Post Cardiac Arrest Care

  1. Applies to pediatric patients resuscitated from cardio-respiratory arrest who have a perfusing rhythm and pulse, and who remain unresponsive.

  3. Continue to support respirations with BVM, attempting to time support with the patients own respirations

  5. 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.

  7. 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%.

  9. Stabilize dysrhythmias:

    1. Stable tachycardia or bradycardia – treat per protocols

    3. 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


  11. Support blood pressure

    1. 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

    2. 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


  13. Obtain a 12-lead EKG.

  15. Check glucose and treat per protocol

  17. Seizure activity – monitor for seizure activity and treat per protocol.

  19. Monitor for fever.