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- Patients who achieve return of spontaneous circulation (ROSC) after cardiac arrest require close monitoring in an intensive care setting along with treatment for the underlying cause of arrest.
- Continuous telemetry monitoring is crucial to detect recurrent arrhythmias or cardiovascular instability.
- Frequent neurologic assessments including pupillary examination and Glasgow Coma Scale scoring should be performed to trend neurologic recovery.
- Other monitoring parameters:
- Vital signs
- Oxygenation (pulse oximetry)
- Ventilation (end-tidal CO2 monitoring)
- Glucose
- Body temperature (avoid hyperthermia)
- Testing to determine the etiology of arrest may include:
- Laboratory studies (CBC, BMP, magnesium, troponin)
- Blood gas analysis
- Toxicology screen
- Imaging studies (CXR, head CT)
- Echocardiography
- EEG
- Children at risk for seizures should have continuous EEG monitoring and immediate treatment if seizures occur.
- Ongoing care requires managing shock, optimizing oxygenation/ventilation, treating arrhythmias, and avoiding complications such as aspiration pneumonia.
- Follow up after discharge includes cardiology or neurology consultation depending on the cause of arrest and presence of ongoing medical issues. Physical, occupational and speech therapy is arranged as needed.