I've been waiting for this one for a long time. I got to interview Dr. Stephen Bernard on the topic of post-cardiac arrest care.
Professor Stephen Bernard
Professor Stephen Bernard is a senior intensivist at the Alfred Hospital and Director of Intensive Care at Knox Private Hospital in Victoria, Australia. He is also Medical Advisor to Ambulance Victoria. Dr. Bernard was the lead author on one of the original establishing studies for post-arrest temperature management.
My discussion with Dr. Bernard was based on a talk he gave at the Australasian College for Emergency Medicine
Maintain 36 C for 24 Hours
Dr. Bernard and the Alfred Hospital in Australia are moving to the protocol outlined in the TTM trial
Is there anyone who still deserves to be cooled to 33 C?
Dr. Bernard feels patients that get intra-arrest cooling may still benefit until we have further trial results.
Neuro-Prognosticate as per the protocol in the Nielsen trial
Chris Nickson summarized the Neuro-Prognostication Protocol wonderfully
Time Zero Prognostication
It is tough. Unwitnessed asystole is probably one situation in which you can choose a palliative route if the situation otherwise supports it.
Pt should be taken to a 24/7 cardiac interventional center
This doesn't necessarily mean the patient needs to go to the lab immediately, they just need to be able to go when needed
Maintain an SpO2/SaO2 between 90-95%
No hypocapnea, Perhaps slight hypercapnea
Tune in Next Week for Part II of the Interview
More on the TTM Trial
The Thoughts of Others
— John Myburgh (@JAMyburgh) November 19, 2013
— John Myburgh (@JAMyburgh) November 21, 2013