You are called to see a 62-year old male now 3 hours post CABG x 4 with hypotension and escalating vasoactive requirements. As you arrive to the bedside, he arrests. How do you manage this situation? This talk outlines the management of cardiac arrest in the intensive care unit post open heart surgery, as per the CALS (Cardiac Advanced Life Support) algorithm. Key differences from the standard ALS (Advanced Life Support) algorithm are highlighted, including delaying CPR by up to 1 minute to troubleshoot the initial rhythm, the role of emergency resternotomy, and avoidance of 1mg doses of adrenaline.