CALS

Cardiac arrest in the post-sternotomy surgical patient is extremely stressful to all those involved. Firstly the physician needs to ask the question: is this arrest mechanical and do we need to crack the chest???

Secondly situational awareness is needed. Is there CHB and are there epicardial wires attached to the patient allowing immediate relief of normal CO? If not could I attach external pads and pace that way?

You’re thinking of giving adrenaline…. Please strongly consider the dose used. A much reduced dose of 100mcg is often advised rather than the familiar 1mg for refractory PEA arrest.

There are a few option available to us that are unique to the cardiac environment and so reading this document is strongly advised, even to the most senior clinician!