View source for 2-3 ADULT CARDIAC ARREST: CEREBRAL COOLING PROTOCOL

{| class="wikitable"
|'''EMT - Emergency Medical Technician'''  ''Perform/Confirm All Above Interventions''
|}
This protocol is designed to be implemented by providers at the Intermediate and paramedic levels only due to the need for a functioning IV and advanced airway. It assumes the provider has followed all of the steps in the Adult CCR protocol prior to institution.

'''Inclusion Criteria:'''

# Patient sustained a witnessed cardiac arrest from V-tach, V-fib or PEA/Asystole and has had a Return of Spontaneous Circulation within 60 minutes of arrest '''''without''''' a return of normal neurologic function
# The patient has an advanced airway established and a functioning IV
# The patient is over age 15

'''Exclusion Criteria''' (this protocol should not be used if any of the following are present:

# The patient has a valid DNR
# The etiology of the cardiac arrest is felt to be traumatic or due to a stroke
# The patient has a known coagulopathy
# The patient has a systolic BP less than 90 despite epinephrine
# The patient is suspected to have environmental hypothermia

{| class="wikitable"
|'''AEMT – Advanced Emergency Medicine Tech  ''' ''Perform/Confirm All Above Interventions''
|}

# Initiate transport
# Confirm placement of IV or IO
# Confirm placement of advanced airway using capnography Direct EMR’s and EMTs to continue CPR.
# Place ice packs on the neck, axilla and groin, protecting the skin with a towel
# Administer up to 2 liters of cooled NS, if available
# '''CONTACT MEDICAL CONTROL''' for additional orders.

{| class="wikitable"
|'''Intermediate ''' ''Perform/Confirm all above interventions''
|}
{| class="wikitable"
|'''PARAMEDIC''' ''Perform/Confirm all above interventions''
|}

# Observe for shivering. If it develops, contact medical control for orders to administer '''rocuronium (Zemuron)'''