Post cardiac arrest care: Difference between revisions
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==Prognostication<ref>Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066</ref>== | ==Prognostication<ref>Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066</ref>== | ||
*OHCA has about a 10% survival to discharge rate | *Out-of-hospital cardiac arrest (OHCA) has about a 10% survival to discharge rate | ||
*In-hospital cardiac arrest has just over a 20% survival to discharge rate | *In-hospital cardiac arrest has just over a 20% survival to discharge rate | ||
**About half will have no to mild disability, and the other half will have moderate to severe disability | **About half will have no to mild disability, and the other half will have moderate to severe disability | ||
Revision as of 06:37, 20 June 2019
Management
- Maintain perfusion (cerebral)
- Treat hypotension
- Ignore hypertension
- Maintain normal PaCO2 (~40)
- Target Normoxia
- PaO2 80-120
- Therapeutic Hypothermia
- PCI
- Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases[1]
- Aggressively treat hyperglycemia
- No IV fluids with glucose
- RISS
- Aggressive seizure treatment
- Prophylaxis unproven
- Minimize Irritation
- Sedatives +/- paralytics
- Supine positioning
Prognostication[2]
- Out-of-hospital cardiac arrest (OHCA) has about a 10% survival to discharge rate
- In-hospital cardiac arrest has just over a 20% survival to discharge rate
- About half will have no to mild disability, and the other half will have moderate to severe disability
- Lack of pupillary reflexes upon ROSC after OHCA are not reliable in prognosticating return of neurologic function
See Also
References
- ↑ Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017
- ↑ Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066