ACLS - Pregnancy

Perform BLS/ACLS as otherwise indicated. Call a CODE OB and get Neonatology /OBGYN/ Anesthesia to the bedside STAT. The mother is the priority.

The main differences are as below:

Maternal Interventions

1. Oxygenate well, avoid excess ventilation
2. IV should be placed above the diaphragm
3. Stop any IV magnesium and give IV calcium chloride or gluconate in this case.

Obstetric Interventions

1. Continuous left lateral uterine displacement (provides relief of aortocaval compression after 20 weeks gestational age). If unsuccessful then trial left-lateral tilt of 30 degrees using a firm wedge to support the pelvis and thorax.
   1. One hand:
   2. Two hand:
2. Detach fetal monitors
3. Prepare for perimortem Caesarean at 4-5 minutes of CPR without ROSC, which should be completed within 5 minutes of onset of cardiac arrest.