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===Acute Immediate Post-Cardiac Arrest Care===
{{familytree/start |summary=Post-Cardiac arrest care}}
{{familytree | | | | | | | A01 | | | | | A01= '''Return of spontaneous circulation<br>(ROSC)'''}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | | | | | | | A02 | | | | | A02=<div style="float: left; text-align: left; line-height: 150% "> '''Optimize [[ventilation]] and [[oxygenation]]'''<br> ❑ Maintain oxygen saturation ≥ 94% <br> ❑ Consider advanced airway and waveform [[capnography]] <br> ❑  Do not hyperventilate <br>
: ♦ Start at 10-12 breaths/min<br>
: ♦ Titrate to target PETCO<sub>2</sub> of 35-40 mmHg </div>}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | | | | | | | A03 | | | | | A03= <div style="float: left; text-align: left; line-height: 150% ">'''Treat [[hypotension]] ([[SBP]]<90 mmHg)'''<br> ❑ IV/IO bolus <br>
: ♦ 1-2 L [[normal saline]] or [[lactated Ringer's]]  <br>
❑ [[Vasopressor]] infusion <br>
: ♦ [[Epinephrine]] IV infusion: 0.1-0.5 mcg/kg/min, or<br>
: ♦ [[Dopamine]] IV infusion: 5-10 mcg/kg/min, or<br>
: ♦ [[Norepinephrine]] IV infusion: 0.1-0.5 mcg/kg/min<br>
❑ Consider treatable causes <br> ❑ 12-Lead [[ECG]] </div>}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | | | | | | | A04 | | | | | A04= '''Follow commands?'''}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | |,|-|-|-|-|-|(| | | | | | }}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B01 | | | | A05 | | | | | B01= No| A05= Yes|border=0}}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B02 | | | | |!| | | | | | B02= Consider induced [[hypothermia]]}}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | |`|-|-|-|-| A06 | | | | | A06= '''[[STEMI]]''' <br>Or<br> '''High suspicion of [[AMI]]'''}}
{{familytree | | | | | | | |!| | | | | | }}
{{familytree | |,|-|-|-|-|-|(| | | | | | }}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B03 | | | | A07 | | | | | B03= Yes| A07= No|border=0 }}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | B04 | | | | |!| | | | | | B04= Coronary reperfusion}}
{{familytree | |!| | | | | |!| | | | | | }}
{{familytree | |`|-|-|-|-| A08 | | | | | A08= '''Advanced critical care'''}}
{{familytree/end}}
''Adapted from 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 9.''<ref name="pmid20956225">{{cite journal| author=Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M et al.| title=Part 9: post-cardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. | journal=Circulation | year= 2010 | volume= 122 | issue= 18 Suppl 3 | pages= S768-86 | pmid=20956225 | doi=10.1161/CIRCULATIONAHA.110.971002 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20956225  }} </ref>

Revision as of 23:06, 1 January 2014

Acute Immediate Post-Cardiac Arrest Care

 
 
 
 
 
 
Return of spontaneous circulation
(ROSC)
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Optimize ventilation and oxygenation
❑ Maintain oxygen saturation ≥ 94%
❑ Consider advanced airway and waveform capnography
❑ Do not hyperventilate
♦ Start at 10-12 breaths/min
♦ Titrate to target PETCO2 of 35-40 mmHg
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Treat hypotension (SBP<90 mmHg)
❑ IV/IO bolus
♦ 1-2 L normal saline or lactated Ringer's

Vasopressor infusion

Epinephrine IV infusion: 0.1-0.5 mcg/kg/min, or
Dopamine IV infusion: 5-10 mcg/kg/min, or
Norepinephrine IV infusion: 0.1-0.5 mcg/kg/min
❑ Consider treatable causes
❑ 12-Lead ECG
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Follow commands?
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
No
 
 
 
Yes
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Consider induced hypothermia
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
STEMI
Or
High suspicion of AMI
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Yes
 
 
 
No
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Coronary reperfusion
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Advanced critical care
 
 
 
 
 
 
 
 
 

Adapted from 2010 AHA guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 9.[1]

  1. Peberdy MA, Callaway CW, Neumar RW, Geocadin RG, Zimmerman JL, Donnino M; et al. (2010). "Part 9: post-cardiac arrest care: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation. 122 (18 Suppl 3): S768–86. doi:10.1161/CIRCULATIONAHA.110.971002. PMID 20956225.