Dr. Michael Allison is a Chief Resident in the combined Emergency Medicine/Internal Medicine/Critical Care Residency. He was invited to the recent Greater Chesapeake Emergency Medicine Conference to speak about ways to improve upon cardiac arrest care – using principles as applicable in the ICU as in they are in the Emergency Department. In under twenty minutes he’ll teach you a few things on how to appropriately monitor your arrest patient using ultrasound and end-tidal CO2. Using these tips may make your next resuscitation a success!
- Cardiac ultrasound is really only helpful early in PEA arrest. Don’t even bring it in the room if there’s a shockable rhythm!
- The Stoplight Approach to ending resuscitation: No activity? Stop. Some activity? Consider your clinical scenario. Organized contractions? Keep going.
- Use end-tidal CO2 to monior your compressions. Decreasing ETCO2 over time may signal early compressor fatigue!
- Jumps of greater than 10mmHg in ETCO2 can be an early indicator of ROSC! Just make sure it’s not from the bicarbonate, which can artificially increase the ETCO2.
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