Final answer:
Resuscitation team leaders should activate the protocol for perimortem cesarean delivery after a maternal cardiac arrest if there's no return of spontaneous circulation within 4-5 minutes, specifically when the gestation is 24 weeks or beyond.
Step-by-step explanation:
The protocol for perimortem cesarean delivery should be activated by resuscitation team leaders when a patient, who is near the end of pregnancy, experiences a cardiac arrest and resuscitative efforts do not rapidly result in a return of spontaneous circulation. This intervention is considered when the fetal gestation is 24 weeks or beyond, and it is typically initiated within 4-5 minutes of the maternal cardiac arrest if there is no return of spontaneous circulation. The goal is to relieve potential aortocaval compression by the gravid uterus, improve maternal hemodynamics for better resuscitation outcomes, and deliver the fetus. This is all coordinated after confirming the need with the team involved, ensuring that crucial steps like the confirmation of patient identity, surgical site, and procedure are acknowledged by the surgeon, nurse, and anesthesia professional.