Post-ROSC management Flashcards
What is the aim of Post-ROSC management?
Minimise post-cardiac arrest syndrome:
Brain injury
Myocardial Dysfunction
Systemic ischaemia /reperfusion response
What can we do Post-ROSC to reduce the chance of passive regurgitation?
Raise the head to 30 degrees
What airway should we use post-ROSC?
The most advanced possible
Why do we want to avoid hypotension post-ROSC?
Studies have shown increased negative outcomes
AND
May exacerbate brain injury
Why do we need to address high BGL post-ROSC
High BGL after ROSC is linked to poor neurological outcomes
Why is temperature important post-ROSC?
Hyperthermia may aggravate ischemia-reperfusion injury and neuronal damage
How many breaths per minute should we give a patient post-ROSC?
10-12
What saturations should we aim for in a patient without who doesnt require a BVM post-ROSC?
94-98%
What should we do if our post-ROSC patient has increasing hypercapnia (>45mmHg)?
Increase ventilation
Aim to decrease EtCO2 by 1mmHg/min
How to we manage Hypotension in the ROSC adult?
250mL aliquots up to 20mL/kg
-Cease if signs of fluid overload
How do we manage hypotension in the ROSC adult when fluid fails?
Syringe driver
-Start at 5mcg/min
OR
-manual infusion at 0.1mcg/kg/min (1drop = 6mcg/min
-consult if 50mcg/min required
OR
bolus adrenaline up to 50mcg
How do we manage hypotension in the ROSC paed ?
Saline up to 10mL/kg
How do we manage recurrent episodes of VT/VF or non sustained episodes of VT in the ROSC adult?
IV/IO Amiodarone
-300mg infusion over 20mins
OR
-150mg over 10 mins if 300 administered during arrest
How do we manage hypoglycaemia in the ROSC adult?
Titrate glucose to a BGL of 3.5-10mmol/L
How do we manage hypoglycaemia in the ROSC paed?
Aim to a BGL of 3.5-10mmol/L
-Start with 2mL/kg
-Max Dose 5mL/kg
