Post cardiac arrest care - Revision history

Rossdonaldson1: Rossdonaldson1 moved page Post cardiac arrest to Post cardiac arrest care

2021-02-27T20:54:55Z

Rossdonaldson1 moved page Post cardiac arrest to Post cardiac arrest care

← Revisión anterior	Revisión del 20:54 27 feb 2021
(Sin diferencias)

Elcatracho: /* PrognosticationBreu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066 */

2021-02-10T02:34:36Z

PrognosticationBreu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066

← Revisión anterior		Revisión del 02:34 10 feb 2021
Línea 26:		Línea 26:
	**About half will have no to mild disability, and the other half will have moderate to severe disability		**About half will have no to mild disability, and the other half will have moderate to severe disability
	*Lack of pupillary reflexes upon ROSC after OHCA are not reliable in prognosticating return of neurologic function		*Lack of pupillary reflexes upon ROSC after OHCA are not reliable in prognosticating return of neurologic function
			*Recommended to wait minimum of 72 hours post-ROSC for prognostication

	==See Also==		==See Also==

Elcatracho: /* Management */

2021-02-10T02:31:54Z

Management

← Revisión anterior		Revisión del 02:31 10 feb 2021
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	**Prophylaxis unproven		**Prophylaxis unproven
	**AHA recommends EEG for comatose patients<ref>Callaway CW, Donnino MW, Fink EL, et al. Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S465–82.</ref>		**AHA recommends EEG for comatose patients<ref>Callaway CW, Donnino MW, Fink EL, et al. Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S465–82.</ref>
			**If epileptiform activity present, treat as you would other patients with [[seizure]]
	*Minimize Irritation		*Minimize Irritation
	**[[Sedation\|Sedatives]] +/- paralytics		**[[Sedation\|Sedatives]] +/- paralytics

Elcatracho: /* Management */

2021-02-10T02:31:05Z

Management

← Revisión anterior		Revisión del 02:31 10 feb 2021
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	*Aggressive [[seizure]] treatment		*Aggressive [[seizure]] treatment
	**Prophylaxis unproven		**Prophylaxis unproven
			**AHA recommends EEG for comatose patients<ref>Callaway CW, Donnino MW, Fink EL, et al. Part 8: post-cardiac arrest care: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S465–82.</ref>
	*Minimize Irritation		*Minimize Irritation
	**[[Sedation\|Sedatives]] +/- paralytics		**[[Sedation\|Sedatives]] +/- paralytics

ElavemanMD: /* Management */

2019-10-06T05:51:35Z

Management

← Revisión anterior		Revisión del 05:51 6 oct 2019
Línea 9:		Línea 9:
	*PCI		*PCI
	**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>		**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>
			**More recent data suggests that there is no difference in 90 day mortality/neurologic outcomes for immediate vs. delayed angiography in patients who had a shockable rhythm during arrest <ref>“Coronary Angiography after Cardiac Arrest without ST-Segment Elevation.” New England Journal of Medicine, vol. 381, no. 2, Nov. 2019, pp. 188–190., doi:10.1056/nejmc1906523.</ref>
	*Aggressively treat [[hyperglycemia]]		*Aggressively treat [[hyperglycemia]]
	**No IV fluids with glucose		**No IV fluids with glucose

ClaireLewis: /* Management */

2019-09-25T17:03:17Z

Management

← Revisión anterior		Revisión del 17:03 25 sep 2019
Línea 1:		Línea 1:
	==Management==		==Management==
	*Maintain perfusion (cerebral)		*Maintain perfusion (cerebral)
	**Treat hypotension		**Treat [[hypotension]]
	**Ignore hypertension		**Ignore [[hypertension]]
	**Maintain normal PaCO2 (~40)		**Maintain normal PaCO2 (~40)
	*Target ~~Normoxia~~		*Target [[oxygen\|normoxia]]
	**PaO2 80-120		**PaO2 80-120
	*[[Therapeutic Hypothermia]]		*[[Therapeutic Hypothermia]]
	*PCI		*PCI
	**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>		**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>
	*Aggressively treat hyperglycemia		*Aggressively treat [[hyperglycemia]]
	**No IV fluids with glucose		**No IV fluids with glucose
	**RISS		**RISS
	*Aggressive seizure treatment		*Aggressive [[seizure]] treatment
	**Prophylaxis unproven		**Prophylaxis unproven
	*Minimize Irritation		*Minimize Irritation
	**Sedatives +/- paralytics		**[[Sedation\|Sedatives]] +/- paralytics
	**Supine positioning		**Supine positioning

