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Intraoperative Cardiac Arrest: Difference between revisions
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Children (<12 year old): 2x more likely to experience CA, infants (<1 year old): 10x, neonates (<1month old): 50x | Children (<12 year old): 2x more likely to experience CA, infants (<1 year old): 10x, neonates (<1month old): 50x | ||
'''<u>Causes for Pediatric Perioperative Arrest:</u>'''<ref name=":0">Shaffner DH, Heitmiller ES, Deshpande JK. Pediatric perioperative life support. Anesth Analg. 2013 Oct;117(4):960-979. doi: 10.1213/ANE.0b013e3182a1f3eb. Epub 2013 Sep 10. PMID: 24023023.</ref> | |||
'''<u>Causes for Pediatric Perioperative Arrest:</u>'''<ref name=":0">Shaffner DH, Heitmiller ES, Deshpande JK. Pediatric perioperative life support. Anesth Analg. 2013 Oct;117(4):960-979. doi: 10.1213/ANE.0b013e3182a1f3eb. Epub 2013 Sep 10. PMID: 24023023.</ref> | '''<u>Causes for Pediatric Perioperative Arrest:</u>'''<ref name=":0">Shaffner DH, Heitmiller ES, Deshpande JK. Pediatric perioperative life support. Anesth Analg. 2013 Oct;117(4):960-979. doi: 10.1213/ANE.0b013e3182a1f3eb. Epub 2013 Sep 10. PMID: 24023023.</ref> | ||
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** Bradycardia or cardiovascular collapse: - Traction, pressure, or insufflation involving the abdomen, eye, neck, or heart - Undiagnosed cardiomyopathy | ** Bradycardia or cardiovascular collapse: - Traction, pressure, or insufflation involving the abdomen, eye, neck, or heart - Undiagnosed cardiomyopathy | ||
** Overdose - Weight-based dosing of IV anesthetic on induction in a child with hypovolemia or compensated shock may lead to collapse | ** Overdose - Weight-based dosing of IV anesthetic on induction in a child with hypovolemia or compensated shock may lead to collapse | ||
'''<u>Important Resuscitation Steps</u>'''<ref name=":0" />'''<u>:</u>''' | |||
'''<u>Important Resuscitation Steps</u>'''<ref name=":0" />'''<u>:</u>''' | '''<u>Important Resuscitation Steps</u>'''<ref name=":0" />'''<u>:</u>''' | ||
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# Assign roles | # Assign roles | ||
'''<u>Resuscitation Algorithm for Intraoperative Pulseless Arrest</u>'''<ref name=":0" />'''<u>:</u>''' | |||
[[File:PALS Shaffner.jpg|thumb|Intraoperative Pulseless Arrest Resuscitation]]Important Notes: | |||
[[File:PALS Shaffner.jpg|thumb|Intraoperative Pulseless Arrest Resuscitation|left]]Important Notes: | |||
* Medication have not been shown to change outcome, more emphasis on effective compression. | * Medication have not been shown to change outcome, more emphasis on effective compression. | ||
* Compression depth: | * Compression depth: | ||
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* IO access is as effective as IV access and may be easier to obtain during circulatory collapse | * IO access is as effective as IV access and may be easier to obtain during circulatory collapse | ||
[[File:Prone Chest Compression.jpg|thumb|Prone Chest Compression (Shaffner et al. 2013)]] | [[File:Prone Chest Compression.jpg|thumb|Prone Chest Compression (Shaffner et al. 2013)|left]] | ||
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* MVO2 | * MVO2 | ||
** <30% was associated with no ROSC | ** <30% was associated with no ROSC | ||
'''<u>Post Resuscitation:</u>''' | '''<u>Post Resuscitation:</u>''' | ||