Post-Arrest Care
Return of spontaneous circulation is the start of the next phase, not the end. Post-cardiac arrest care aims to protect the brain and heart and find the cause, and it is one of the core cases on every ACLS course.
The priorities
Secure the airway and ventilate to normal CO2, give oxygen to keep saturations in the recommended range, treat low blood pressure, get a 12-lead ECG and consider coronary reperfusion, check whether the patient follows commands, and consider temperature control and critical care.
A palpable pulse and blood pressure, often preceded by an abrupt, sustained rise in end-tidal CO2 on capnography.
Place or confirm an advanced airway if needed, using waveform capnography. Avoid hyperventilation; the course teaches target ranges for oxygen saturation and CO2. See airway management.
Treat hypotension with fluids and vasopressor or inotrope infusions as needed, aiming for the blood pressure targets taught on the course. See ACLS drugs.
Obtain a 12-lead ECG. If it suggests STEMI, or there is high suspicion of a coronary cause, the patient needs urgent assessment for coronary reperfusion. See acute coronary syndromes.
If the patient does not follow commands, temperature control is considered as part of post-arrest care, alongside critical care management. Neurological prognosis is not made early.
Revisit the H’s and T’s. The recovery link of the chain of survival continues long after discharge.
This guide summarises what the ACLS course teaches for education only. It is not a clinical protocol: follow the current American Heart Association guidelines, linked below, and your institution’s policies.
Other life support and first aid courses: BLS Course · PALS Course · First Aid Course · Training calendar
Return of spontaneous circulation: a sustained pulse and blood pressure after cardiac arrest.
It lowers CO2 and can reduce blood flow to the brain.
To look for STEMI or other coronary causes needing reperfusion.
Deliberate management of body temperature for patients who do not follow commands, as part of post-arrest care.
Yes, it is one of the core cases.
Reading an algorithm is not the same as running one. Safety First Medical Services is an American Heart Association training centre on Al Reem Island, Abu Dhabi, with HeartCode, classroom and on-site ACLS and a two-year AHA ACLS Provider eCard.
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What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.
Last reviewed by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.