Action	Rationale
Basic life support
Perform manual uterine displacement, or 25- to 30-degree left lateral tilt	Decreased aortocaval compression
Increase chest wall compression force	Decreased chest wall compliance with breast hypertrophy and diaphragmatic elevation
Use cricoid pressure, if assistance is available	Decreased gastric aspiration
Perform compressions higher on the sternum (slightly above center of sternum)	Elevated diaphragm and contents
Remove fetal and uterine monitors before defibrillation	Loss of adequate cardiac shock dose; produces skin burns at monitor sites
Heimlich maneuver; use chest thrust if unable to encircle the gravid abdomen	Enlarged uterus displaces diaphragm
Advanced cardiac life support
Start intravenous therapy above diaphragm	Aortocaval compression
Early tracheal intubation; use short laryngoscope handle and smaller endotracheal tube	Difficult ventilation with pharyngeal edema, breast hypertrophy, diaphragmatic elevation
Consider other etiologies (e.g., magnesium toxicity)	Magnesium used as tocolytic therapy
Consider left wide paddle, adhesive pad, or breast displacement	Dextrorotation of the heart; breast hypertrophy
Verify endotracheal tube with carbon dioxide detector	Esophageal detector more likely not to reinflate after compression
Alter ventilation volumes and rates	Tailor ventilator support to oxygenation and ventilation
Perform emergency hysterotomy after four minutes	Decreased aortocaval and venous compression
Continue all maternal resuscitative efforts (cardiopulmonary resuscitation, positioning, defibrillation, and drugs) during and after cesarean delivery	Decreased aortocaval and venous compression