ROSC (Return of Spontaneous Circulation) Flashcards
A healthy ______ is the primary goal of all cardiopulmonary-cerebral resuscitation.
brain
In the immediate post resuscitation period what are the most important actions the paramedic can take to restore cerebral function?
Optimize ABCs, oxygenation, and perfusion.
When the medic is reassessing the patient what are the 4 most important things to check?
1) Check tube placement
2) Do not hypo or hyperventilate patient
3) Maintain SpO2
4) Maintain PetCO2
How many breaths per minute should the ROSC patient receive?
10 breaths per minute. 1 every 6 seconds.
What is the optimal SpO2 range of the ROSC patient?
between 92 and 96%
What is the optimal PETCO2 range of the ROSC patient?
between 35 and 45 Torr
If ROSC was obtained from VF/Pulseless VT what drug and at what rate should be administered?
Amiodarone drip of 150mg over 10 minutes. Followed by an Amiodarone maintenance infustion of 1mg/min.
What are the Amiodarone infusion mixing instructions for the ROSC patient?
Dilute 150mg of Amiodarone in 100mL of DW5 to yield and concentration of 1.5 mg/mL.
What two diagnostic procedures should you perform on the ROSC patient?
12 Lead and a blood glucose level.
What drug and at what rate should be given for hypotension that is unresponsive to fluid bolus?
Levophed Infusion 0.1 to 0.5 mcg/kg/min titrated to remain a systolic BP of >90mmHg.
What are the mixing instructions for Levophed for the ROSC patient?
Dilute 4 mg of Levophed in 250mL of NS to yield a concentration of 16 mcg/mL
What drug and at what dose should be given for post resuscitation sedation to maintain airway?
Versed 2.5 to 5 mg slow IVP every 5 minutes as needed. Maximum total is 20 mg.
Most patients will require _______ _______ immediately following post resuscitation?
ventilatory assistance.
You must avoid hyperventilation, what diagnostic tool should you be using?
Capnography
In the ROSC patient, you should elevate the head how many degrees? Why?
15 to 30 degrees, this will assist in increasing cerebral venous drainage and decrease ICP.
You should avoid even mild ______. You should consider whether the instability of this patient comes from ______, ________, or _______ problem in the cardiovascular system.
hypotension
volume, pump, or rate
A _______ _______ _______ may develop in the immediate post-resuscitation period and is best ______ _________.
supraventricular tachycardia and is best left untreated.
Bradycardia in the post resuscitation period should first be managed by__________________ before administration of atropine or other chronotropic agents.
ruling out hypoxia, airway, and/or ventilation problems
Why should you closely monitor fluid resuscitation?
Large volumes of fluid can cause increased pre-load that may cause decreased coronary perfusion pressure.
