Knowledge
Collections of articles, notes and knowledge from the metajournal community.
Airway
Analgesia
Anesthesia
Complications
Critical care
Decision making
Drugs
Epidural
Intrathecal
Intravenous anesthetics
Ketamine
Neuromuscular agents
Obstetric anesthesia
Opioid
Pain
Pediatric anesthesia
Perioperative medicine
Postoperative complications
Regional anesthesia
Sugammadex
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Cardiac arrest is rare in pregnancy (1 in 30,000) and resuscitation is founded on the same approach used for the non-pregnant patient, focusing on:
- Recognition
- Calling for help
- A B C (D)
- Good for mother = good for baby
However, unique to maternal resuscitation:
- Airway difficulties are more likely.
- Aortocaval compression dramatically impedes resuscitation – employ left lateral tilt!
- Consider perimortem cesarean section
The rationale for Perimortem Cesarean Section is:
- The presence of baby and gravid uterus severely limits resuscitation of the mother.
- Emergency cesarean section at cardiac arrest is done for the mother’s benefit, not the baby.
- A decision to perform emergency CS must be made within 4 minutes of arrest, and the baby delivered within 5 minutes. (Although there is some evidence of benefit when performed up to 10 minutes after arrest.)
- The only equipment required is a scalpel and an appropriately skilled doctor.
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Continuous paravertebral block is an effective alternative to thoracic epidural for managing post-operative pain after open nephrectomy, with a better side-effect profile.
pearl
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