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Algorithm of Resuscitation Care

The document outlines the post-resuscitation care for patients who have achieved return of spontaneous circulation (ROSC) but remain comatose. Immediate treatment involves maintaining airway, breathing, and circulation. Temperature should be controlled between 32-36 degrees Celsius. Diagnosis involves determining if the likely cause was cardiac, with ECG, coronary angiography, and CT scans used. ICU management optimizes recovery through temperature control, ventilation, hemodynamics monitoring, and preventing seizures and fever for 72 hours before prognostication. Secondary prevention and follow up rehabilitation are also addressed.

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jyothi
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84 views

Algorithm of Resuscitation Care

The document outlines the post-resuscitation care for patients who have achieved return of spontaneous circulation (ROSC) but remain comatose. Immediate treatment involves maintaining airway, breathing, and circulation. Temperature should be controlled between 32-36 degrees Celsius. Diagnosis involves determining if the likely cause was cardiac, with ECG, coronary angiography, and CT scans used. ICU management optimizes recovery through temperature control, ventilation, hemodynamics monitoring, and preventing seizures and fever for 72 hours before prognostication. Secondary prevention and follow up rehabilitation are also addressed.

Uploaded by

jyothi
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Post-resuscitation Care

(ROSC and comatose)

Airway and Breathing


 Maintain SpO 2 94 – 98%
 Advanced airway
 Waveform capnography
 Ventilate lungs to normocapnia
Immediate treatment

Circulation
 12-lead ECG
 Obtain reliable intravenous access
 Aim for SBP > 100 mmHg
 Fluid (crystalloid) – restore normovolaemia
 Intra-arterial blood pressure monitoring
 Consider vasopressor/ inotrope to maintain SBP

Control temperature
 Constant temperature 32 oC – 36 oC
 Sedation; control shivering

Likely cardiac cause?

No Yes

ST elevation on 12 lead ECG?


Diagnosis

No Yes

Consider Coronary
Coronary angiography ± PCI
angiography ± PCI

Consider CT brain No Cause for cardiac arrest


and/or CTPA identified?
Yes

Treat non-cardiac cause of


Admit to Intensive Care Unit
cardiac arrest

ICU management
 Temperature control: constant temperature 32 oC – 36 oC for ≥ 24 h; prevent fever for at least 72 h
 Maintain normoxia and normocapnia; protective ventilation
Optimising recovery

 Optimise haemodynamics (MAP, lactate, ScvO 2, CO/CI, urine output)


 Echocardiography
 Maintain normoglycaemia
 Diagnose/treat seizures (EEG, sedation, anticonvulsants)
 Delay prognostication for at least 72 h

Secondary prevention
e.g. ICD, screen for inherited Follow-up and rehabilitation
disorders, risk factor management

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