Nursing Interventions for a Patient With Sudden Cardiac Arrest in the Operating Room: A Case Report

Abstract

Introduction. Intraoperative sudden cardiac arrest is a rare, life-threatening event requiring immediate recognition, coordinated resuscitation, and structured perioperative nursing care. This case report describes the application of standardized NANDA International (NANDA-I), Nursing Outcomes Classification (NOC), and Nursing Interventions Classification (NIC) terminology to nursing management of an intraoperative cardiac arrest.

Case Presentation. A 62-year-old man with a history of myocardial infarction, coronary stent placement, hypertension, hypercholesterolemia, and hypothyroidism underwent total left knee arthroplasty. Following tourniquet release, the patient developed severe hypotension that rapidly progressed to pulseless electrical activity and subsequently ventricular fibrillation.

Intervention. Advanced life support was initiated, including high-quality cardiopulmonary resuscitation, epinephrine administration, endotracheal intubation, defibrillation, continuous physiological monitoring, and subsequent transfer to intensive care. Nursing care was structured according to Carpenito’s Bifocal Model and the NANDA-I–NOC–NIC framework, with particular emphasis on cardiovascular surveillance, emergency management, airway management, defibrillation, and continuity of care.

Outcome. Return of spontaneous circulation was achieved, although a subsequent cardiac arrest required further resuscitation. Coronary angiography identified an anterior ST-elevation myocardial infarction requiring percutaneous coronary intervention. The patient subsequently recovered neurological and functional capacity and regained independence in activities of daily living.

Conclusion. Standardized nursing terminology provided a structured framework for documenting clinical reasoning, interventions, and measurable outcomes during a complex intraoperative emergency, while supporting continuity of care across perioperative and critical care settings.