The post cardiac arrest care algorithm includes the following steps:
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What do you do after ROSC ACLS?
The post cardiac arrest care algorithm includes the following steps:
- Verify ROSC.
- Manage the airway including ETT placement and provide 10 breaths per minute.
- Using quantitative waveform capnography, titrate the oxygen to maintain a PETCO2 of 35-40 mm Hg.
- Insert and maintain an IV for medication administration.
What is the normal PETCO2 range to be maintained for intubated & ventilated patients?
Normal PaCO2 is 35-45 mm Hg, therefore PetCO2 would theoretically be 34-44 mm Hg, and should never be more than 5 mm Hg less than the arterial CO2 in patients with normal pulmonary physiology.
What should u do if ROSC is achieved?
The patient should be cooled to 32–36°C as soon as possible after ROSC using whatever technique is available in your institution, and kept cool for 24 hours. Control shivering as needed with sedation or paralysis and consider a non-contrast head CT to exclude intracranial hemorrhage.
Do you continue CPR after ROSC?
If the patient shows signs of return of spontaneous circulation, or ROSC, administer post-cardiac care. If a nonshockable rhythm is present and there is no pulse, continue with CPR.
What is PETCO2?
INTELLiVENT®-ASV® uses partial pressure of end tidal CO2 (PetCO2) measured by the CO2 sensor as monitoring input for the regulation of ventilation. The measured PetCO2 value is used to track partial CO2 pressure in the arteries (PaCO2).
What does a PetCO2 reading of less than 10mmhg suggest?
Evaluating the effectiveness of chest compressions is accomplished in the following manner: Measurement of a low ETCO2 value (< 10 mmHg) during CPR in an intubated patient would indicate that the quality of chest compressions needs improvement.
What is a PETCO2?
Quantitative waveform capnography is the continuous, noninvasive measurement and graphical display of end-tidal carbon dioxide/ETCO2 (also called PetCO2). Capnography uses a sample chamber/sensor placed for optimum evaluation of expired CO2.
What does a low PETCO2 mean?
A reduced PetCO2 is often a reflection of gas exchange abnormalities, usually some variation of ventilation-perfusion mismatching.
What is a good Petco 2 level for ACLS?
waveform during CPR Optimize chest compression for effective CPR so that PETCO 2 values are between 10 and 20 mm Hg. If PETCO 2 values less than 10 mm Hg or less measured after initiation of ACLS is associated with poor outcome
What is the relationship between ROSC and petco2 during CPR?
When chest compressions fail to achieve identified threshold values, ROSC is rarely achieved. The main determinant of PETCO2 during CPR is blood delivery to the lungs.
What is considered a low petco2 level during CPR?
Persistently low PETCO2 values less than 10 mm Hg during CPR in intubated patients is a good indicator that achieving ROSC will be unlikely.
How can ACLS providers help patients achieve ROSC?
If ACLS providers can quickly identify a specific condition that is causing or contributing to the patient’s cardiac arrest and correct it, the patient may be able to achieve ROSC. Identifying underlying causes is of particular importance in cases of PEA and asystole.