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Saudi Journal of Medical and Pharmaceutical Sciences (SJMPS)
Volume-11 | Issue-10 | 1018-1027
Review Article
Approach to Post-Cardiac Arrest Care: A Review of Integrated Protocols from Pre-Hospital to ICU
S. F. Alshehri, Y. M. Althomali, S. A. Al muhsin, J. T. Bajon, R. M. Y. Sawadi, R. M. Messawa, E. Y. Daak, A. S. Hakami, K. A. Alghidani, S. F. Alkhammash, W. G. Alghamdi, M. Z. M. Alshehri, Z. S. Alhumaidi, M. M. M. Alghamdi, S. A. Alomari
Published : Oct. 29, 2025
DOI : https://doi.org/10.36348/sjmps.2025.v11i10.012
Abstract
Post-cardiac arrest care represents a critical link in the chain of survival, yet outcomes for patients who achieve return of spontaneous circulation (ROSC) remain suboptimal. The period following ROSC is characterized by the complex, multisystem pathophysiology of post-cardiac arrest syndrome (PCAS), which includes profound brain injury, myocardial dysfunction, and a systemic ischemia-reperfusion response. Improving survival and neurological function requires a shift from a series of isolated interventions to a comprehensive, structured, and multidisciplinary system of care that spans the entire patient journey from the pre-hospital environment to the intensive care unit (ICU) and beyond. This review examines the integrated protocols that define modern post-cardiac arrest management. It details the continuum of care, beginning with pre-hospital stabilization and transitioning to in-hospital therapeutic strategies, including targeted temperature management (TTM), hemodynamic optimization, and neurological protection. A central focus is placed on elucidating the distinct and interdependent roles of a broad multidisciplinary team, encompassing not only direct clinical providers such as Paramedics, Nursing Specialists, and Respiratory Therapists, but also the essential technical and administrative personnel who form the operational backbone of this system. The specific contributions of Radiologic Technologists, Biomedical Technicians and Specialists, Nursing Technicians, Unit Coordinators, and Medical Secretaries are analyzed to demonstrate how their functions are integral to the consistent and reliable implementation of evidence-based guidelines. The review further explores the communication strategies and systemic protocols that orchestrate this complex collaboration, addresses common implementation challenges, and surveys the future landscape of post-cardiac arrest care, including emerging technologies and evolving therapeutic paradigms. The central thesis is that optimal patient outcomes are not merely a function of clinical expertise but are fundamentally dependent on the seamless integration of this entire multidisciplinary ensemble.
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