ALCS Algorithms

Post-Cardiac Arrest Care Algorithm

When to Use This Algorithm

Use this algorithm when a patient has achieved ROSC after experiencing cardiac arrest. Immediate and systematic post-cardiac arrest care is crucial for improving survival and neurological outcomes.

Steps in the Algorithm

  1. Manage Airway
    • Ensure early placement of an endotracheal tube.
    • Prioritize securing the airway to maintain adequate ventilation and oxygenation.
  2. Manage Respiratory Parameters
    • Start at 10 breaths per minute.
    • Target oxygen saturation (SpO2) between 92%-98%.
    • Maintain arterial carbon dioxide pressure (PaCO2) between 35-45 mm Hg.
  3. Manage Hemodynamic Parameters
    • Aim for a systolic blood pressure >90 mm Hg.
    • Maintain mean arterial pressure (MAP) >65 mm Hg.
    • Use vasopressors or inotropes if needed to achieve target blood pressure and MAP.
  4. Obtain 12-Lead ECG
    • Perform an ECG to assess for any signs of myocardial infarction or other cardiac issues.
    • Look for ST-elevation myocardial infarction (STEMI) or other significant findings.
  5. Consider Emergency Cardiac Intervention If:
    • STEMI is present.
    • The patient has unstable cardiogenic shock.
    • Mechanical circulatory support is required.

Neurological Assessment

  • Does Patient Follow Commands?
    • Yes:
      • If the patient is awake and follows commands, proceed with other critical care management.
    • No:
      • If the patient is comatose, initiate targeted temperature management (TTM).
      • Obtain a brain CT scan to assess for any cerebral damage or other neurological issues.
      • Monitor with electroencephalography (EEG) for seizures or other abnormalities.
      • Continue other critical care management protocols.

Evaluate and Treat Rapidly Reversible Etiologies

  • Identify and Treat Underlying Causes
    • Assess for and address any reversible causes of the cardiac arrest, such as:
      • Hypoxia
      • Hypovolemia
      • Hydrogen ion (acidosis)
      • Hypo/Hyperkalemia
      • Hypothermia
      • Tension pneumothorax
      • Tamponade (cardiac)
      • Toxins
      • Thrombosis (pulmonary or coronary)
  • Expert Consultation
    • Involve relevant specialists for consultation and continued management of the patient’s condition.

Key Takeaways

Effective post-cardiac arrest care involves maintaining airway, respiratory, and hemodynamic parameters, performing a thorough neurological assessment, and addressing any reversible causes of the arrest. Early and aggressive management is essential to optimize outcomes and reduce the risk of complications.

BG Gradient ProMed

Simple, affordable pricing

Select your Online ACLS, PALS, BLS, or CPR Medical Certification Course below

ACLS - ProMed
acls
Recertification
$129

The Advanced Cardiac Life Support (ACLS) is an accredited online medical certification course that teaches medical professionals to respond to nearly all cardiopulmonary emergencies.

PALS - ProMed
Pals
Recertification
$129

The Pediatric Advanced Life Support (PALS) Recertification instructs medical professionals on performing pediatric cardiopulmonary resuscitation in emergencies.

BLS - ProMed
Bls
Recertification
$65

The Basic Life Support (BLS) Recertification is intended to teach healthcare professionals the basic steps of CPR and rescue breathing for adults, children, and infants.

CPR - ProMed
Cpr
Recertification
$35

Our online medical certification course for CPR, Automated External Defibrillator (AED), and First Aid is designed to teach adult, child, and infant CPR and AED use.

ProMed NRP Recertification Pricing Icon
NRP
Recertification
$129

The Neonatal Resuscitation Program (NRP) trains medical professionals in performing resuscitation procedures and life-saving techniques for newborns at the time of delivery.