Post-Resuscitation Care Protocol

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Questions and Answers

What is the primary goal of administering a fluid bolus of normal saline following ROSC?

To treat arrhythmias

To prevent STEMI

To reduce the risk of hyperventilation

To increase blood pressure to at least 90 mmHg (correct)

What should be monitored continuously after ROSC?

Only SpO2

SpO2 and CO2 waveform capnography (correct)

ECG only

Only CO2 waveform capnography

What is the recommended dose of lidocaine for treating frequent or multifocal PVCs after ROSC?

2 mg/kg IV bolus

1 mg/kg IV bolus (correct)

0.5 mg/kg IV bolus

No lidocaine is recommended

What should be done if the patient remains unconscious and is not pregnant after successful resuscitation of an atraumatic cardiac arrest?

Recommend an ICE ALERT to the STEMI Center Signup and view all the answers

Why is a 12-lead ECG recommended after ROSC?

To rule out STEMI Signup and view all the answers

What is the concentration of premixed dopamine in D5W?

1,600 mcg/mL Signup and view all the answers

Why is routine administration of anti-arrhythmics following ROSC not indicated?

Because it is not supported by evidence Signup and view all the answers

What is the primary goal of evaluating the patient after ROSC?

To determine and treat the underlying causes of the cardiac arrest Signup and view all the answers

What is the first step in evaluating the patient after ROSC?

Check for the presence of carotid pulse Signup and view all the answers

What is the recommended action if the patient's systolic BP remains less than 90 mmHg after administering two normal saline boluses?

Administer premixed dopamine, 400 mg in 250 mL D5W Signup and view all the answers

What is the primary reason for performing a 12-lead ECG after ROSC?

To rule out a STEMI Signup and view all the answers

What should be done if the patient has frequent or multifocal PVCs after ROSC?

Administer lidocaine, 1 mg/kg IV bolus Signup and view all the answers

Why is it important to monitor CO2 waveform capnography after ROSC?

To ensure adequate ventilation and oxygenation Signup and view all the answers

What is the primary goal of administering premixed dopamine after ROSC?

To increase the patient's blood pressure Signup and view all the answers

Why is it important to transport all ROSC patients to a STEMI center?

Because they all require further evaluation and treatment Signup and view all the answers

What should be done if a STEMI is detected on the 12-lead ECG after ROSC?

Call a STEMI Alert Signup and view all the answers

Study Notes

Post-ROSC Evaluation and Treatment

After successful resuscitation (ROSC), evaluate for presence of carotid pulse and adequate ventilation/oxygenation, avoiding hyperventilation.
Monitor SpO2 and CO2 waveform capnography continuously.
Obtain blood pressure if there is a carotid pulse.

Arrhythmia Treatment

Treat arrhythmias according to the appropriate protocol.
Administer lidocaine, 1 mg/kg IV bolus, for frequent (more than 6/minute) or multifocal PVCs, and repeat at half dose in 10 minutes if indicated.

Blood Pressure Management

Administer a fluid bolus of normal saline, 500 mL IV/IO, if systolic BP is less than 90 mmHg, and repeat once if necessary.
If normal saline boluses are not successful, administer premixed dopamine, 400 mg in 250 mL D5W (1,600 mcg/mL), starting at 30 drops per minute and titrating until BP is equal to or greater than 90 mmHg systolic.

ECG and STEMI Alert

Perform a 12-lead ECG if time permits, and call a STEMI Alert immediately if a STEMI is present.
Transport all ROSC patients to a STEMI center, even if there is no ST segment elevation, but only call a STEMI Alert if there is ST segment elevation.

Additional Considerations

Attempt to determine and treat the underlying causes of the cardiac arrest.
Consider an ICE ALERT to the STEMI Center for unconscious patients who are not pregnant after successful resuscitation of an atraumatic cardiac arrest.

Post-ROSC Evaluation and Treatment

After successful resuscitation (ROSC), evaluate for presence of carotid pulse and adequate ventilation/oxygenation, avoiding hyperventilation.
Monitor SpO2 and CO2 waveform capnography continuously.
Obtain blood pressure if there is a carotid pulse.

Arrhythmia Treatment

Treat arrhythmias according to the appropriate protocol.
Administer lidocaine, 1 mg/kg IV bolus, for frequent (more than 6/minute) or multifocal PVCs, and repeat at half dose in 10 minutes if indicated.

Blood Pressure Management

Administer a fluid bolus of normal saline, 500 mL IV/IO, if systolic BP is less than 90 mmHg, and repeat once if necessary.
If normal saline boluses are not successful, administer premixed dopamine, 400 mg in 250 mL D5W (1,600 mcg/mL), starting at 30 drops per minute and titrating until BP is equal to or greater than 90 mmHg systolic.

ECG and STEMI Alert

Perform a 12-lead ECG if time permits, and call a STEMI Alert immediately if a STEMI is present.
Transport all ROSC patients to a STEMI center, even if there is no ST segment elevation, but only call a STEMI Alert if there is ST segment elevation.

Additional Considerations

Attempt to determine and treat the underlying causes of the cardiac arrest.
Consider an ICE ALERT to the STEMI Center for unconscious patients who are not pregnant after successful resuscitation of an atraumatic cardiac arrest.

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Description

This quiz covers the steps to be taken after a successful resuscitation, including evaluating the patient's vital signs, monitoring oxygenation and ventilation, and treating any arrhythmias that may arise.