EJAEur J Anaesthesio/2023;40:1-13OPENGUIDELINESCardiac arrest in the perioperative period:a consensusguideline for identification,treatment,and preventionfrom the European Society of Anaesthesiology andIntensive Care and the European Society for Trauma andEmergency SurgeryJochen Hinkelbein,Janusz Andres,Bernd W.Bottiger,Luca Brazzi,Edoardo De Robertis,Sharon Einav,Carl Gwinnutt,Bahar Kuvaki,Pawel Krawczyk,Matthew D.McEvoy,Pieter Mertens,Vivek K.Moitra,Jose Navarro-Martinez,Mark E.Nunnally,Michael O'Connor,Marcus Rall,Kurt Ruetzler,Jan Schmitz,Karl Thies,Jonathan Tilsed,Mauro Zago and Arash AfshariINTRODUCTION Cardiac arrest in the operating room is aRESULTS This guideline contains background informationrare but potentially life-threatening event with mortality ratesand recommendation for the treatment of cardiac arrest in theof more than 50%.Contributing factors are often known,andoperating room environment,and addresses controversialthe event is recognised rapidly as patients are usually undertopics such as open chest cardiac massage (OCCM),re-full monitoring.This guideline covers the perioperative periodsuscitative endovascular balloon occlusion (REBOA)andand is complementary to the European Resuscitation Coun-resuscitative thoracotomy,pericardiocentesis,needle decil (ERC)guidelines.compression and thoracostomy.MATERIAL AND METHODS The European Society ofCONCLUSION Successful prevention and management ofAnaesthesiology and Intensive Care and the European So-cardiac arrest during anaesthesia and surgery requires an-ciety for Trauma and Emergency Surgery jointly nominated aticipation,early recognition and a clear treatment plan.Thepanel of experts to develop guidelines for the recognition,ready availability of expert staff and equipment must also betreatment and prevention of cardiac arrest in the periopera-taken into consideration.Success not only depends ontive period.A literature search was conducted in MEDLINE,medical knowledge,technical skills and a well organisedEMBASE,CINAHL and the Cochrane Central Register ofteam using crew resource management but also on anControlled Trials.All searches were restricted to publicationsinstitutional safety culture embedded in everyday practicefrom 1980 to 2019 inclusive and to the English,French,through continuous education,training and multidisciplinaryItalian and Spanish languages.The authors also contributedco-operation.individual,independent literature searches.Published online xx month 2023From the University Department of Anaesthesiology,Intensive Care Medicine and Emergency Medicine,Johannes Wesling Klinikum Minden,University Hospital RuhrUniversity Bochum,Minden,Germany (H,Department of Anaesthesiology and Intensive Care Medicine,Medical Faculty and University Hospital of Cologne,CologneGermany (BWB.)Department of Anaesthesioogy and Intensive Therapy.Jagiellonian University Medical Colege,Krakow,Poland (A).Department of SurgicaSciences,University of Turin,Turin (LB),Division of Anaesthesia,Analges
