Evaluation of Guideline Education and Implementation in Cardiopulmonary Resuscitation Post Sternotomy

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Miles, Kristin
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2018-12-14
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Standard Basic Life Support and Advanced Cardiac Life Support do not provide guideline modifications or concessions for patients who suffer from cardiac arrest after cardiac surgery with a sternotomy. There is a great focus on external cardiac massage (chest compressions) as the priority for individuals requiring cardiopulmonary resuscitation (CPR). In the immediate post-operative sternotomy population, external cardiac massage may lead to increased chest trauma and further patient demise. The Society of Thoracic Surgeons Expert Consensus for the Resuscitation for Patients Who Arrest After Cardiac Surgery recently made recommendations for delaying external cardiac massage until defibrillation has taken place in patients with ventricular fibrillation or pulseless ventricular tachycardia and for maximizing pacemaker output in patients with asystole, prior to starting chest compressions. If these efforts do not result in restoration of circulation after one minute, CPR will be initiated beginning with chest compressions. We are educating and implementing this new guideline specifically for CPR in the immediate post-operative sternotomy patient. Educational sessions about the new resuscitation recommendations were completed. Knowledge of the new resuscitation protocol was compared in a pre and posttest for staff taking care of post-op sternotomy patients on postoperative day zero with improved knowledge on post testing after educational session demonstrated. Competency was measured using a Mock Code and assessing proficiency using simulation which demonstrated competency.
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University
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