Cardiology run a very very busy PCI service, not all calls are cardiac and this is an issue, but some result or begin in a cardiac arrest. The Out of hospital arrest scenario is real and need senior support.
OOHCA has become a common reason for the on-call team to be called to the PCI Cath Lab.
The Department led by Paul Morrison has started the complex process and set out these basic parameters for good care after a OOHCA presents to you in Cath Lab.
Obviously discuss every case with the consultant / Senior on call ASAP but here is some food for thought.
ENSURE THAT THE OTHER MEMBERS OF THE ON CALL TEAM KNOW WHERE YOU ARE !
Download the Targeted Temperature Management Guideline for OOHCA below
Minimum monitoring standards should apply at all times
- Secure Peripheral venous access
- Intubate as soon as practical
- Insert NG tube simultaneously
- Ventilate on Oxylog to achieve: SpO2 94-98%
- Arterial line insertion.
- Target parameters are:
- Pa O2 10 - 13kPa
- Pa CO2 4.7 - 6.0kPa
- K+ 4 - 4.5mmol/l
- Glucose 6 - 10mmol/l
- Appropriate record keeping: either ITU obs chart or intrahospital transfer sheet.
- Nursing care: On arrival in theatre, BEGIN consultation with Senior nurse ITU to agree a nursing care plan whilst in theatre and transfer to ITU
- Transfer to ITU. [ See note above.]