Friday, October 1, 2010

Cardiac Arrest


Cardiopulmonary resuscitation also known as (CPR) is executed to preserve intact brain function until extra measures are done to reestablish circulation of blood and breathing in a person who is in cardiac and respiratory arrest
1.      Determine unresponsiveness
a.      shake and shout "are you okay?"
b.      call for help
2.      Position the client, if no evidence of trauma (if trauma, see section III of this lesson)
3.      Open the airway
a.      head-tilt, chin lift
b.      jaw thrust (if spinal injury suspected)
4.      Assess for breathing: look, listen and feel
5.      Give rescue breaths
a.      assess if breaths go into lungs by chest movement
b.      if air does not go in, reposition airway (see #3 above)
c.       if air still does not go in, check for foreign body
                                                                                   i.      abdominal thrust (Heimlich manueuver)
                                                                                ii.      do not proceed until airway and rescue breathing established
d.      when airway is clear, check for abscence of pulse
e.      begin chest compressions
                                                                                   i.      be sure client is on a firm surface
                                                                                ii.      hand position is critical
                                                                              iii.      two finger-widths above xiphoid
                                                                               iv.      lower one-half of sternum
1.       for adult, 1.5 to 2 inch compression depth
2.      two rescuers, 80 to 100 compressions per minute
3.      one rescuer, 80 compressions per minute
f.        alternate compressions and breaths
                                                                                   i.      one and two rescuers, 15 compressions to two breaths
                                                                                ii.      reassess cardiopulmonary status after one minute and every few minutes thereafter
6.      Early defibrillation
a.      In adults, the arrhythmia most correctable is ventricular fibrillation if treated promptly
b.      Before starting CPR for ventricular fibrillation, call for help

CPR - Early defibrillation is the key to successful resuscitation for many adults. Continually reassess during CPR to see if the client regains a pulse or begins breathing. Reassess to see that the chest moves and pulses are palpable during CPR.

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