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13 Cards in this Set
- Front
- Back
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Post Cardiac Arrest Care: What should be done with the patient's bed?
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elevate to 30% to prevent aspiration and cerebral edema
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Post Cardiac Arrest Care: describe oxygen therapy
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titrate to keep O2 sats >94%
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Post Cardiac Arrest Care: which drugs are used to keep SBP > 90
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fliuds, dopamine 5-10 mcg/kg/min, norepinephrine 0.1-0.5 mcg/kg/min, epinephrine 0.1-0.5 mcg/kg/min
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Post Cardiac Arrest Care: when should therapeutic hypothermia be used?
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post cardiac arrest recovery if patient is unable to follow verbal commands after ROSC
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Post Cardiac Arrest Care: what should be done to detect new or recurrent ACS?
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12 lead EKG, continuous monitoring if possible
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Post Cardiac Arrest Care: what is the MABP goal?
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>65 mm Hg
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Post Cardiac Arrest Care: treatment for myocardial stunning
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fluids to optimize volume status, dobutamine 5-10 mcg/kg/min, mechanical augmentation (IABP)
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Post Cardiac Arrest Care: describe neurological management
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serial neuro exams; EEG if comatose to exclude seizures, anti-epileptics if seizing; keep core temp < 37.7, therapeutic hypothermia if no contraindications, cold IV fluid bolus 30 ml/kg, surface or endovascular cooling for 32-34 dec celcius x24 hours, slow rewarming by 0.25 deg C per hour after 24 hours; considered CT scan to exclude intracranial process; sedation/muscle relaxants as needed
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Post Cardiac Arrest Care: identify labs to monitor
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lactate (adequate perfusion), potassium (avoid hypoK which is proarrhythmic, keep >3.5), UO/Scr (detect AKI), glucose (goal 140-180s); avoid hypotonic fluids (may increase edema, including cerebral edema)
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Post Cardiac Arrest Care: what are potential complications of therapeutic hypothermia?
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coagulopathy, arrhythmias, hyperglycemia, pneumonia, sepsis
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Post Cardiac Arrest Care: should patients be hyperventilated to correct acidemia?
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no, allow adequate perfusion to take care of this (can alter cerebral blood flow, exacerbate cerebral ischemic injury); hypoventilation is not good either
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Post Cardiac Arrest Care: can fibrinolytics be used for PE?
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yes, if unstable
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Post Cardiac Arrest Care: are steroids recommended?
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unclear at this time
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