Every minute counts !

Per-operative course :

A 35 years old female with no comorbid illness having normal investigations ( ASA class 1st) was to undergo exploratory laparotomy in a secondary care hospital.

• The patient was anesthetised and the surgery was started by the team of surgeons
• After half an hour she developed cardiac arrest on the operation table.

• The anaesthetic agents were stopped 
• The cardiac massage was started and continued for 4 minutes while she was intubated and on 100% oxygen.
• But there was no response to  CPR.
• An open thoracotomy was done immediately. 
• A direct cardiac massage was done from the apex to the base of the heart. 
• There was an immediate response and the heart restarted beating. 
• The planned surgery was carried out successfully.
• The sternotomy wound was closed.
• Patient discharged home in a stable condition.

Teaching message: Every minute counts to prevent Brain damage while doing CPR

 

Further reading click the Link:  Thoracotomy versus closed chest compression

This case was contributed by 
Dr Mir Ghulam Mohammad
Senior Consultant Anesthesiologist 
& Intensive care Physician
J&K Health services Kashmir