Peer Reviewed Content
Alternative Resuscitation Protocol for Special Population Aaron Morton MMSc, PA-C, ATC, FAPACVS Emory Center for Critical Care / Emory University Hospital Atlanta, Georgia David Lizotte MPAS, PA-C, FAPACVS Cardiac Advanced Resuscitation Education / Fenton, Missouri Amanda Murray MMSc, PA-C, FAPACVS Appleton, Wisconsin
ABSTRACT Purpose: The purpose of this article is to inform readers of the presence and need for alternative resuscitation protocol and review the evidence surrounding post-cardiac surgery patients. Method: A PubMed search was completed reviewing evidence behind specific protocols. Search terms included post-cardiac surgery arrest management, epinephrine in cardiac surgery, emergent resternotomy, and internal cardiac massage. Additionally, MeSH terms were searched including heart arrest, resuscitation, cardiac surgery complications. Results: Significant evidence supporting utilization of alternative protocol and interventions were well supported within the body of published literature. Conclusion: An alternative evidenced-based resuscitation protocol for post-cardiac surgery patients who suffer cardiac arrest is well supported. The protocol which deviates from Advanced Cardiac Life Support (ACLS) with alternation in medication dosing, emphasis on electrical therapy via epicardial pacing, defibrillation and cardioversion, as well as emergent resternotomy reduces the failure to rescue rate. Further adoption of protocol and team-based training will be necessary to provide the best opportunity for survival in this special population. Keywords: post-operative cardiac surgery arrest, resternotomy, cardiac surgery complications. INTRODUCTION Advanced Cardiac Life Support (ACLS) is taught to scores of healthcare providers every year regardless of their role or specialty. Many providers are required to maintain ACLS certification even though it is not the best protocol for their patient population. While standard
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Journal of the Association of PAs in Cardiothoracic and Vascular Surgery
