A definitive care hospital for ROSC patients is a hospital with which capability if the additional transport time does not exceed 15 minutes?

• A. ECMO capability
• B. Neurosurgery on-call
• C. Interventional radiology
• D. Targeted temperature management

Answer: (D)

After return of spontaneous circulation, protecting the brain is the top priority in post-arrest care. Targeted temperature management provides controlled cooling (or strict normothermia) to reduce brain metabolism and limit reperfusion injury, which helps improve neurological outcomes. If a hospital can deliver this therapy within a short transport time, it becomes the definitive care center for ROSC patients because timely initiation of temperature management is a key determinant of recovery.

Other capabilities have their roles in specific situations (for example, ECMO for certain refractory cases, neurosurgery for intracranial pathology, or interventional radiology for vascular issues), but they are not the standard defining feature for post-arrest care within the stated time frame. Therefore, targeted temperature management is the best answer.