One reason you or your relative may need to be admitted to critical care would be following a cardiac arrest. A cardiac arrest is an event when for various causes, a patients’ heart will either stop beating, or beat in an uncontrolled rhythm that does not generate any blood pressure.
In these situations, where a cardiac arrest has occurred, cardio pulmonary resuscitation, commonly known as CPR, may be started. This involves compressing the chest, in an attempt to squeeze the heart, and contribute a blood pressure physically. Alongside this, oxygen will be applied and forced into the lungs in order to get some oxygen into the body.
Sadly, in contrast to what is often seen on television, despite this resuscitation, many people who have suffered a cardiac arrest will pass away. In the UK, when a cardiac arrest occurs outside of hospital, in patients whom CPR is started upon, only 9 out of 100 will ultimately make it out of hospital alive.
If the resuscitation is initially successful, and the heart starts beating again, then the patient will very likely be admitted to critical care. They will likely be put on a ventilator to help them breath, and will receive medication to keep them sedated and their blood pressure supported. Please see our videos on induced coma, ventilation, and lines for more information regarding this.
After a patient is then admitted to critical care, we will then support them and monitor closely over a period of time. Sadly, despite the initial ‘success’ of some resuscitations, patients may rapidly deteriorate, and pass away shortly after coming to critical care.
Some others will continue to survive the initial period, and the next step will be to try to wake the patient up, by stopping their sedation. In some cases, patients do wake up, and we are able to take them off the ventilator, and they may continue to improve afterwards.
In other cases however, sadly, when we try to reduce or stop their sedation, the patient either does not wake up at all, or may develop seizures or other worrying signs. This is an indication that during their initial cardiac arrest, they had a prolonged period of time without getting oxygen to their brain, and they have acquired significant brain damage. Ultimately they will not survive, despite the initial ‘success’ of the resuscitation, and the immediate period afterwards. In these situation we will prioritise comfort care, and so will stop any support and allow the patient to pass away peacefully.