*The newest information for 2022 is available here:    • 7e: PostCardiac Arrest Care (2022) OLD  

This lesson discusses PostCardiac Arrest Care. The steps vary depending on the status of the person receiving care. The use of induced hypothermia is explained. Figure 30 in the corresponding ACLS manual can be used in accompaniment to this lesson.

*The newest information for 2022 is available here:    • 7e: PostCardiac Arrest Care (2022) OLD  

"If an individual has a return of spontaneous circulation or ROSC, start postcardiac arrest care immediately. The initial BLS and ACLS processes are meant to save an individual’s life, while postcardiac arrest care is meant to optimize ventilation and circulation, preserve heart and brain tissue and function, and maintain recommended blood glucose levels.
Consider blood pressure support in any individual with systolic blood pressure less than 90 mmHg or mean arterial pressure, or MAP, less than 65.

Unless contraindicated, 1 to 2 liters of IV saline or Lactated Ringer’s is the first intervention.

When blood pressure is very low, consider vasopressors (commonly referred to as “pressors”):
Epinephrine is the pressor of choice for individuals who are not in cardiac arrest.
Dopamine, phenylephrine, and methoxamine are alternatives to epinephrine.
Norepinephrine is generally reserved for severe hypotension or as a lastline agent.
Titrate the infusion rate to maintain the desired blood pressure.

Hypothermia is the only documented intervention that improves and/or enhances brain recovery after cardiac arrest. It can be performed in unresponsive individuals (that is., comatose) and should be continued for at least 24 hours.

The goal of induced hypothermia is to maintain a core body temperature between 89.6 to 96.8 degrees Fahrenheit (that is, 32 to 36 degrees Celsius). Device manufacturers have developed several innovative technologies that improve the ability to affect and manage hypothermia in the postarrest individual.

Hypothermia should be induced and monitored by trained professionals. Induced hypothermia should not affect the decision to perform percutaneous coronary intervention (or PCI), because concurrent PCI and hypothermia are reported to be feasible and safe.

For Adult Immediate PostCardiac Arrest Care Algorithm, please refer to Figure 30 in your corresponding ACLS manual."

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