Post Cardiac Arrest Care
- Applies to pediatric patients resuscitated from cardio-respiratory arrest who have a perfusing rhythm and pulse, and who remain unresponsive.
- Continue to support respirations with BVM, attempting to time support with the patients own respirations
- ETCO2 should be used in line with bag during BVM. If the patient is breathing and BVM is not necessary then nasal cannula ETCO2 should be placed on the patient.
- Maintain normal ventilation and oxygenation. Respiratory rate of 1 breath every 2 to 3 seconds (20-30 breaths per minute) is adequate for pediatric patients in cardiac arrest when an advanced airway is in place or if the patient is only in respiratory arrest. Target a pulse oximetry value of 94 to 99%.
- Stabilize dysrhythmias:
- Stable tachycardia or bradycardia – treat per protocols
- If initial arrest rhythm was v-fib or v-tach, give Amiodarone 5 mg/kg (max 300 mg) IV/IO over 10 minutes if not already given during resuscitation. If significant ventricular ectopy persists, repeat amiodarone per protocol
- Support blood pressure
- Administer 20 mL/kg boluses of NS to maintain adequate blood pressure for age (70 + 2xPatient Age) if post arrest rhythm is sinus tachycardia, otherwise for other cardiac rhythms use 10ml/kg NS
- b. If the patient’s SBP is less than lower limit based on the above equation after first bolus of fluid, call medical control for further instructions
- Obtain a 12-lead EKG.
- Check glucose and treat per protocol
- Seizure activity – monitor for seizure activity and treat per protocol.
- Monitor for fever.