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Cardiac arrest in the catheterization laboratory: Are we getting better at resuscitation?

      Cardiac arrest (CA) in the cardiac catheterization laboratory is a unique situation, where the early links of the Chain of Survival are near certain, including early recognition of the CA, early application of chest compresssions, and when needed defibrillation is available within seconds rather than minutes. However, resuscitation efforts can be compromised by logistical circumstances, including limited space around the angiographic table, the imposition of needed radiological equipment over the patient, resulting in the need for the rescuer providing chest compressions to awkwardly stretch to reach the patient. Fluoroscopy is generally necessary during the resuscitation effort to potentially identify and treat the etiology of the cath lab arrest, often a catastrophic coronary complication, i.e. acute coronary closure or perforation.
      • William P.
      • Rao P.
      • Kanakadandi U.
      • Asencio A.
      • Kern K.B.
      Mechanical CPR in and on the way to the cardiac catheterization laboratory.
      • Yadav K.
      • Truong H.T.
      Cardiac arrest in the catheterization laboratory.
      This can result in extensive radiation exposure to the rescuer’s hands and head. The AHA 2010 Guidelines addressing “Cardiac Arrest in Special Circumstances” noted, Although high-quality chest compressions improve the chance of successful resuscitation and survival, it is difficult to perform effective, high-quality chest compressions during PCI”.
      • Vanden Hoek T.L.
      • Morrison L.J.
      • Shuster M.
      • et al.
      American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Part 12. Cardiac arrest in special circumstances.
      .
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