Critical Care Mailbag - End Tidal CO2 in Cardiac Arrest

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Nurses Edition Commentary

Mizuho Spangler, DO, Lisa Chavez, RN, and Kathy Garvin, RN
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David H., M.D. (@BritFltDoc) -

Scott,
I have used a femoral art line to help guide resuscitation in cardiac arrest, and I agree that I think it is an excellent adjunct, especially in patients where body habitus makes a pulse check anatomically difficult feel. Where I have ended up with a question though, is if the line is giving an arterial waveform and a SBP of say 40, is this giving the patient better perfusion to the brain than CPR? Without an arterial line, CPR would continue until a pulse was felt. Do we know if brain perfusion is better based on the presence of a palpable pulse, or an arterial pressure of 35-45mmHg without CPR?
Would appreciate your thoughts. Thanks. Dave.

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