Intervention: Pupillary light reflex (PLR), pupillometry, corneal reflex, myoclonus, and status myoclonus assessed within 1 week after cardiac arrest Long (2016) suggests a systematic process to analyse capnography waveforms, divided into 5 steps: 2 Wheatley I (2018) Respiratory rate 3: how to take an accurate measurement. Nursing Times. https://www.nursingtimes.net/clinical-archive/respiratory-clinical-archive/respiratory-rate-3-how-to-take-an-accurate-measurement-25-06-2018/ The prognostic value of rhythmic/periodic discharges were investigated in 9 observational studies. 199, 210, 228, 231, 237–241

Population: Adults (older than 18 years) with cardiac arrest in any setting (in-hospital or out-of-hospital) Time frame: All years and languages were included if there was an English abstract. Literature search was updated to October 2019. The prognostic value of sporadic, nonrhythmic/periodic discharges was investigated in 5 observational studies. 199, 226, 228, 237, 238 In 3 studies, 199, 226, 238 sporadic, nonrhythmic/periodic discharges within 24 hours after ROSC predicted poor neurological outcome from 3 months to 6 months. Specificity ranged from 84.6% to 100% and sensitivity ranged from 0.5% to 7.9% (certainty of evidence from moderate to very low). Study design: Randomized trials, nonrandomized trials, and observational studies (cohort and case-control studies) with a comparison group were included.

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Outcome: ROSC, survival, or survival with favorable neurological outcome at discharge/28 days or longer Results of clinical examination usually cannot be concealed from the treating team. Therefore, a risk of self-fulfilling prophecy exists even when index tests that are based on clinical examination are not explicitly included in the criteria for withdrawal of life-sustaining therapy. Comparator: Placement of an IV cannula and drug administration through this IV during cardiac arrestConsider thrombolytic drug therapy when pulmonary embolus is the suspected or confirmed as the cause of cardiac arrest.