Rossdonaldson1: /* PrognosticationBreu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066 */

2019-06-20T06:37:42Z

PrognosticationBreu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066

← Revisión anterior		Revisión del 06:37 20 jun 2019
Línea 19:		Línea 19:

	==Prognostication<ref>Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066</ref>==		==Prognostication<ref>Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066</ref>==
	*OHCA has about a 10% survival to discharge rate		*Out-of-hospital cardiac arrest (OHCA) has about a 10% survival to discharge rate
	*In-hospital cardiac arrest has just over a 20% survival to discharge rate		*In-hospital cardiac arrest has just over a 20% survival to discharge rate
	**About half will have no to mild disability, and the other half will have moderate to severe disability		**About half will have no to mild disability, and the other half will have moderate to severe disability

Kearny89 at 02:23, 4 June 2019

2019-06-04T02:23:07Z

← Revisión anterior		Revisión del 02:23 4 jun 2019
Línea 17:		Línea 17:
	**Sedatives +/- paralytics		**Sedatives +/- paralytics
	**Supine positioning		**Supine positioning

			==Prognostication<ref>Breu AC. Clinician-Patient Discussions of Successful CPR—The Vegetable Clause. JAMA Intern Med. 2018;178(10):1299–1300. doi:10.1001/jamainternmed.2018.4066</ref>==
			*OHCA has about a 10% survival to discharge rate
			*In-hospital cardiac arrest has just over a 20% survival to discharge rate
			**About half will have no to mild disability, and the other half will have moderate to severe disability
			*Lack of pupillary reflexes upon ROSC after OHCA are not reliable in prognosticating return of neurologic function

	==See Also==		==See Also==

SLuckettG: /* Management */

2019-03-08T00:44:33Z

Management

← Revisión anterior		Revisión del 00:44 8 mar 2019
Línea 1:		Línea 1:
	==Management==		==Management==
	*Maintain perfusion (cerebral)		*Maintain perfusion (cerebral)
	**~~treatment~~ hypotension		**Treat hypotension
	**~~ignore~~ hypertension		**Ignore hypertension
	**normal PaCO2 (~40)		**Maintain normal PaCO2 (~40)
	*Normoxia		*Target Normoxia
	**PaO2 80-120		**PaO2 80-120
	*[[Therapeutic Hypothermia]]		*[[Therapeutic Hypothermia]]
Línea 10:		Línea 10:
	**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>		**Early reperfusion therapy is important to ID coronaries as ECG cannot reliably predict them in these cases<ref>Kern, KB. Optimal Treatment of Patients Surviving Out-of-Hospital Cardiac Arrest. J Am Coll Cardiol Intv. 2012; 5(6):597-605. doi:10.1016/j.jcin.2012.01.017</ref>
	*Aggressively treat hyperglycemia		*Aggressively treat hyperglycemia
	**~~no IVFs~~ with glucose		**No IV fluids with glucose
	**RISS		**RISS
	*Aggressive seizure treatment		*Aggressive seizure treatment
	**~~prophylaxis~~ unproven		**Prophylaxis unproven
	*Minimize Irritation		*Minimize Irritation
	**~~sedatives~~ +/- paralytics		**Sedatives +/- paralytics
	**~~supine flat~~		**Supine positioning

	==See Also==		==See Also==

Rossdonaldson1: Text replacement - "Tx" to "treatment"

2016-08-01T13:22:58Z

Text replacement - "Tx" to "treatment"

← Revisión anterior		Revisión del 13:22 1 ago 2016
Línea 1:		Línea 1:
	==Management==		==Management==
	*Maintain perfusion (cerebral)		*Maintain perfusion (cerebral)
	**Tx hypotension		**treatment hypotension
	**ignore hypertension		**ignore hypertension
	**normal PaCO2 (~40)		**normal PaCO2 (~40)