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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.