Temperature Control After Cardiac Arrest

After return of spontaneous circulation (ROSC), temperature becomes a neurologic treatment decision rather than a routine comfort measure. Start by asking whether the adult can follow verbal commands. A patient who is awake and following commands does not need targeted temperature management (TTM); an adult who remains unresponsive to verbal commands is eligible for active temperature control. The current target is not automatically 33 °C. The 2025 AHA guidance distributed through Heart & Stroke permits selection of one temperature between 32.0 °C and 37.5 °C, maintained for at least 36 hours. The 2024 Canadian cardiovascular societies update favours controlled normothermia and prevention of fever rather than routine induced hypothermia. These are Canadian-facing practice positions; the remaining disagreement is between specialty societies, not between Canadian and foreign jurisdictions. Temperature control sits inside a larger post-arrest bundle that includes oxygenation, ventilation, blood-pressure support, coronary reperfusion decisions, seizure management, and delayed neurologic prognostication.