to allow the drug additional time to
take eect or administer additional sodium
pentobarbital to the animal to facilitate death.
If, on the other hand, the needle is moving in
a side to side fashion (like a true metronome),
the heart muscle is simply fibrillating, twitching
or spasming aimlessly, and is not circulating
blood. In this case, the animal is technically
dead; nevertheless, the euthanasia technician
should wait until the fibrillation has ceased and
the syringe is still before declaring the animal
dead. (IMPORTANT NOTE: Injecting more drug
into a heart that is fibrillating does not have
any eect, as the heart is no longer capable of
pumping that drug to the brain—the technician
should just wait as long as necessary for the
heart to become still).
To perform a cardiac stick, one uses essentially
the same technique as for giving an IC injec-
tion (see Chapter 2), except that the syringe
attached to the needle is empty. Unlike IC injec-
tion, however, the needle need not be inserted
into a chamber of the heart; any portion of the
heart muscle will do. As long as some blood is
drawn into the syringe upon aspiration, either a
small flash or a large surge, the needle is prop-
erly placed in the heart for purposes of a cardiac
stick. If the animal is particularly obese or has a
broad, barrel chest, switching to a longer nee-
dle may be required. Conversely, if the animal is
tiny, the technician will want to use the smallest
needle available; in fact, it may be necessary to
remove the syringe from the needle once the
needle has been placed in the heart in order
to accurately determine whether the heart is
moving, since the syringe may weigh the needle
down and prevent the technician from seeing
movement. Be aware that once the syringe is
removed there may be a discharge of blood
through the open hub of the needle.
Even though a cardiac stick is the best method
of verifying death aside from rigor mortis, it
is not generally used when the euthanasia
is being viewed by the animal’s owner or by
another member of the public. Although the
stick is not conducted until after the euthana-
sia technician has confirmed that the animal
is fully unconscious and completely unable to
feel pain, to the uninitiated, viewing a needle
in the heart may be disturbing. In these situa-
tions, extra care must be taken to ensure that
the determination of death is 100 percent
accurate. In addition to using a stethoscope to
verify the absence of a heartbeat, the techni-
cian should verify that the gums and mucous
membranes of the animal’s mouth have turned
Verification of Death