CPR in the Operating Room
Mar 21, 2024![](https://kajabi-storefronts-production.kajabi-cdn.com/kajabi-storefronts-production/file-uploads/blogs/2147545446/images/042ea2c-5c5b-051-b5d5-3afc056d8c3c_3-3.png)
CPR in the operating theatre can be a daunting prospect, with many hazards and considerations that come along with it. 🔥🚨
The importance of prompt, quality, and uninterrupted CPR is well established as one of the main factors of successful outcomes in cardiac arrest. The ANZCOR guidelines suggest that an unresponsive patient, who is not breathing normally is the indication for CPR, but where does that leave patients under anaesthesia? 🤷♀️
Here’s what you need to know:
The top 4 indications for CPR in the OT are:
1️⃣ Impalpable pulse
2️⃣ Severe hypotension
3️⃣ Severe bradycardia
4️⃣ Abrupt decrease in ETCO2 capnography
As soon as CPR is required, communication with the surgical team must be made and many decisions made concurrently:
👉 Who commences the CPR? (Surgeon, nurse, someone else?)
👉 Is surgical site bleeding the cause of arrest? Should the surgical team attempt to manage the bleeding during CPR?
👉 Are there instruments, bodily fluids or other dangers in the field of compressions?
👉 Is the patient prone? Lateral? Should they return to supine to increase the efficacy of CPR? How will this happen with the shortest delay in compressions?
👉 Use closed loop communication.
👉 An ETCO2 of >20mmHg indicates effective CPR.
Remember the rates!
👉 Compressions: 100-120 per minute
👉 Compressions to breaths: 30/2
👉 When there is a secure airway: 1 breath every 6 seconds with no interruption to CPR (RR of 10).
Keep an eye out for more Concept Series Articles and our Advanced Anaesthesia Live Series on Advanced Life Support.
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Ref:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9647646/
https://www.anzcor.org/home/adult-advanced-life-support/guideline-11-2-protocols-for-adult-advanced-life-support/
https://rcoa.ac.uk/sites/default/files/documents/2023-11/NAP7_Chapter%2025_FINAL.pdf