Institutional preparedness and management of intraoperative cardiac arrest: a survey

Abstract

Aim: Cardiac arrest in the operating room is rare but the worst event during anesthesia and surgery. Anesthesiologists who are familiar with the patient's medical history and risks of the ongoing surgery mainly witness intraoperative cardiac arrest. There is limited evidence to guide the management of intraoperative arrest specifically. As in any other setting, cardiopulmonary resuscitation has to be initiated as soon as cardiac arrest is recognized. This includes the performance of efficient chest compressions, ensuring ventilation, and defibrillation as rapidly as possible if ventricular fibrillation or pulseless ventricular tachycardia is present. In this survey study, we aimed to determine the presence of adequate equipment and management of intraoperative cardiac arrest in T & uumlrkiye. Methods: We conducted a web-based survey among members of the Turkish Society of Anaesthesiology and Reanimation. The survey consisted of 37 closed-answer questions. All the feedback and answers to the survey questions were statistically analyzed and recorded. Results: A total of 252 participants completed the survey. The most common reasons were hypovolemia, pulmonary embolism, myocardial infarction, and others. The mortality rate was found to be 55.6%, of which 27.08% was immediately in the operating room. Out of 252 participants,224 (88.9%) reported that they received advanced life support education. Among these educated participants, only 32.9% got a specific chapter about intraoperative cases. Ratio for the follow-up of guidelines was 94.8%. Sixty-eight physicians (29.8%) received the training in less than one year,108 (47.4%) in between 1 and 5 years and 52 (22.8%) in between 5 and 10 years. Conclusion: Intraoperative cardiac arrest cases must be studied more to create better management of the victims and improve the outcomes. Underestimated events in the operating room will probably end with unintended consequences. Even though some hospitals provide good standards of organizational preparation for emergencies, our survey showed that this is not the case and is not standard everywhere. Well-equipped institutes and highly trained staff may improve both technical and non-technical skills for CPR.