Post-cardiac arrest care (ACLS)

Table of content(s)

1. Introduction 
2. VOMIT: an acronym to describe post-cardiac arrest care 
3. Airway management techniques
4. Blood pressure support and vasopressors 
5. How do you perform targeted temperature management?
6. Conclusion

Cardiac arrest is a challenging health condition that needs critical care. The journey to recovery is vital, and post-cardiac arrest care helps prevent further complications. It stabilizes the patient and enhances their heart’s condition. You need to take good care of this critical phase and support the other organs of the body. 

In this blog, we will discuss the vital components of post-cardiac arrest care of ACLS. If you are a healthcare professional curious to know what happens after a cardiac arrest, this guide is for you. Explore how post-cardiac arrest care can boost recovery. 

VOMIT: an acronym to describe ACLS post-cardiac arrest care 

During post cardiac arrest care, which is the best course of action? Here are the key steps to help stabilize patients and boost recovery. One of the easiest ways to remember the components is the acronym VOMIT. 

1. V-Ventilation: This ensures that the patient’s airway is clear and provides ventilation. This maintains proper oxygen levels in the body.
2. Oxygenation: It is necessary to administer high levels of oxygen and improve blood oxygen saturation. It is crucial for protecting the brain and other organs from further damage. 
3. Monitoring: Monitors vital signs such as blood pressure, heart rate, and oxygen levels. It finds out the abnormalities and ensures a prompt response. 
4. Interventions: This includes several medical procedures and treatments, such as administering medications, defibrillation, and advanced cardiovascular life support (ACLS) protocols. This stabilizes the patient. 
5. Therapeutics: Ongoing medications and treatment address the underlying causes. This includes therapeutic hypothermia to reduce brain injury. This plays a major role in post-cardiac arrest care. 

Read more: Identifying and Treating Second Degree AV Heart Block Type II

Airway management techniques

Airway management ensures adequate ventilation and oxygenation. Post cardiac arrest care in ACLS outlines several strategies and optimizes airway management in these situations. 

1. Endotracheal intubation: This secures the airway in post-cardiac arrest patients. It places a tube through the mouth or nose of the patient and into the trachea. This helps maintain an open airway and offers controlled ventilation. A trained person must perform intubation and is guided by capnography. This confirms proper placement. 
2. Supraglottic airway devices: When intubation is not feasible, supraglottic airway devices such as the laryngeal mask airway can be used. These devices can be inserted and offer a secure airway, ensuring effective ventilation. 
3. Bag-valve-mask ventilation: BVM ventilation is a crucial technique that is used immediately post-cardiac arrest. If advanced airway devices are not in place, then this is beneficial. Proper technique avoids gastric insufflation. This ensures adequate oxygenation and ventilation. 
4. Continuous positive airway pressure: (CPAP) is beneficial for patients with pulmonary edema and congestive heart failure. This helps keep the airways open while reducing the work of breathing. This improves oxygenation. 
5. Monitoring and adjustments: Monitor oxygen saturation continuously. Adjust ventilator settings or airway management based on these parameters to optimize ventilation and oxygenation. 

Blood pressure support and vasopressors 

Blood pressure support and the use of vasopressors help maintain adequate perfusion to critical organs in the body. Advanced cardiovascular life support offers specific recommendations for managing blood pressure. Here are the key guidelines:

1. Importance of blood pressure support: Post-cardiac arrest, patients often experience hemodynamic instability. This includes hypotension, which leads to inadequate perfusion of vital organs such as the kidneys and brain. A systolic blood pressure of at least 90 mmHg or a mean arterial pressure (MAP) of 65 mmHg ensures adequate organ perfusion. This enhances the outcomes and improves the condition. 
2. Initial fluid resuscitation: The first step is to manage hypotension. This is done by administering intravenous fluids, such as normal or lactated Ringer’s solution. This helps you restore blood volume while improving cardiac output. Monitor carefully and avoid fluid overload.
3. Use vasopressors: When fluid resuscitation is insufficient for maintaining adequate blood pressure, vasopressors are beneficial. The key vasopressors include epinephrine, norepinephrine, and dopamine.
4. Continuous monitoring and titration: Continuous hemodynamic monitoring helps meet the blood pressure targets. Titrate the vasopressor doses depending on the patient’s response. This helps aim for the lowest effective dose and minimizes potential side effects.

Read more: Identifying and Treating First-Degree AV Block (First-Degree Heart Block)

How do you perform ACLS targeted temperature management?

Targeted temperature management ACLS improves the chances of brain recovery. You can induce targeted temperatures in unresponsive individuals. Continue for at least 24 hours. The goal of temperature management is to maintain a core body temperature between 89.6 and 96.8 degrees F. Induce and monitor targeted temperature management. This must not affect the decision to perform percutaneous coronary intervention (PCI). This is because concurrent PCI and targeted temperature management are safe. 

Conclusion

Post-cardiac arrest care of ACLS protocols helps improve patient outcomes. It involves processes such as effective airway management and targeted temperature management. This enables healthcare providers to impact the patient’s survival and neurological function. Adhere to the guidelines to stabilize patients, save lives, and ensure better health outcomes.