The mainstay of treatment for someone suffering from sudden cardiac arrest is immediate cardiopulmonary resuscitation (CPR) and applying an automated external defibrillator (AED) with defibrillation if indicated. If someone is not conscious and not breathing normally, it is important to assume they are in cardiac arrest and follow these three steps:
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After the ambulance arrives (or the code team, if in the hospital), they will continue CPR and check the need for defibrillation (an arrest due to ventricular fibrillation or ventricular tachycardia). The medical team will obtain vascular access and provide medications such as epinephrine and antiarrhythmic drugs (to treat arrhythmia). Almost always, the individual suffering from cardiac arrest will receive an advanced airway, commonly through intubation.
It is common practice for paramedics to stay on-scene to continue resuscitation since there is not always more a hospital can do for a cardiac arrest patient. Ultimately, some patients may not be transported to the hospital and declared dead on the scene after exhausting resuscitation efforts.
After a patient achieves a pulse back, or if paramedics feel a still pulseless patient needs transport with CPR ongoing, the patient will be transported to the most appropriate hospital. Resuscitation will continue in the hospital, and patients who regain pulses will be admitted to an intensive care unit, where they will have their vital signs monitored closely.
Patients revived after suffering from cardiac arrest are almost always intubated and unresponsive when admitted to the intensive care unit.
During cardiac arrest, the brain can have an extended period of time without oxygen, and this results in a spectrum of anoxic brain injury. Patients will be monitored in an intensive care unit and may be sedated for a period of time. Some, but not all, patients will have their body temperatures lowered by the medical team if they meet criteria indicating it may help in their recovery. In addition, it is common for patients to undergo imaging, such as CT or MRI scans, and brain wave monitoring (EEG), among various other tests. After 72-96 hours, medical professionals will begin to assess neurologic function and recovery. However, for patients who survive cardiac arrest, it can take months or longer for their neurologic injury to heal.
