Authors: Lewis O Jones, Lou Mitchell / Editors: Steve Fordham, Sandi Angus / Reviewer: Stewart McMorran, Tadgh Moriarty / Codes: R1 / Published: 08/12/2020 / Reviewed: 24/06/2024
This module focusses on the Emergency Department (ED) care of patients post-cardiac arrest i.e. after the return of spontaneous circulation.
Before commencing this session you should:
- Be an advanced life support (ALS) certified provider
After completing this session you will be able to:
- Explain how to stabilise a post-arrest patient
- Formulate a plan for their ongoing care
- Make an evidence-based assessment of their short term prognosis
- Describe medico-legal and ethical issues regarding withdrawing or withholding care
References
- Yan S, Gan Y, Jiang N, Wang R, Chen Y, Luo Z, et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care [Internet]. 2020 Dec 22 [cited 2024 May 30];24(1):61.
- Mangla A, Daya MR, Gupta S. Post-resuscitation care for survivors of cardiac arrest. Indian Heart J. 2014 Jan-Feb;66 Suppl 1(Suppl 1):S105-12. doi: 10.1016/j.ihj.2013.12.028. [cited 2024 May 30].
- del Castillo J, Lpez-Herce J, Matamoros M, Caadas S, Rodriguez-Calvo A, Cechetti C, et al. Hyperoxia, hypocapnia and hypercapnia as outcome factors after cardiac arrest in children. Resuscitation. 2012 Dec 1;83(12):145661.
- Nolan JP, Sandroni C, Bttiger BW, Cariou A, Cronberg T, Friberg H, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Medicine 2021 47:4 [Internet]. 2021 Mar 25 [cited 2024 May 30];47(4):369421.
- Skrifvars MB, Ameloot K, Aneman A. Blood pressure targets and management during post-cardiac arrest care. 2023 [cited 2024 May 30];
- Padkin A. Glucose control after cardiac arrest. Resuscitation. 2009 Jun;80(6):611-2.
- Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary SEARCH STRATEGY SEARCH OUTCOME. 1950;
- Elfwn L, Lagedal R, James S, Jonsson M, Jensen U, Ringh M, et al. Coronary angiography in out-of-hospital cardiac arrest without ST elevation on ECGShort- and long-term survival. Am Heart J. 2018 Jun 1;200:905.
- Dumas F, Cariou A, Manzo-Silberman S, Grimaldi D, Vivien B, Rosencher J, et al. Immediate Percutaneous Coronary Intervention Is Associated With Better Survival After Out-of-Hospital Cardiac Arrest. Circ Cardiovasc Interv [Internet]. 2010 Jun [cited 2024 Jun 4];3(3):2007.
- Kovacs E, Pilecky D, Szakal-Toth Z, Fekete-Gyor A, Gyarmathy VA, Geller L, et al. The role of age in post-cardiac arrest therapy in an elderly patient population. Physiol Int [Internet]. 2020 Jul 20 [cited 2024 Jun 4];107(2):31936.
- Hirlekar G, Jonsson M, et al. Comorbidity and survival in out-of-hospital cardiac arrest. Resuscitation. 2018 Dec;133:118-123.
- Terman SW, Shields TA, Hume B, Silbergleit R. The influence of age and chronic medical conditions on neurological outcomes in out of hospital cardiac arrest. Resuscitation. 2015 Apr 1;89(C):16976.
- National Institute for Health and Care Excellence (NICE). Cardiac arrest – out of hospital care: | What is the Prognosis? | CKS | [Internet]. [cited 2024 May 31].
- Kaye P. Early prediction of individual outcome following cardiopulmonary resuscitation: systematic review. Emerg Med J. 2005 Oct;22(10):700-5. [cited 2024 Jun 4];
- Momiyama Y, Yamada W, Miyata K, Miura K, et al. Prognostic values of blood pH and lactate levels in patients resuscitated from out-of-hospital cardiac arrest. Acute Medicine & Surgery [Internet]. 2017 Jan 1 [cited 2024 Jun 4];4(1):2530.
- Decisions relating to cardiopulmonary resuscitation. Guidance from the British Medical Association, the Resuscitation Council (UK) and the Royal College of Nursing.
- Treatment and care towards the end of life – professional standards – GMC [Internet]. [cited 2024 Jun 4].
