Bundling Care in Comatose Post Cardiac Arrest Patients

Abstract

Post cardiac arrest syndrome (PCAS), an inflammatory state resulting from an ischemia-reperfusion injury impacting multiple organ systems. Hospital teams from the ED to Cath Labs to the ICU must practice in synchrony to optimize care. Key priorities in patients who remain comatose following return of spontaneous circulation are imperative to reduce the impact of PCAS. The team must focus on interventions and coordinated care to limit the damage of reperfusion injury to the brain/body. The complexity and heterogeneity of this patient population presents the team with challenges related to time, place, intervention sequence and elements. This presentation will focus on delivering care to the cardiac arrest and comatose post-cardiac arrest patient, selecting interventions maximizing oxygenation/ventilation and hemodynamics while implementing the strategies of TTM, Neurologic care, seizure surveillance, and management to lessen the pathologic impact of PCAS in the form of bundles of care. Target goals, interventions, and outcomes for the bundle elements will be shared.