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Intraoperative Cardiac Arrest: Difference between revisions
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Source: 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. | Source: 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. | ||
[[File:PALS Shaffner.jpg|thumb]] | [[File:PALS Shaffner.jpg|thumb|Intraoperative Pulseless Arrest Resuscitation]] | ||
* Medication have not been shown to change outcome, more emphasis on effective compression. | |||
* Compression depth: | |||
** For a child is at least ⅓ the depth of the chest size, or 5 cm | |||
** For infant: 4cm | |||
* Allow complete recoil, don’t lean on chest | |||
* Don’t interrupt compression | |||
* Intubate, follow ETCO2 | |||
* 100 compressions : 8-10 ventilations per min | |||
* Avoid overinflation | |||
* Biphasic shock - First dose: 2-4J/kg - Second dose: 4J/kg - Third dose: 4-10J/kg | |||
* Epi dose: - 10 MICROg/kg IV/IO - 100 MICROg/kg ETT | |||
* PEA vs. VFib: PEA appears organized and pulseless | |||
* Call for ECMO if no ROSC after 6 mins | |||
* Ice to head | |||
* If prone, perform 2 mins CPR prone, evaluate EtCO2 then consider supine | |||
* 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)]] | |||
'''<u>Critical Event Resources:</u>''' | |||
App: PEDI-CRISIS | |||
Available on Apple Store and Google Play | |||
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