Jump to content


Photo

Post Arrest Care Protocols?


  • Please log in to reply
8 replies to this topic

#1 mg/kg

mg/kg

    Advanced Member

  • Members
  • PipPipPip
  • 43 posts

Posted 21 December 2011 - 01:00 AM

Hey everyone,


What (if any) are your program's post arrest care protocols? The company I currently work for (ground) only really goes as far as "maintain Sp02 above 95%" and give fluids for hypotension. What is everyone doing for their pts post arrest?


Mike
  • 0

#2 MA_Flt_Medic

MA_Flt_Medic

    Member

  • Members
  • PipPip
  • 15 posts

Posted 21 December 2011 - 03:01 AM

I guess I'm not understanding your question...
Doesn't it depend upon how the pt is presenting, and what the precipitating causes of the arrest where? Can there be a blanket "post arrest" SMO?
I suppose you manage the oxygenation, electrolytes and acid base issues, MAPs w/ pressors etc, hypothermia if it's indicated. While managing the underlying cause of the arrest. Not sure what you are looking for.



  • 0


Nunquam Quietus

#3 mg/kg

mg/kg

    Advanced Member

  • Members
  • PipPipPip
  • 43 posts

Posted 21 December 2011 - 03:43 AM

I guess I'm not understanding your question...
Doesn't it depend upon how the pt is presenting, and what the precipitating causes of the arrest where? Can there be a blanket "post arrest" SMO?
I suppose you manage the oxygenation, electrolytes and acid base issues, MAPs w/ pressors etc, hypothermia if it's indicated. While managing the underlying cause of the arrest. Not sure what you are looking for.




After getting ROSC, what does your system require or better yet allow? Is there a specific written protocol(s) for such events? My neck of the woods requires us to contact medical control if the pt is in need of dopamine or epi infusions after we achieve ROSC. Just curious what other are doing in terms of post arrest care.
  • 0

#4 yourAVERAGEmedic

yourAVERAGEmedic

    Advanced Member

  • Members
  • PipPipPip
  • 187 posts

Posted 27 December 2011 - 06:27 PM

How long are your transport times? Assuming you are doing ground CCT...

ROSC care starts with one question: awake or not awake? If the patient is awake, care is supportive, maintain vitals, etc, and don't treat tachycardias unless potentially lethal (e.g. VT)

patients who are not awake, generally defined as a GCS of under 8-10 depending on the system, are the cooling candiates. cooling is best driven by the strategies used at the receiving facility. Don't have your own cooling that cannot be maintained at the accepting CCU. cooling then rewarming is dangerous if not controlled. We utilize a pretty comprehensive management strategy for ROSC patients. but treatment is focused on the underlying etiology.

The most important post-arrest intervention is arguably performing regular 12-lead EKGS to monitor for STEMI.
  • 0

Kevin Collopy, BA, FP-C, CCEMT-P, NREMT-P, CMTE


#5 old school

old school

    Advanced Member

  • Members
  • PipPipPip
  • 1121 posts

Posted 27 December 2011 - 11:08 PM

We have a post-resuscitation protocol. It covers the indications for pressors, inotropes, IVF, etc.

We also have a therapeutic hypothermia protocol for resuscitated patients who meet certain criteria (witnessed arrest with immediate CPR, etc).

PM me if you want more info.
  • 0
bring it in for the real thing

#6 mg/kg

mg/kg

    Advanced Member

  • Members
  • PipPipPip
  • 43 posts

Posted 28 December 2011 - 02:00 AM

We have a post-resuscitation protocol. It covers the indications for pressors, inotropes, IVF, etc.

We also have a therapeutic hypothermia protocol for resuscitated patients who meet certain criteria (witnessed arrest with immediate CPR, etc).

PM me if you want more info.




Apparently you cannot receive any new messages.
  • 0

#7 old school

old school

    Advanced Member

  • Members
  • PipPipPip
  • 1121 posts

Posted 28 December 2011 - 03:08 AM

Apparently you cannot receive any new messages.


Fixd B)
  • 0
bring it in for the real thing

#8 Macgyver

Macgyver

    Advanced Member

  • Members
  • PipPipPip
  • 868 posts

Posted 28 December 2011 - 05:28 AM

Silly me - I was thinking he was interested in protocols for treating pepper sprayed / CS / mace'd protesters etc once in police custody....
  • 0
Ken BHSc, RN, REMT-P

#9 Jack Frost

Jack Frost

    Newbie

  • Members
  • Pip
  • 3 posts

Posted 28 December 2011 - 02:54 PM

I have a copy of our guidelines, PM me if you want them.

Essentially it boils down to; RSI, therapeutic cooling (if collapse to ROSC >10/60), Rx reperfusion arrythmias and maintain systolic BP >120 with fluids / adrenaline (epi).

-Tim.
  • 0
Tim D.
BN/BP, RN, GAP