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The Case for Standardized Maternal Cardiac Arrest Simulation Training in Prehospital and Hospital-Based Settings
Andrea D Shields1, Jacqueline Vidosh1, Thomas W Trimarco1
1Department of Obstetrics & Gynecology, University of Connecticut Health, Farmington, Connecticut; Department of Obstetrics & Gynecology, San Antonio Uniformed Services Health Education Consortium, San Antonio, Texas; Department of Emergency Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; MedStar Institute for Innovation, Simulation Training & Education Lab, MedStar Health, Washington, DC; Bulverde Spring Branch Fire EMS, Bulverde, Texas; Department of Health, Behavior, and Society, University of Texas at San Antonio School of Public Health, San Antonio, Texas; Department of Obstetrics & Gynecology, University of Connecticut Health, Farmington, Connecticut; Department of Obstetrics & Gynecology, University of Connecticut Health, Farmington, Connecticut; and Department of Public Health Sciences, University of Connecticut Health, Farmington, Connecticut.
Abstract:
Maternal mortality and severe maternal morbidity in the United States remain unacceptably high, with cardiovascular disease a leading cause of pregnancy-related death. Maternal cardiac arrest, although rare, is a sentinel event that reflects system readiness for obstetric emergencies. Unlike pediatric or adult cardiac arrest, for which Basic, Pediatric, and Advanced Cardiac Life Support certifications are standard, maternal cardiac arrest management lacks a validated, standard training curriculum. Evidence demonstrates that structured, team-based simulation improves knowledge retention, accelerates response times, enhances coordination, and improves performance metrics in resuscitation. This perspective calls for a comprehensive, multidisciplinary maternal emergency and cardiac arrest training program, modeled after Advanced Cardiac Life Support, with standardized simulation, credentialing, and policy-level mandates. Such standardization may reduce delays in care that lead to preventable deaths, improve equity, and foster a national safety culture in maternal health.
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