The patient’s survival to hospital discharge depends on the success of post-cardiac arrest care. After successful cardiopulmonary resuscitation from cardiac arrest or shock, the child undergoes a systematic treatment protocol that targets respiratory, cardiovascular, and neurologic systems and targeted temperature management. Transport of the patient to an institution with the capability and experienced staff to manage the patient’s condition best is another critical key in the chain of survival.

Another goal of post-cardiac care is to prevent morbidities and mortalities in the hospital. The usual causes are hemodynamic instability and respiratory problems. Late in the disease process, the patient can deteriorate and experience multiorgan failure and brain injury.

Post-cardiac arrest care has two phases. These focus on improving oxygenation, ventilation, perfusion, and cardiopulmonary function, along with neurologic care and targeted temperature management as necessary. 

The first phase of post-cardiac arrest care emphasizes continued advanced life support measures for immediately life-threatening medical conditions, close monitoring, and additional diagnostic testing.

 First phase interventions include:

• Airway support, oxygenation, and ventilation
• End-tidal carbon dioxide monitoring via capnography
• Arterial blood gas (ABG) analysis with lactate and base deficit  
• Chest X-ray
• Blood pressure and perfusion optimization
• Venous oxygen saturation monitoring
• Confirmation and treatment of the underlying cause of the arrest

The second phase of post-cardiac arrest care supports multiorgan functions with targeted temperature management. 

Throughout the post-cardiac arrest period, the provider must continuously apply the systematic assessment of the seriously ill child using the primary, secondary, and diagnostic assessments. The Post Cardiac Arrest Checklist guides the team so that all critical aspects of postresuscitation care are addressed.