Medic 9 · 15 min · ground

Post-ROSC — hypoxic PEA

AHA 2025 · 90–98% (AHA 2025 post-ROSC; 100% until a sat can be measured) · 6 mL/kg PBW (4–8) · Pplat ≤30 · ΔP ≤14 (trainer) · PaCO2 ~35–45

67-year-old found down, presumed aspiration. PEA 12 minutes, ROSC after epi ×2 and a good tube. Still unresponsive. Sat 91% on the bag at 20, etCO2 28 and falling.

Handoff

They are blowing her down. AHA 2025: 100% until a sat can be measured, then SpO2 90–98%. PaCO2 ~35–45, 6 mL/kg — not 100% and a rate of 20 the whole way. Hypocapnia hurts the brain that just reperfused. 15 minutes to the ICU.

1
SpO2 90–98% (AHA 2025) — 100% only until the probe reads
Once sat is reliable, wean off 100%. Do not chase this trainer’s 92–96 house band.
2
etCO2 / PaCO2 ~40, not 28
Hypocapnia vasoconstricts a freshly injured brain.
3
6 mL/kg, Pplat ≤30
Aspiration plus CPR is a dirty lung. Protect it. Trainer ΔP line is 14.

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