I commend Tsiouris et al on their report of improved intensive care unit (ICU) preparation for emergency resternotomy following protocol development and institutional training in the June issue of Critical Care Nurse.1 The authors highlight the problem of maintaining staff competencies for low-volume, high-risk procedures and the impact of focused quality improvements. More than 5000 patients experience arrest after cardiac surgery each year in the United States.2 Of patients who experience a cardiac arrest in the hospital, a reported 26% survive to discharge.2 However, in units where staff members have undergone specialized training in cardiac surgical resuscitation (CSR), the discharge survival rates were 65% to 87% for these patients.3,4
The Society of Thoracic Surgeons (STS) Task Force on Resuscitation After Cardiac Surgery published a specialized response protocol in the 2017 STS expert consensus statement for resuscitation after cardiac surgical arrest,5 the universal...