This lesson discusses Post-Cardiac 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.

"If an individual has a return of spontaneous circulation or ROSC, start post-cardiac arrest care immediately. The initial BLS and ACLS processes are meant to save an individual’s life, while post-cardiac 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”):
Dopamine and Norepinephrine are the pressors of choice for individuals who are not in cardiac arrest.
Vasopressin and phenylephrine are the second agents to be added.
Epinephrine is generally reserved for severe hypotension or as a last-line agent.

Titrate the infusion rate to maintain the desired blood pressure.

Targeted temperature management is the only documented intervention that improves/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 targeted temperature management is to maintain a core body temperature between 89.6 to 96.8 degrees F (32 to 36 degrees C) for at least 24 hours by using a cooling device with a feedback loop. Device manufacturers have developed several innovative technologies that improve the ability to affect and manage targeted temperature management in the post-arrest individual.

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

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

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