Chapter 13: Post-Resuscitation Care

Question 1

What is post-cardiac arrest syndrome?

Answer 1

1. Post-cardiac arrest brain injury
2. Post-cardiac arrest myocardial dysfunction
3. Systemic ischaemia / reperfusion response
4. Persistent precipitating pathology

Question 2

Main steps in Adult Post-Resuscitation Care:

Answer 2

1. Airway & Breathing
2. Circulation
3. Control temp
4. Likely cardiac cause?
5. Cause for cardiac arrest identified?
6. Admit to ICU
7. ICU Mx
8. Secondary prevention

Question 3

What does Mx of Airway & Breathing include:

Answer 3

1. Maintain sats 94-98%
2. Insert advanced airway
3. Capnography
4. Maintain normocapnia

Question 4

What does Mx of Circulation include:

Answer 4

1. 12 lead ECG
2. IV access
3. Crystalloid fluids
4. Restore normovolaemia
5. SBP > 100
6. Inotropes / vasopressors to maintain SBP
7. Intra-arterial BP monitoring

Question 5

What does Temperature control entail:

Answer 5

1. Prevent fever
2. Sedation
3. Control shivering

Question 6

Likely Cardiac cause - NO - Options & Pathway:

Answer 6

1. CTB or CTPA
2. Rx non-cardiac cause of arrest
3. Admit to ICU

Question 7

Likely Cardiac cause - YES - Options & Pathway:

Answer 7

1. 12 lead ECG
2. Check for ST elevation
3. If ST elevation IS present - Cor Angio +/- PCI
4. If ST elevation NOT present - Consider Cor Angio +/- PCI

Question 8

Cause for arrest identified - YES - Pathway:

Answer 8

Admit ICU
ICU Mx:
1. Temp control - prevent fever for at least 72 hrs
2. Maintain normoxia
3. Maintain normocapnia
4. Maintain normoglycaemia
5. Avoid hypotension
6. Echo
7. Dx / Rx seizures - EEG, sedation, AEDs
8. Delay prognostication for at least 72 hrs

Question 9

What does Secondary Prevention entail?

Answer 9

1. ICD
2. Risk factor Mx
3. Screen for inherited disorders