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Post ROSC

The document outlines the post-cardiac arrest care protocol, emphasizing airway management, breathing support, circulation control, and differential diagnosis of potential causes. It includes specific guidelines for ventilation, fluid administration, and monitoring vital signs, as well as the importance of temperature and glucose control. Additionally, it highlights the need for neurological assessment and delaying prognostication for 72 hours after achieving normothermia.

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proaidkits
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4 views1 page

Post ROSC

The document outlines the post-cardiac arrest care protocol, emphasizing airway management, breathing support, circulation control, and differential diagnosis of potential causes. It includes specific guidelines for ventilation, fluid administration, and monitoring vital signs, as well as the importance of temperature and glucose control. Additionally, it highlights the need for neurological assessment and delaying prognostication for 72 hours after achieving normothermia.

Uploaded by

proaidkits
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Post Cardiac Arrest Care

(Return of Spontaneous Circulation)

A AIRWAY MANAGEMENT
Open, maintain and protect as necessary.
Advanced airway as required
Use capnography

2025 B BREATHING SUPPORT 2025

If required, ventilate every 6 seconds (children every 3 seconds)


Target oxygen saturation of 94-98%
Target normocarbia (CO2 35-45 mmHg) INITIAL VENTILATION
Apply lung protective ventilation when appropriate Tidal volume 6ml/kg (ideal weight)
PEEP ≥ 5 cmH2O
Target pH > 7.20 and

C CIRCULATION CONTROL ETCO2 35-45 mmHg

Maintain and monitor perfusion


Monitor heart rate, blood pressure and capillary refill
Consider appropriate fluid administration INITIAL INOTROPE
Consider vasopressor/inotrope infusion
Start adrenaline 0.3µg/kg/min
and titrate to effect
Advanced monitoring (mix 3mg adrenaline with 47 ml saline
Initially target SBP > 90 mmHg (MAP > 65 mmHg) or 12mg in 188ml. Administer at
Urine output (0.5ml/kg/hour) 0.3ml/kg/hour)
Measure lactate levels

D DIFFERENTIAL
DIAGNOSIS Hypoxia
CONTRIBUTORY CAUSES

Tension pneumothorax
Hypovolaemia Tamponade
Hypo/hyper-kalaemia Thrombosis (coronary)
Search for and correct Hydrogen ion imbalance (acidosis) Thrombosis (pulmonary)
Hypoglycaemia Toxins and drugs
possible causes of the arrest Hypothermia Trauma

E EVALUATION
12-lead ECG (consider right-sided leads)
Coronary angiography if arrest of suspected cardiac origin
Early reperfusion if indicated (especially STEMI and LBBB)
Continuous ECG monitoring
Haemodynamic monitoring

F FOCUS ON NORMAL TEMPERATURE


Avoid fever of > 37.5°C

G GLUCOSE CONTROL
Avoid hyper/hypo-glycaemia

H HEAD/NEUROLOGICAL ASSESSMENT
Monitor for seizures
Consider EEG monitoring
Consider brain imaging
Delay prognostication for 72 hours post normothermia 1

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