Post Cardiac Arrest Triage Protocol

Question 1

Where should POHCA Pt’s be transported to & why?

Answer 1

Regional Cardiac Receiving Center:

• Banner University Main
• NWMC
• St Mary’s
• TMC
• Banner South
• St Joes
• NWMC Houghton

*Deliver therapeutic hypothermia & 24/7 cardiac catheterization

Question 2

What Criteria Should be Met in order to deliver these Pt’s to a CRC

Answer 2

1. Adult (age 18 or older) not known to be pregnant (See High Risk OB
   Triage Protocol)
2. Palpable pulse or other evidence of spontaneous circulation after
   nontraumatic OHCA
3. No prehospital medical care directive (Orange form)for withholding care

*Pts w/ an unstable airway or uncontrolled hemorrhage should be
transported to the closest facility

Question 3

Number of ROSC Priorities

Answer 3

6

Question 4

1st ROSC Priority

Answer 4

Support Airway/Oxygenation/Ventilation:

• Leave I-gel in place
• ETCO2 @ 40 (35-45)
• Continue maximal O2 therapy
• BVM ventilation rate of 8-10 bpm
• Do not overventilate/hyperventilate

Question 5

2nd ROSC Priority

Answer 5

Prevent hyperthermia only, do not
perform therapeutic hypothermia

Question 6

3rd ROSC Priority

Answer 6

Obtain 12-lead ECG

Question 7

4th ROSC Priority

Answer 7

Obtain Peripheral IV Access

Question 8

5th ROSC Priority

Answer 8

• Prep Push Dose Epi stick
• Monitor for shock & TX if vitals are downtrending or if in shock

Question 9

6th ROSC Priority

Answer 9

If Rearrest Occurs:

• Resume Compressions
• Do not give 3rd dose of Push Dose Epi

Question 10

Prior to Transport

Answer 10

1. Transmit 12 Lead
2. Provide STEMI ALERT if patients meets STEMI criteria
3. Provide Direct communication to the receiving facility