History:

 

• Respiratory arrest
• Cardiac arrest

 

Significant Findings:

 

• Return of pulse

 

Differential:

 

• Continue to address specific differentials associated with the original dysrhythmia

 

Treatment:

 

• Continue ventilatory support
• 100% Oxygen
• EtCO2 ideally >20
• RR <12

• 12-Lead EKG

• Place 2nd IV/IO

 

Termination of ventricular rhythms?

 

• Yes

 

• • if not previously administered, administer Amiodarone (Cordarone) 150 mg IV/IO over 10 min followed by 1 mg/min IV/IO infusion

 

• • if previously administered, administer Amiodarone (Cordarone) 1 mg/min IV/IO infusion

 

• No

 

Sustained Pulse

 

• Hypotension?

 

• • FOLLOW HYPOTENSION GUIDELINE

 

 

• STEMI?

 

• • FOLLOW ACUTE CORONARY SYNDROME GUIDELINE

 

• Bradycardia?

 

• • FOLLOW BRADYCARDIA GUIDELINE

 

PEARLS:

 

• Rule out pulmonary edema before administration of Normal Saline bolus to a hypotensive patient.

• If patient remains hypotensive after initial 500 mL Normal Saline, administer an additional 500 mL; total 1,000 mL.

• For transcutaneous pacing set rate for 70 beats per minute. Increase current (mA) until electrical and mechanical capture occur or pacing current reaches (200 mA).
• Amiodarone (Cordarone) is not a primary post-arrest medication unless significant ectopy is present.

 

Amiodarone Infusion

 

• 150 mg infusion over 10 minutes:

• • Add 150 mg Amiodarone (Cordarone)
  • 50 mL bag Normal Saline
  • administer through a 10 gtt set at 50 drops per minute.

 

1 mg/min infusion:

• Add 150 mg Amiodarone (Cordarone)
• 50 mL bag Normal Saline
• administer through a 60 gtt set at 20 drops per minute.

• Transport to a PCI capable hospital.