Have your say: The STS expert consensus statement on resuscitation in arrest after cardiac surgery

The Workforce on Evidence-Based Surgery has created an expert consensus statement on the management of resuscitation in patients who arrest after cardiac surgery.

The STS believes that if a patient arrests after cardiac surgery and external cardiac massage is not providing adequate perfusion with a systolic over 60mmHg, then am emergency resternotomy should always be performed in under 5 minutes to prevent irreversible brain injury.

This is not easy to achieve and this document provides comprehensive advice regarding rapidly reversible causes of arrests to avoid a resternotomy, how to organize your teams to achieve a good outcome and how to train your teams to provide the best outcomes possible.  The STS provides a one page poster as a summary of this advice.

This document is currently out for consultation and we want your advice and opinions. Please click on this link to provide your ideas and feedback.

http://www.sts.org/Expert-Consensus-for-the-Resuscitation-of-Patients-who-Arrest-After-Cardiac-Surgery

We would like to know :

Do you like the presented STS protocol ?

Do you agree that in VF arrest, you should proceed to deliver 3 shocks prior to external massage ?

Do you agree that epinephrine and atropine should not be a routine part of the algorithm ?

Do you agree that for a patient who arrests and external massage is not generating an adequate perfusion pressure, that this person needs an urgent resternotomy once all rapidly reversible causes have been excluded ?

We have paired up with the APACVS who has created a charity to provide training in this protocol. Training will be provided by a network of trained and experienced physicians assistants and senior nurse practitioners. www.csu-als.org

Do you have any ideas or suggestions for the national training program that they will be leading ? 

Thank you very much for your interest. Please do get in contact if you have any questions.

Joeldunning@doctors.org.uk

Chairman of the STS workforce on resuscitation in arrest after cardiac surgery

sfirestone@sts.org

Lead systematic reviewer for the STS evidence based workforce.