See Table 1 for a comparison of CALS-S1 and AHA’s ACLS.2,3 Overview The key components of the CALS-S guideline are as follows: The purpose of this article is to present a summary of these evidence-based guidelines for resuscitation of patients with cardiac arrest after cardiac surgery. COM garner the support of the AHA and Society of Thoracic Surgeons for implementation in the future. NCI-D-13-00064-color.indd 123 4/11/14 10:23 PM H E R R MA NN W W W.A ACNA DVA NCE D CRIT ICA LCA RE. Unauthorized reproduction of this article is prohibited. The author declares no conflicts of interest. Offering CALS-S courses is an early grassroots effort among a few dedicated centers that hope to Cheryl Herrmann is Cardiac Clinical Nurse Specialist, UnityPoint Health-Methodist, 221 NE Glen Oak Ave, Peoria, IL 61636 ( ). Course materials may be obtained from, and institutions are encouraged to train their own staff in CALS-S. A limited number of CALS-S courses are offered in the United States, and no certification or instructor course is available. The CALS-S course2 has been modified for the United States in collaboration with the EACTS. The AHA may offer a CALS-S course in the future. Currently, the American Heart Association (AHA) has not adopted the CALS-S curriculum as a certification training course. Keywords: CALS-S, cardiac surgery arrest, cardiac surgery resuscitation, emergent resternotomy In the United States, many cardiac surgery programs have established their own cardiac surgery arrest protocols as a result of the limitations of ACLS in patients undergoing cardiac surgery. The purpose of this article is to discuss the CALS-S guideline and how to implement it. Support–Surgical (CALS-S) guideline provides a standardized algorithm approach to resuscitation of patients who experience cardiac arrest after cardiac surgery. CSU-ALS standards are established in the United Kingdom and embraced by the EACTS. In 2009, the Clinical Guidelines Committee of the European Association for Cardio-Thoracic Surgery (EACTS) published “Guideline for Resuscitation in Cardiac Arrest After Cardiac Surgery” ().1 This guideline was initially named CALS (Cardiac Surgery Advanced Life Support) and currently is referred to as CSU-ALS (Cardiac Surgery Unit-Advanced Life Support) in the United Kingdom and CALS-S (Cardiac Advanced Life Support–Surgical) in the United States. When treated promptly, 17% to 79% of patients with cardiac arrest after cardiac surgery survive to discharge.1 Current Advanced Cardiac Life Support (ACLS) guidelines do not specifically address cardiac surgery arrests and treatment of specific causes. The Cardiac Advanced Life C ardiac arrest in the immediate postoperative recovery period in a patient undergoing cardiac surgery is typically related to reversible causes-tamponade, bleeding, ventricular arrhythmias, or blocks associated with conduction problems. When treated promptly, 17% to 79% of patients who experience cardiac arrest after cardiac surgery survive to discharge. 123–129 © 2014 AACN Cardiac Advanced Life Support– Surgical Guideline Overview and Implementation Cheryl Herrmann, RN, APN, MS, CCRN, CCNS-CSC-CMC ABSTRACT Cardiac arrest in the immediate postoperative recovery period in a patient who underwent cardiac surgery is typically related to reversible causes-tamponade, bleeding, ventricular arrhythmias, or heart blocks associated with conduction problems. AACN Advanced Critical Care Volume 25, Number 2, pp.
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