Cardiac Arrest in Pregnancy In-Hospital ACLS Algorithm
Perimortem cesarean delivery: If no ROSC, complete perimortem cesarean delivery ideally within _____ min after time of arrest.
5 minutes
Once advanced airway is in place, give 1 breath every ___ seconds ( ___ breaths/min) w/ continuous chest compressions.
1 breath every 6 seconds (10 breaths/min)
Continue BLS/ACLS (5)
1) high-quality CPR 2) defibrillation when indicated 3) other ACLS interventions (ex: epinephrine) 4) assemble maternal cardiac arrest team 5) consider etiology of arrest
team planning should be done in collaboration with what 6 specialties?
1) obstetric 2) neonatal 3) emergency 4) anesthesiology 5) intensive care 6) cardiac arrest services
maternal interventions (5)
1) perform airway management 2) administer 100% O2, avoid excessive ventilation 3) place IV above diaphragm 4) if receiving IV magnesium, STOP & give calcium chloride or gluconate 5) continue BLS/ACLS
perform obstetric interventions (3)
1) provide continuous lateral uterine displacement 2) detach fetal monitors 3) prepare for perimortem cesarean delivery
List priorities for pregnant women in cardiac arrest (2)
1) provision of high-quality CPR 2) relief of aortocaval compression w/ lateral uterine displacement
List the potential etiologies of maternal cardiac arrest A B C D E F G H
Anesthetic complications Bleeding Cardiovascular Drugs Embolic Fever General non-obstetric causes of cardiac arrest (H's & T's) Hypertension
True or false: In pregnancy, a difficult airway is less common
FALSE In pregnancy, a difficult airway is common. Use the most experienced provider.
What is the goal of perimortem cesarean delivery?
Improve maternal & fetal outcomes
Types of airways (2)
endotracheal intubation supraglottic advanced airway
Who receives the neonate after perimortem delivery?
neonatal team
How do you confirm and monitor ET tube placement?
perform waveform capnography or capnometry
