Post-Resus Care

Question 1

What is the main goal of resuscitation?

Answer 1

1. Return pt. to normal cerebral function
2. Normal haemodynamic Fx
3. Est. & maintain stable cardiac rhythm

Question 2

What is post-cardiac arrest syndrome?

Answer 2

1. Brain injury
2. Myocardial dysFx
3. Systemic ischemia/ reperfusion response
4. Persistent precipitating pathology

Question 3

What approach to follow to Rx pt. immediately post-resus?

Answer 3

1. ABCDE approach

Question 4

Post-resus ABCDE approach - A & B - Aim:

Answer 4

1. Clear airway
2. Adequate oxygenation
3. Adequate ventilation

Question 5

Adult Post-Resus Care Guidelines - A & B:

Answer 5

1. Sats 94-98%
2. Insert advanced airway
3. Waveform capnography
4. Ventilate lungs to normocapnia

Question 6

Which post-resus pt’s need intubation, sedation & controlled ventilation?

Answer 6

1. Those w/ obtunded cerebral Fx

Question 7

Post-resus ABCDE approach - C - Aim:

Answer 7

1. Maintain normal sinus rhythm
2. Maintain normal cardiac output

To adequately perfuse vital organs

Question 8

Adult Post-Resus Care Guidelines - C:

Answer 8

1. 12 lead ECG
2. IV access
3. Restore normovolaemia - crystalloid fluids
4. SBP > 100 mmHg
5. Inotropes/vasopressors to maintain SBP
6. IABP monitoring

Question 9

Post-resus ABCDE approach - D & E - Aim:

Answer 9

1. Evaluate neurological Fx
2. Ensure arrest not been ass. w/ other medical or surgical conditions needing immediate Rx

Question 10

Adult Post-Resus Care Guidelines - E - Control Temperature:

Answer 10

1. Constant temp: 32 - 36°C
2. Sedation
3. Control shivering

Question 11

Which post-resus pt’s need targeted temp Mx?

Answer 11

1. Those who remain comatosed after initial resus

Question 12

What to do after post-resus ABCDE approach?

Answer 12

1. Hx
2. Monitoring
3. Investigations
4. Pt. transfer

Question 13

Post-resus approach - Hx - Aim:

Answer 13

1. Determine pt’s state of health
2. Chronic medication

Question 14

Post-resus approach - Monitoring - Aim:

Answer 14

1. Continuous asssessment of vital organ Fx
2. ID trends

Question 15

Post-resus approach - Investigations - Which ones to run?

Answer 15

1. FBC - anaemia
2. Biochemistry - renal Fx, electrolytes, glucose, troponin, baseline
3. ABG - Ventilation & oxygentation, acid/base balance
4. 12 lead ECG - ACS, old MI, rhythm, baseline
5. Echo - LV & RV Fx

Question 16

Post-resus approach - Pt. Transfer - Aim:

Answer 16

1. Safe transfer of pt. between resus site & place of definitive care

ICU or CCU