ANZCOR guidelines

Question 1

What is the post arrest BP targets?

Answer 1

SBP >100
or a BP equal to the patients normal blood pressure

Question 2

What are the post arrest sats targets?

Answer 2

94-98%
Avoid hyperoxia

Question 3

What are the post arrest C02 targets?

Answer 3

Normocarbia 35-45
However if strong suspicion of intracranial injury then can aim for lower end of normocarbia (35-40)

Question 4

What are the post arrest BSL targets?

Answer 4

BSL 4-10
Strict control increases risk of hypoglycaemia
Avoid hypo/hyperglycaemia

Question 5

What is the post arrest care for AMI?

Answer 5

ANZCOR recommends immediate (not delayed) cardiac cath if evidence of STEMI/new LBBB/STEMI equivalent on ECG post ROSC

Selected patients not meeting above criteria but deemed at high risk should also be taken for Cath

Question 6

What is the post arrest care for pulmonary embolism?

Answer 6

If ROSC has occurred without the use of thrombolysis, there is no evidence to suggest its use

Theoretical benefits but studies have also shown increase bleeding risk post arrest, so no survival or QOL advantage in the evidence

Question 7

What are the inclusion criteria for organ donation?

Answer 7

• older than 16 (for adults), no max age (paeds can donate to paeds)
• Receiving end of life care
• Condition likely to cause cessation of all brain function (brain death)
• Condition likely to cause cessation of circulation (circulatory death)

Question 8

What are the exclusion criteria for organ donation?

Answer 8

• CJD
• active HIV
• Other uncontrolled infections (treated infections ie Hep B ok)
• Metastatic or non-curable malignant disease
• Past history of malignancy that poses risk for transmission no matter the time frame (ie melanoma, choriocarcinoma)

Question 9

What is the surgical sieve in medical diagnosis?

Answer 9

VITAMIN CDEF

Vascular
Infective
Traumatic
Autoimmune
Metabolic
Iatrogenic (including drugs)
Neoplastic
Congenital
Degenerative
Endocrine
Functional

Question 10

What are the ANZCOR recommendations for cardiac arrest with massive PE?

Answer 10

• Consider fibrinolytic therapy as per local protocol, continue CPR for at least 30mins post this
• Consider performing CPR for at least 60-90mins

Question 11

What are the ANZCOR recommendations for cardiac arrest with Asthma

Answer 11

• Consider and treat for anaphylaxis
• Early intubation
• Consider disconnecting tube and pressing on chest wall (ie CPR) to relieve hyperinflation/gas trapping
• Seek and treat pneumothoraces

Question 12

What are the ANZCOR recommendations for cardiac arrest with Avalanche?

Answer 12

• Consider early rewarming via extracorporeal means
• Full resuscitative measures
• Seek and treat traumatic, hpoxic and hypothermic causes

Poor survival likelihood if
- >35mins buried and in cardiac arrest with an obstructed airway
- Serum potassium >12 initially
- Buried and obstructed with initial core temperature <32C