No! While our post-ROSC patient’s ultimately need definitive care at a cardiac arrest receiving center, what they need MOST in the 5-10 minutes after achieving ROSC is optimization of their hemodynamics and ventilation. These patients have suffered a significant neurologic insult by the very nature of having had a cardiac arrest and any further episodes of hypoxemia or hypotension only compounds this, making favorable neurologic recovery less likely. Additionally, getting an EKG on scene can help us identify a STEMI earlier, and have a cardiac cath lab ready for the patient on arrival. If the patient DOES rearrest, knowing that the patient had a STEMI can also better direct their care once they arrive to the emergency department. As long as it is safe at the scene to do so, we recommend that all crews take 5-10 minutes to do the following prior to loading the patient for transport
- Obtain a set of post-ROSC vital signs
- Get IV access and hang dopamine (if initial BP is WNL you do not have to start the infusion, but it is best practice to have it hanging and ready to go should they become hypotensive)
- Obtain an EKG
- Check the patient’s airway, SpO2, EtCO2 and ensure their advanced airway is still functioning appropriately and is secured prior to transport
Once these things have been done, initiate transport and continue to monitor the patient throughout transport for signs of rearrest.