Post-Arrest Care & Targeted Temperature Management (TTM)
The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved.
Post-arrest care and recovery are the final two links in the ACLS chain of survival.
Once ROSC is obtained, the goals of ACLS are aimed at establishing & maintaining:
- Pulse of 60 – 100;
- Systolic BP > 90 mm Hg;
- MAP > 65 mm Hg;
- SaO2 of 92-98%; and
- ETCO2 of 35-45 mm Hg
Patients with an identified ST elevation MI (STEMI) should have a cardiology consult and be taken to the cath lab as soon as possible for PCI.
Non-ST elevation MI patients should be admitted to ICU for close monitoring.
The patient’s GCS (level of consciousness) should be evaluated to determine if targeted temperature management (TTM) is indicated.
Patients that cannot obey simple commands should be cooled to 32-36 C for 24 hours.
Patients can undergo PCI, CT, and MRI while being cooled.
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