System | Action |
Airway | Intubate → Ventilation tidal volume @ 6-8 mL/kg |
Place OG or NG tube | |
Confirm endotracheal and OG/NG tube placement with chest x-ray | |
Breathing | SpO2 goal >94% → adjust PEEP & FiO2 to achieve goal |
EtCO2 goal 30-40 mmHg → adjust respiratory rate to achieve | |
Circulation | 12-lead ECG → Activate cardiac catheterization lab for STEMI; consult cardiology for all other patients |
SBP goal >90 mmHg (MAP > 65 mmHg) → Use fluids, norepinephrine infusion, then epinephrine infusion to achieve goal | |
Place central line | |
Place arterial line | |
Perform point of care ultrasound with the cardiac, lung, and IVC views | |
Send labs, which includes an arterial blood gas and serum lactate | |
Place Foley catheter → Goal urine output 0.5-1 mL/kg/hr | |
Consider CT chest angiography to rule-out a pulmonary embolism | |
Disability | Begin cooling → Goal temperature 32–36°C |
Consider head CT |