Anaes SAQs · Critical incidents & patient safety
Arrest during emergency laparotomy — theatre ALS with the ERC 2025 modifications
Final SAQ on perioperative cardiac arrest: NAP7 incidence, causes and outcomes, the ERC 2025 operating-room modifications, adult ALS drugs and shocks, and the special circumstances of LAST, cardiac surgery and pregnancy.
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Prompt
During an emergency laparotomy for bleeding, the arterial line shows a systolic pressure below 50 mmHg and the end-tidal carbon dioxide falls despite treatment. Outline the NAP7 context, your immediate actions, your rhythm-directed drugs and shocks, and the modifications for local anaesthetic toxicity, cardiac surgery and pregnancy.
Question
During an emergency laparotomy for bleeding, the arterial line shows a systolic pressure below 50 mmHg and the end-tidal carbon dioxide falls despite treatment. Outline the NAP7 context, your immediate actions, your rhythm-directed drugs and shocks, and the modifications for local anaesthetic toxicity, cardiac surgery and pregnancy.[4]
References5ShowHide
- [1]Armstrong RA, Soar J, Kane AD, et al. Peri-operative cardiac arrest: epidemiology and clinical features of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia, 2024.PMID 37972476
- [2]Armstrong RA, Cook TM, Kane AD, et al. Peri-operative cardiac arrest: management and outcomes of patients analysed in the 7th National Audit Project of the Royal College of Anaesthetists. Anaesthesia, 2024.PMID 37972480
- [3]Soar J, Böttiger BW, Carli P, et al. European Resuscitation Council Guidelines 2025 Adult Advanced Life Support Resuscitation 215 (2025) 110769, 2025.Source
- [4]Lott C, Karageorgos V, Abelairas-Gomez C, et al. European Resuscitation Council Guidelines 2025 Special Circumstances in Resuscitation Resuscitation 215 (2025) 110753, 2025.Source
- [5]Frerk C, Mitchell VS, McNarry AF, et al. Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults. British journal of anaesthesia, 2015.PMID 26556848