Return of Spontaneous Circulation (ROSC) Medical Directive

Question 1

ROSC MD

What are the indications for the ROSC MD?

Answer 1

Patient with return of spontaneous circulation (ROSC) after the resuscitation was initiated.

Question 2

ROSC MD

What are the conditions for 0.9% NaCl Fluid Bolus?

Answer 2

Age: ≥2 years
SBP: Hypotension
Other: Chest auscultation is clear.

Question 3

ROSC MD

What are the contraindications to 0.9% NaCl Fluid Bolus?

Answer 3

Fluid overload.

Question 4

ROSC MD

How should ventilation and oxygenation be optimized?

Answer 4

Titrate oxygenation 94-98%.
Avoid hyperventilation and target ETCO2 to 30-40 mmHg with continuous waveform capnography (if available).

Question 5

ROSC MD

What is the ROSC fluid bolus dosing for ages ≥2 years to <12 years?

Answer 5

Route: IV
Infusion: 10 ml/kg
Infusion interval: immediate
Reassess every: 100 ml
Max volume: 1000 ml

Question 6

ROSC MD

What is the ROSC fluid bolus dosing for ages ≥12 years?

Answer 6

Route: IV
Infusion: 10 ml/kg
Infusion interval: immediate
Reassess every: 250 ml
Max volume: 1000 ml