CC Concepts: Post CPA Care Flashcards
What is the goal immediately after ROSC?
Sustaining spontaneous circulation and perfusion of vital organs, attenuating further injuries, and preventing rearrest.
It is important to assess for abnormalities following ROSC in with -?
Electrolytes, glucose, acid-base status, HCT, arterial oxygenation and ventilation
Therapeutic considerations of emergency cases involve what being examined? How and why?
Early hemodynamics optimization = optimize tissue oxygen delivery (fluid administration, vasopressors/ inotropes, RBC transfusion, oxygen supplementation) and to decrease oxygen demand (sedation, mechanical ventilation, NMB, temperature control)
Glycemic control = hyperglycemia is often seen and is associated with poorer outcomes (worsens ischemic brain injury)
Critical illness-related corticosteroid insufficiency = essential to the physiologic response to severe sepsis, regulation of vascular tone, and endothelial permeability
True or False: Rapid reoxygenation following prolonged ischemia is an important goal of CPR and essential for saving lives.
False, immediate oxygenation increases oxidative brain injury, increases neural degeneration, worsens functional neurologic outcome, and negatively affects overall survival
What is the only known treatment to be effective in increasing neurologically intact survival after resuscitation?
Mild therapeutic hypothermia, 89.6 - 93.2 F, for 24 - 48 hours if comatose followed by a slow rewarming of 0.5 - 1 F an hour
Intracranial hypertension can be treated with what medication or fluid type to decrease cerebral edema, preventing further compromise of cerebral blood flow?
Mannitol or Hypertonic saline
Myocardial dysfunction following CPA is often associated with -?
Increased central venous pressure and pulmonary capillary wedge pressure, reduced left and right sided systolic and diastolic ventricular function with increased end-diastolic and end-systolic volume, and reduced left ventricular ejection fraction and cardiac output.
