Cardiac Arrest Treatment Algorithm | Five Points to Remember

Authors:
Rab T, Kern KB, Tamis-Holland JE, et al., on behalf of the Interventional Council, American College of Cardiology.
Citation:
Cardiac Arrest: A Treatment Algorithm for Emergent Invasive Cardiac Procedures in the Resuscitated Comatose Patient. J Am Coll Cardiol 2015;66:62-73.

The following are five points to remember from the American College of Cardiology’s Interventional Council regarding a treatment algorithm for emergent invasive cardiac procedures in the resuscitated comatose patient:

  1. There needs to be an easily implementable algorithm to identify resuscitated comatose patients following cardiac arrest who are appropriate candidates for emergent coronary angiography.
  2. Urgent consultation and evaluation by a multidisciplinary team, including the interventional cardiologist, should occur before the patient is transferred to the catheterization laboratory, and early initiation of therapeutic hypothermia is strongly recommended.
  3. The Interventional Council emphasizes their viewpoint and explicitly recommends without reservation that percutaneous coronary intervention (PCI) outcomes in cardiac arrest patients not be included in public reporting.
  4. A national platform for tracking outcomes of cardiac arrest patients undergoing PCI is needed and should distinguish patients with and without ST-segment elevation.
  5. Randomized, controlled trials of early PCI in post-cardiac arrest patients without ST-segment elevation are needed.

Keywords: Acute Coronary Syndrome, Algorithms, Arrhythmias, Cardiac, Cardiopulmonary Resuscitation, Catheterization, Coma, Coronary Angiography, Heart Arrest, Out-of-Hospital Cardiac Arrest, Heart Conduction System, Hypothermia, Induced, Percutaneous Coronary Intervention, Referral and Consultation, Resuscitation


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