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

Photo by Brian Burns

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

Lower FiO2

Maintain an SpO2/SaO2 between 90-95%

Normal PaCO2

No hypocapnea, Perhaps slight hypercapnea

Tune in Next Week for Part II of the Interview

More on the TTM Trial

* My initial Wee

* A quick interview with Jon Rittenberger

The Thoughts of Others

https://twitter.com/JAMyburgh/statuses/402940221630603264

https://twitter.com/JAMyburgh/statuses/403351251791781888

More from Steve can be found at the EDECMO Podcast Site

Now, on to the Podcast...