1. Cardiac Arrest: Audit of practice in ICU from 1 st August 2014 to 31 st January 2015 Dr C Hickey and Dr Elizabeth Little

2. 26 Cardiac Arrests admitted to ICU

3. Demographics: Age range 13 Males 13 Females 19 Out of Hospital 7 In Hospital

4. Coronary intervention PCI and pacing

5. Outcomes post Cardiac Arrest From our study, 42% of Out Of Hospital Ardiac Arrests survived to ICU discharge. 2015 ILCOR review, 40- 50% survive.

6. Therapeutic cooling Number cooled: 22 out of 26 : 84.6% All cooled for 24 hours 16 cooled to 33 degrees 4 cooled to 34 degrees 2 cooled to 36 degrees Not cooled or stopped: 4 – OOH, asystolic cardiac arrest, RIP – OOH, PEA (awaiting TAVI) poor outcome, RIP – OOH PEA, temporarily paced and survived GCS 13 – IH (Loughlinstown) Cardiac arrest, PCI, survived GCS 15

7. Temperature For patients cooled to 33 degrees Mean time to target 307 minutes (54 to 720 minutes)

8. Temperature 34 Degrees 36 Degrees

9. DEATHS Of the 15 patients who died 12 died in ICU 3 on the ward 14 patients had treatment withdrawn 1 went into VT arrest- no ROSC

10. 15 patients who died

11. Patients who survived to ICU discharge GCS

12. Wards patients discharged to

13. 2015 ILCOR guidelines - changes Urgent PCI following cardiac arrest if likely cause Targeted temperature management remains important but there is now an option to target a temperature of 36 degrees instead of the previously recommended 32–34°C The prevention of fever remains very important Prognostication is now undertaken using a multimodal strategy and there is emphasis on allowing sufficient time for neurological recovery and to enable sedatives to be cleared.

14. THANK YOU Questions?