Return of Spontaneous Circulation (ROSC)
Reversible Causes
Hypothermia
Hypovolaemia
Hypoxia
Hypo/hyperkalaemia
Toxins
Tension Pneumothorax
Thrombus
Tamponade
Post ROSC Management
Re-assess ABCDE
12 Lead ECG
Vital Signs inc Temp and Blood Glucose
IV Fluids
Consider inotropic support (in line with local and national guidelines)
Bradycardia? Consider Atropine
Consider support from specialist Paramedic/HEMS for post ROSC sedation
Convey to local ED
Recognition of Life Extinct (ROLE)
Recognising life extinct may be due to unsuccessful resuscitation attempts or that resuscitation was not viable to begin with. Following ROLE document:
Time of ROLE
Presenting rhythm
Suspected cause (otherwise unknown)
Notify coroner (via Police) if not expected
Expected? Refer to local guidelines
Public place? Liaise with Police, discuss conveyance
In addition for a Paediatric ROLE document:
Position and circumstances child was found in
Clothes child was wearing
Any nappies
Approx temperature of the room and if windows were open
Who was present when the child was found
Drug history and past medical history of the child
Signs of life extinct:
Valid - signed/dated RESPECT or DNACPR documentation. Other advanced directive. (These documents need to be viewed by the clinician)
Rigor Mortis
Hypostasis
Hemicorporectomy
Decapitation
Massive Cranial Destruction
Decomposition/putrefaction
Foetal maceration in a new born
Incineration (full thickness burns, charring greater than 95% of the bodies surface)
