Standards from both The Society of Thoracic Surgeons (STS) and American Heart Association (AHA) advise immediate defibrillation in this situation. Chest compressions carry added risk and should be deferred in favor of shocks, or pacing for asystole, if available within one minute. The STS has advocated for use of this specialized cardiac surgical resuscitation (CSR) protocol “in lieu of ACLS” since 2017. And despite regulatory requirements for hospitals to provide resuscitation education for the specific populations they serve, only 40% of session attendees at AACN’s 2023 National Teaching Institute had received such instruction by their employers. One reason is likely the absence of available evidence-based training materials, which this ongoing blog and www.ecsr.info website will address.
As the creator of the first US “CALS” course in 2010 and co-author of the STS guideline, I developed a standardized one-day CSR training program for ICU providers which is now commercially available. This CSR “tool-kit” contains my planning documents, scenarios, slides, and all needed materials for cardiac surgical centers to conduct internal CSR training, without prior course participation. I am excited to launch these resources and passionate about sharing evidence with facilities across the US, thus reducing mortality from these events.
I am requesting YOUR feedback to learn more about what works and what doesn’t when responding to arrests in this unique population. Are you following the STS protocol? How are you training? What strategies can you share with others or would like help with? Please send your questions and responses here – I hope to stimulate a nationwide conversation on this subject. My goal is to encourage adoption of the STS protocol and ensure that every cardiac surgical patient in the US receives evidence-based resuscitation care, regardless of training budgets. Thank you for your comments!
Reference: Dunning J, Levine A, Ley SJ, et al. The Society of Thoracic Surgeons expert consensus for the resuscitation of patients who arrest after cardiac surgery. Ann Thorac Surg 2017;103:1005-1020.