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Acute Immediate Post-Cardiac Arrest Care

Return of spontaneous circulation (ROSC)

Optimize ventilation and oxygenation ❑ Maintain oxygen saturation ≥ 94% ❑ Consider advanced airway and waveform capnography ❑ Do not hyperventilate ♦ Start at 10-12 breaths/min ♦ Titrate to target PETCO2 of 35-40 mmHg

Treat hypotension (SBP<90 mmHg) ❑ IV/IO bolus ♦ 1-2 L normal saline or lactated Ringer's ❑ Vasopressor infusion ♦ Epinephrine IV infusion: 0.1-0.5 mcg/kg/min, or ♦ Dopamine IV infusion: 5-10 mcg/kg/min, or ♦ Norepinephrine IV infusion: 0.1-0.5 mcg/kg/min ❑ Consider treatable causes ❑ 12-Lead ECG

Follow commands?

No

Yes

❑ Consider induced hypothermia

STEMI Or High suspicion of AMI

Yes

No

❑ Coronary reperfusion

Advanced critical care

Adapted from 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 9.

Dont's

• Do not Hyperventilate or overbag the patient, it may lead to decreased cardiac output.