Post Cardiac Arrest

Question 1

Optimize Ventilation and Oxygenation

Answer 1

1. Maintain O2 94-99%
2. Advanced airway / capnography
3. Avoid hypercapnia or hypocapnia

Question 2

Treat Persistent Shock

Answer 2

1. Consider fluid boluses (10-20 ml/kg or 5-10 ml/kg over 10 - 20 minutes)
2. Need for inotropic/vasopressor support for fluid-refractory shock

Question 3

Drugs for hypotensive shock

Answer 3

1. Epi (0.1 - 1 mcg/kg per min)
2. Dopamine (10 - 20 mcg/kg per min)
3. Norepinephrine (0.1-2 mcg/kg per min)

Question 4

Drugs for normotensive shock

Answer 4

1. Dobutamine (2 - 20 mcg/kg per min)
2. Dopamine (2 - 20 mcg/kg per min)
3. Epi ( 0.1 to 0.3 mcg/kg per min)
4. Milirone ( 50 mcg/kg over 10-60 mins, infusion 0.25-0.75 mcg/kg per min)

Question 5

Possible Contributing factors

Answer 5

Hs and Ts

Question 6

Lastly Monitor

Answer 6

1. Agitation/Seizures
2. BS
3. ABGs, electrolytes, calcium
4. TTM
5. Consider transport to tertiary care center

Question 7

Fluid resuscitation calculation

Answer 7

4 - 2 - 1

Question 8

<10 kg

Answer 8

4ml/kg per hour

Question 9

10-20 kg

Answer 9

40ml/h + 2ml per hour
for each KG between 10 and 20 kg

Example 15 kg child
40 + 2 x 5 = 50 ml/hr

Question 10

> 20 kg

Answer 10

60 ml/h + 1 ml/kg per hour for each kg above 20 kg