Case of the Month #12 - cardiac arrest

Published 02/02/2022

After arriving at the hospital, what are the next steps in managing this patient?

Immediate treatment
  • Airway and breathing
    • Control oxygenation (avoiding hyperoxia) with target oxygen saturations between 94-98%1
      • Aim for normocarbia 1
      • Protective lung ventilation (TV 6-8mL/kg IBW and PEEP 4-8cm H20)1
      • Nasogastric tube (NGT) to decompress stomach and prevent diaphragm splinting
      • Adequate sedation to reduce oxygen consumption
      • If using neuromuscular blockade, consider continuous EEG to detect seizure activity
      • Chest X-ray (CXR) to check endotracheal tube position, NGT, central venous catheter position and complications from CPR e.g. pneumothorax from rib fractures
    • Circulation
      • Maintain SPB >100mmHg1
      • 12- lead ECG
      • Consider arterial line insertion for blood pressure and blood gas monitoring
      • Consider central venous catheter insertion to facilitate vasopressor or inotropic agent delivery