ICU Cases · Arrhythmia & cardiac arrest
Cardiac arrest in the ICU — the full ALS to the post-arrest care
A long case on the ICU cardiac arrest — the ALS algorithm (the VF, the shocks, the adrenaline, the amiodarone), the ROSC, the TTM (32 to 36), the coronary intervention, and the prognostication.
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Prompt
A 60-year-old man collapses in the ICU with a VF arrest. Outline the management from the arrest to the post-arrest care.
Presentation
A 60-year-old man, day 2 of a severe sepsis, suddenly loses consciousness. The monitor shows a broad-complex, chaotic rhythm at 250 per minute — the ventricular fibrillation. He has no pulse.
References3ShowHide
- [1]Nielsen N, Wetterslev J, Cronberg T, et al. Targeted temperature management at 33°C versus 36°C after cardiac arrest. New England Journal of Medicine, 2013.PMID 24237006
- [2]Soar J, Donnino MW, Maconochie I, et al. 2018 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Resuscitation, 2018.PMID 30409433
- [3]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.