Post-resuscitation care. Degree of compliance with the 2010 ILCOR Guidelines

Purpose of the study: To describe the degree of compliance with ILCORpost-resuscitation care of cardiac arrest (CA)Guidelines assisted by SAMU-Asturias from 07/01/2013 to 12/31/2014. Material andmethods:Retrospective observational study of CA with return of spontaneous circulation (ROSC) assisted by SAMUAsturias’ teams related to the degree of compliance with its postresuscitation care procedure. Criterion for inclusion: CA with ROSC requiring orotracheal intubation. Results: 14.647 alert calls revised. 522 (3.56%) were CA. 37.93% of CA victims (198) were admitted alive at hospital; 171 of these (86.36%) required orotracheal intubation. Average age was 65.69±14.69 SD. 69.01% male. 90.64% of CA were witnessed, 57.89% received CPR prior to arrival of ALS team. 13.13% received defibrillation. First monitored rhythm by us was shockable in 31.58% of victims. Procedure includes:Maintaining an arterial oxygen saturation of 94–98%. Goal met in 35.09% of victims, and 39.18% showed higher saturation. Average saturation: 94.66%±10.23 SD. Adjusting ventilation to achieve normocarbia (ETCO2 35–40mmHg). Capnography was used in 91.23% of victims: average ETCO2: 38.39±9.91 SD. In 51.46% of victims out of range no adjustment was recorded. Initiating sedation and analgesia. 22% of victims received none. Blood pressure (BP) control aiming average BP >65mmHg or systolic BP >90mmHg. 40.94% of victims received hemodynamic support. 12-lead ECG. In 88.30% of patients. Control of seizures and hyperpyrexia. Temperature measured in 30.41% of patients. No seizures recorded. Glucose control: 4.4–10mmol/l. Measured in 57.31% of patients. Average value: 14.04±5.15 SD. Levels weren’t adjusted in 60.20% of those out of range. Therapeutic hypothermia was started in 39.18% of victims. 38.80% of them had a shockable rhythm. Conclusions:Despite the importance of post-resuscitation care, emphasized in2010Guidelines, tominimize thepost-cardiac arrest syndrome, and the fact that SAMU-Asturias developed and disseminated a specific procedure, it’s remarkable the low level of compliance with the ILCOR Guidelines.