Immediate Post-Cardiac Arrest Care

Question 1

ROSC

Answer 1

Return of spontaneous circulation

Question 2

Primary goals of Post-Cardiac arrest care

Answer 2

• Optimize hemodynamic and ventilation status
• Initiate TTM (targeted temperature management)
• Provide immediate coronary reperfussion with PCI
• Provide neurologic care

Question 3

Post-Cardiac arrest care algorithm step 1:

Answer 3

Return of spontaneous circulation (ROSC)

Question 4

Post-Cardiac arrest care algorithm step 2:

Answer 4

Optimize ventilation and oxygenation:

• Maintain O2 sat greater than or equal to 94%
• Consider advanced airway and waveform capnograph
• Do not hyperventilate

Question 5

Post-Cardiac arrest care algorithm step 3:

Answer 5

Treat hypotension (SBP less than 90 mmHg)

• IV/IO bolus
• Vasopressor infusion
• Consider treatable causes

Question 6

Post-Cardiac arrest care algorithm step 4:

Answer 6

ECG: if STEMI or high suspicion of AMI

• yes: step 5 coronary reperfusion
• no: step 6 do they follow commands?

Question 7

Post-Cardiac arrest care algorithm step 5:

Yes to STEMI or high suspicion of AMI: action?

Answer 7

Coronary reperfusion

Step 6: follow commands?

Question 8

Post-Cardiac arrest care algorithm step 6:

Do they follow commands?

Answer 8

If yes: advanced critical care, Step 8

If no: initiate TTM, step 7

Question 9

Post-Cardiac arrest care algorithm step 7 & 8:

Answer 9

Step 7: TTM

Step 8: Advanced critical care

Question 10

Treatment of hypotension doses: IV and drugs

Answer 10

IV bolus: 1-2 L NS or LR
Epi IV: 0.1 - 0.5 mcg/kg per min (70kg adult: 7-35 mcg/min
Dopamine IV: 5-10 mcg/kg per min
Norepi: 0.1-0.5 mcg/kg per min (70kg adult: 7-35 mcg/min