Cardiac Arrest - Exam 6 Flashcards
epinephrine
Classification: alpha and beta adrenergic agonist, bronchodilator
Mechaism of action: Potent activator of alpha receptors, myocardial contraction, increase SBP, increase HR, increase CO, positive inotrope
Use: asystole, bronchospasm, anaphalaxis
Side/adverse effects: nervousness, arrhythmias, MI, pulmonary edema
Nursing Implications:
- Monitor EKG
- VS during infusion
- Crash cart nearby
- If arrhythmias begin, notify MD
What is respiratory arrest?
It is a sudden, abrupt cessation of effect lung ventilation (respiration)
What is cardiac arrest?
The sudden cessation of breathing and adequate circulation of the blood by the heart
What cardiopulmonary resuscitation?
The process of externally supporting the circulation and respiration of a person who has cardiopulmonary arrest
What is sudden cardiac death (SCD)?
The unexpected death for cardiac causes. There is a disruption in cardiac function, producing an abrupt loss of cerebral blood flow. Death occurs within 1 hour of onset of acute symptoms
What are the risk factors for cardiac arrest?
- arteriosclerotic heart disease, myocardial infarction
- myocardial ischemia, ventricular irritability, progressive/dangerous dysrhythmias
- fluid and electrolyte imbalance
- hypoxia
- use of certain anesthetic agents
- renal disease, especially with hyperkalemia and hypocalcemia
- intake of certain drugs and dyes
- electrocution
What are the causes of cardiac arrest?
- respiratory failure that has progressed
- ventricular dysrhythmias
- cardiovascular collapse
What are the signs of cardiac arrest?
- unconsciousness
- absent palpable carotid pulse in adults, absent branchial pulse in infants
- absence of spontaneous respirations
What is a crucial step in cardiopulmonary resuscitation?
Establishment of reliable vascular access. If vascular access is accomplished within the first few minutes of resuscitation, infusion of medications and fluids is possible and successful resuscitation may be more likely
What is important to note about IV access?
- Preferred route for drug delivery
- Mandatory for infusion of fluids
- Central line access optimal
- Follow each medication with a flush of NS
What is important to note about intraosseous access?
- Used for infants and children of any age
- Safe and reliable route to administer drugs, fluids, and blood products
- Specially designed bone marrow aspiration needle is inserted into bone (medial tibia)
- Recommended during resuscitation for quick access.
What is important to note about endotracheal route?
- When venous (or intraosseous) access is not available
- Used to deliver LEAN drugs: lidocaine, epinephrine, atropine, narcan
- May require larger doses of drugs to achieve desired effects
- Procedure:
- Dilute medication to total volume of 3-5 mL of NS
- Instill medication into edotracheal tube (ETT) or VIA catheter passed beyong tip of ETT
- Follow med with a flush of 3-5 mL NS
- Administer positive-pressure ventilations with hand resuscitation bag
