Post Resuscitation Care

Dr Mohammad Zikri Ahmad Pensyarah/Pakar Perubatan Kecemasan HUSM

Post Resuscitation care is a systematic post cardiac arrest care after ROSC

Why is it important?

It increases survival rate and quality of life

Who needs post resuscitation care?

Patients who achieve ROSC

How do I know a patient achieves ROSC?

Patient regains pulse, breathing on his own with other signs of life

My patient regains his pulse after CPR, whats next?

Check for breathing

If absent, give assisted breathing every 5-6 seconds

Then keep him in recovery position

Normal breathing + effective circulation => recovery postion

Maintain patent airway

Reduced airway obstruction and risk of aspiration

Then what?

Remember chain of survival?

Recognise-Activate-CPR-DefibACLS-integrated post resusc care

Transfer the patient to the hospital immediately!

He needs optimization of cardiopulmonary function

Transport him to PCI-available hospital with adequate CCU/ICU backup

He requires induced hypothermia and goal directed critical care

We must treat the precipitating cause and prevent recurrence

What else?

This patient requires treatment of ACS, lung injury and multi-organ injury

With subsequent prognostication and rehabilitation

Tell me more about induced hypothermia..?

Protective brain/organs

32-34oC

12-24 hours

Surface cooling device

Cooling blankets

Ice bags

Iced isotonic fluid prehospital PEA and asystole

Esophageal thermometer

But may cause coagulopathy, arrythmias, hypoglycemia, pneumonia and sepsis

Summary?

Ventilation Hemodynamic Cardiovascular Neurological Metabolic

Thank you!