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Clinical
Educator
Risk Mangement
A New Standard for Cardiac Surgical Resuscitation: Toward Harmonized Care #1075 (1.00 CH)
Jill Ley, MS, RN, CNS, FAAN
CNS
Sutter Health
Sacramento, CA
Cardiac surgical patients develop life-threatening emergencies, including tamponade, hemorrhage, and arrhythmias, that require a specialized management approach, as standard Adult Advanced Cardiac Life Support (ACLS) protocols have been shown to be ineffective and potentially harmful in these patients. This session reviews the STS Expert Consensus for the Resuscitation of Patients Who Arrest After Cardiac Surgery, designed exclusively for arrest management in this unique population. Strategies include prioritization of arrhythmia management, using temporary pacing wires or defibrillation prior to avoidable compressions, modification of intravenous epinephrine use, and focus on teamwork and communication. Following sternal closure, emergency resternotomy becomes an essential component reviewed, including timing, equipment, roles, and priorities. The STS now recommends use of these strategies in preference to ACLS protocols. Studies documenting improved outcomes, including a significant reduction in mortality, are presented. The presentation concludes with successful strategies and resources for implementing this program locally.