2-3 ADULT CARDIAC ARREST: CEREBRAL COOLING PROTOCOL

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:

1. 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
2. The patient has an advanced airway established and a functioning IV
3. The patient is over age 15

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

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

AEMT – Advanced Emergency Medicine Tech   Perform/Confirm All Above Interventions

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

Intermediate  Perform/Confirm all above interventions

PARAMEDIC Perform/Confirm all above interventions

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