Post Cardiac Arrest Algorithm

If patient has ROSC/+ Pulse

1. Check O2 Sat, Goal 94%

Manage airway
Early placement of endotracheal tube
Manage respiratory parameters
Start 10 breaths/min
Spo2 92%-98%
Paco2 35-45 mm Hg

2. Check SBP, 90mm Hg – Treat with Fluids (1-2 L NS or LR) and then with Meds

Drips [Mcg/kg/Min] = [Epinephrine, Norepinephrine] [0.1-0.5] or  (Dopamine) (5-10)                    

Manage hemodynamic parameters
Systolic blood pressure >90 mm Hg
Mean arterial pressure >65 mm Hg

3. Check EKG & Labs –Take to Cath Lab as needed if EKG is abnormal & Address incorrect labs as needed.

Consider for emergent cardiac intervention if
• STEMI present
• Unstable cardiogenic shock
• Mechanical circulatory support required

4. Check Consciousness

If Comatose
• Institute Targeted Temperature Management [TTM] 32-360 C for 24 hours by using a cooling device with feedback loop.
• Obtain brain CT
• EEG monitoring
• Other critical care management – Continuously monitor core temperature (esophageal, rectal, ladder), – Maintain normoxia, normocapnia, euglycemia, – Provide continuous or intermittent
electroencephalogram (EEG) monitoring, – Provide lung-protective ventilation

Evaluate and treat rapidly reversible etiologies
Involve expert consultation for continued management

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