Causes of Arrest
Pyrexia must be prohibited post-cardiac arrest. It is common in the first 48 hours and the risk of a poor neurological outcome increases with each degree rise over 37oC. Maintain normothermia - 32 to 36 degrees.
Post ROSC Care
A MAP of about 65-100 mmHg is a reasonable starting point in most –adjusted according to response.
Hypothermia: No adrenaline until >30,
double time in between 30 - 35,
normal once >35
Drugs are often ineffective and will undergo reduced metabolism.
In primary hypothermic cardiac arrest, death should not be confirmed until:
The patient has been re-warmed
Other unsurvivable injuries have been identified
Re-warming has failed despite all available measures
1.5ml/kg bolus AND infusion 15ml/kg / hour
After 5 min 2 further boluses if not better
And double infusion to 30m/kg/hr
Resuscitate for one hour
5 Light headedness, circumoral paraesthesia, slurred speech + tinnitus
10 Convulsions, LOC
15 Coma, myocardial depression
20 Resp arrest + arrhythmia
>25 Cardiac arrest