Post Resuscitation Care

Question 1

When is post resuscitation care started?

Answer 1

Immediately after a sustained ROSC, regardless of location. Consider transport to a recognised centre of care.

Question 2

What are 4 key elements of post-cardiac arrest syndrome?

Answer 2

• Brain injury
• Myocardial dysfunction
• Systemic ischemia/reperfusion response
• Persistence of the precipitating pathology

Question 3

What should you do to prepare yourself after achieving a ROSC?

Answer 3

• Recurrence of VF
• Re-evaluate <C>ABCD</C>
• Maintain pts airway
• Reassess the H’s and T’s
• Measure and record a full set of observations and repeat at regular intervals
• Request additional resources if required
• Extrication plan
• Triage decision

Question 4

Why would you administer adrenaline to a patient post-arrest?

Answer 4

To maintain a systolic blood pressure over 100mmHg

Question 5

Should you maintain airway and breathing support after achieving a ROSC?

Answer 5

Yes - in the event the patient returns not normal cerebral function continue oxygen therapy to maintain saturations above 94%. In patients who remain comatose continue airway management.

Question 6

What is the guidance for post-arrest adrenaline?

Answer 6

Careful administration of an adrenaline bolus, repeated as required, every 3-5 minus to maintain the systolic BP above 100mmHg.

Follow each adrenaline bolus with a flush of 20ml 0.9% saline.

Question 7

In a patient with ROSC after cardiac arrest of suspected cardiac origin with ST elevation on the ECG, what interventions do they need?

Answer 7

Coronary reperfusion via catheterisation

Question 8

How would you manage a combative ROSC patient?

Answer 8

Find the course of the aggression
- hypoglycaemia, hypoxia
- pain relief
- additional support such as anaesthetic management or sedation