Return of Spontaneous Circulation

Question 1

0.9% NaCl Fluid Bolus
Conditions:
AGE?
SBP?
OTHER?

Answer 1

Age: N/A
Systolic Blood Pressure: Hypotension
Other: Chest Auscultation is clear

Normotension ≥ [100mmHg] [Hypotension < 90mmHg] [Paeds: Age x 2 + 70]

Question 2

0.9% NaCl Fluid Bolus
Contraindications

Answer 2

Fluid Overload

Question 3

Oxygenation (SpO2)
and
ETCO2
Value ranges

Answer 3

SpO2 –> 94 - 98%
ETCO2 –> 30 - 40 mmHg

Optimizing oxygenation and targeting SpO2 of 94 to 98% (avoiding 100%) will provide adequate oxygenation and will minimize vasoconstriction and the development of oxygen free radicals. Despite ideal SpO2 values, oxygen administration should be continued if the patient remains unstable.

Question 4

0.9% NaCl Fluid Bolus < 12 Years
Route - IV / IO / CVAD
Infusion?
Infusion Interval ?
Re-assess every?
Max. Volume?

Answer 4

Infusion: 10ml/kg
Infusion interval: Immediate
Re-assess every: 100ml
Max. Volume: 1000ml

if bolus prior to ROSC still can continue with 1000ml

Question 5

0.9% NaCl Fluid Bolus > 12 Years
Route - IV / IO / CVAD
Infusion?
Infusion Interval ?
Re-assess every?
Max. Volume?

Answer 5

Infusion: 10ml/kg
Infusion Interval: Immediate
Re-assess every: 250ml
Max. Volume: 1000ml

Question 6

DOPAMINE
Conditions:
Age?
SBP?

Answer 6

Age: ≥ 8 years
SBP: Hypotension

Question 7

DOPAMINE Contraindications

ROSC

Answer 7

1. Allergy or sensitivity
2. Tachydysrhythmias excluding sinus Tachycardia
3. Mechanical Shock (Obstructive)
4. Hypovolemia
5. Pheochromocytoma

Mechanical Shock - PE, Tamponade, Tension Pneumo

Question 8

DOPAMINE
Route - IV
Initial Infusion Rate?
Titration increments?
Titration Intervals?
Max. Infusion Rate?

SBP Goal with titration?
Discontinuation must be done?

Answer 8

Initial Infusion Rate: 5mcg/kg/min
Titration Increments: 5mcg/kg/min
Titration intervals: 5 mins
Max. Infusion Rate: 20mcg/kg/min

SBP Goal ≥90mmHg to <110mmHg
Discontinuation - must be done gradually over 5 - 10mins