NALS

Post ROSC

EMKF
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

 

 

 

ILCOR 2015 – Paediatric summary

EMKF

ILCOR 2015 – paediatric summary

  1. Paediatric rapid response/medical emergency teams should be implemented in hospitals caring for children
  2. We should consider using less volume when treating patients in shock, especially if febrile without overt signs of shock – the key is to reassess frequently
  3. Rescue breaths should always be provided first if able
  4. After ROSC
    • Keep normothermic or therapeutic hypothermia
    • Check PaO2 and PCO2
    • BP should be kept >50th centile for age with fluid and inotropes
    • EEG within 7 days may help with prognostication – not enough evidence to recommend at this stage