Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/16499
Title: Post resuscitation management of cardiac arrest patients in the critical care environment: A retrospective audit of compliance with evidence based guidelines
Authors: Milonas, Annabel;Hutchinson, A;Charlesworth, D;Doric, A;Green, J;Considine, J
Issue Date: Nov-2017
EDate: 2016-12-16
Citation: Australian Critical Care 2016; 30(6): 299-305
Abstract: BACKGROUND: There is a clear relationship between evidence-based post resuscitation care and survival and functional status at hospital discharge. The Australian Resuscitation Council (ARC) recommends protocol driven care to enhance chance of survival following cardiac arrest. Healthcare providers have an obligation to ensure protocol driven post resuscitation care is timely and evidence based. OBJECTIVES: The aim of this study was to examine adherence to best practice guidelines for post resuscitation care in the first 24h from Return of Spontaneous Circulation for patients admitted to the intensive care unit from the emergency department having suffered out of hospital or emergency department cardiac arrest and survived initial resuscitation. METHOD: A retrospective audit of medical records of patients who met the criteria for survivors of cardiac arrest was conducted at two health services in Melbourne, Australia. Criteria audited were: primary cardiac arrest characteristics, oxygenation & ventilation management, cardiovascular care, neurological care and patient outcomes. FINDINGS: The four major findings were: (i) use of fraction of inspired oxygen (FIO2) of 1.0 and hyperoxia was common during the first 24h of post resuscitation management, (ii) there was variability in cardiac care, with timely 12 lead Electrocardiograph and majority of patients achieving systolic blood pressure (SBP) greater than 100mmHg, but delays in transfer to cardiac catheterisation laboratory, (iii) neurological care was suboptimal with a high incidence of hyperglycaemia and failure to provide therapeutic hypothermia in almost 50% of patients and (iv) there was an association between in-hospital mortality and specific elements of post resuscitation care during the first 24h of hospital admission. CONCLUSION: Evidence-based context-specific guidelines for post resuscitation care that span the whole patient journey are needed. Reliance on national guidelines does not necessarily translate to evidence based care at a local level, so strategies to ensure effective guideline implementation are urgently required.
URI: http://ahro.austin.org.au/austinjspui/handle/1/16499
DOI: 10.1016/j.aucc.2016.12.001
PubMed URL: https://www.ncbi.nlm.nih.gov/pubmed/27993546
Type: Journal Article
Subjects: Cardiac arrest
Cardiopulmonary resuscitation
Evidence-based practice
Nursing care
Emergency nursing
Critical care nursing
Post resuscitation care
Appears in Collections:Journal articles

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