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Cardiac Arrest in Pregnancy


Learning objectives

  • Describe principles of Basic Life Support.

  • Describe principles of Advanced Cardiovascular Life Support as they relate to pregnancy.

The goal of this chapter is to highlight pregnancy-related pearls with regards to maternal resuscitation. This section presupposes knowledge of Basic Life Support and Advanced Cardiovascular Life Support (ACLS) training. Please see your local training agency if you require formal training Fig. 4.1 shows the basic equipment needed for cardiopulmonary. The most important thing to remember is the “ABCs”—airway, breathing, and circulation as summarized in Fig. 4.2 .

Fig. 4.1
Equipment for cardiopulmonary resuscitation including (A) code cart and (B) medications and respiratory equipment.

Fig. 4.2
Essentials of cardiopulmonary resuscitation.

Basic Life Support

Effective Chest Compressions (Fig. 4.3)

  • Rate is 100–120 compressions per minute

    Fig. 4.3, Proper technique for chest compression. Hands should be placed on the lower half of the sternum. Each compression should have a depth of 5–6 cm with full recoil between compressions.

  • Compress the chest 5–6 cm (2–2.5 inches) with each downstroke

  • Allow the chest to recoil completely after each downstroke

  • To check adequacy → have another provider feel for femoral pulse during compressions

  • Change the person doing compressions every 2–3 minutes to avoid fatigue

Ventilation

  • Appropriate compression to ventilation ratio during CPR is 30 compressions to 2 breaths

  • If an advanced airway is in place, give ventilations at a rate of approximately 10 per minute

  • Ventilation rate can later be titrated based on blood gas values

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