Sedation for Conscious Cardiac Arrest Patients

[Carlos Danger]

With all due respect, I disagree. If the patient is conscious and saying "ow" that's plenty conscious. Too conscious.

Well, just because someone responds to noxious stimulus doesn’t mean there is going to be recall, and even if there is recall, it isn’t necessarily distressing. You really have to weigh the risk vs the benefits.

What is the incidence of recall during CPR? I know there has been some studies published on it.

 

[NPO]

Well, just because someone responds to noxious stimulus doesn’t mean there is going to be recall. You really have to weigh the risk vs the benefits.

What is the incidence of recall during CPR? I know there has been some studies published on it.

Off the top of my head, I'm not sure. Not high, but it does exist.

 

[Melbourne MICA]

Sedation during arrest, which typically occurs after defib from an arrest rhythm into a rhythm with output is accomplished typically and more safely with benzos like Midaz but will be done 99/100 in the context of an RSI post ROSC which can of course involve several agents for induction and sedation like Fentanyl, Morphine, Midaz and Ketamine. Panc or similar is used to maintain paralysis and longer term sedation achieved with a Morph/Midaz infusion.

If the patient has been given Midaz/other sedative agent during an arrest in isolation it will be because ROSC was not sustained and the patient went back into VF/VT or asystole before a ROSC protocol was fully initiated. I've seen that happen plenty of times. On occasion a PEA will occur after defib needing a different approach again but also won't involve sedation because an output is not present.