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>'''


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.
'''<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>'''