Pt. on vent in cardiac arrest - would she continue breathing? - page 2
Pardon my ignorance but what would happen? It seems as if the respirations would continue, heartbeat or no...Is that right? Would appreciate any insight - thanks.... Read More
Nov 20, '11I think the OP question has been answered.
However some have stated some other issues which should be addressed.
If a patient arrests while on the ventilator, the ventilator will continue breathing at whatever you have programmed it to do. It is well documented that many CPA patients are manually (ambubag) over-ventilated during CPR, even though we all know what the appropriate RR should be. Here, if a patient on the vent has CPA, we will leave them on the vent, decreasing RR to 8 bpm and Vt to 10-15 ml/kg. This allows us one less thing to worry about during the code, and ensures the patient is not being over-ventilated, which directly decreases coronary and cerebral perfusion pressure, which decrease chance of ROSC. 100% FiO2 has not been shown to significantly improve outcome when compared to 21% FiO2, so that is less of a concern than the actual rate and Vt. In fact, supranormal post-resuscitation PaO2 increases in-hospital mortality.
As previously stated, an art line will allow for early recognition of CPA, especially with things like PEA/EMD. However, EtCO2 is your best monitor for effective compressions and ROSC.