Hospital CPR Flashcards
What medications are commonly used in an arrest?
Epinephrine: to caused bronchodilation and vasoconstriction
- 1st med given to any pulseless or VT/VF/PEA and other arrest arrhythmias
Atropine: antispasmodic and anticholinergic
- for severe bradycardia
Amiadarone or lidocaine: antiarrhythmic
- used for cardiac arrest: 1st line for VT or VF
Oxygen - for lungs and circulation to heart and brain
Magnesium - for VF or VT
What equipment is commonly found on a crash cart?
meds: epinephrine, atropine, lidocaine oxygen/ambu bag arrest form for documentation IV supplies intubation supplies back board
What documentation is required to record a cardiac arrest?
3rd person responsibility:
- locate recording document on crash cart and fill it out asap
- record when code began, sequence of events, interventions (drugs, actions, and responses to treatment)
- all members of code have signed arrest form
What are the roles/responsibilities of 1st and 2nd responder to an unresponsive patient?
1st person (finds patient):
1) Primary survey: ABCD
2) call for help, notify location of code blue
3) begin 1 person CPR
2nd person (responds to call for help)
- confirms arrest, calls the code
- brings crash cart and puts cone in doorway
- gets patient on backboard
- get Ambu bag
- starts 2 person CPR until code team arrives
Who are the various members of the health care team in a code?
ER Physician Respiratory therapist Clinical pharmacist 2 ICU Critical care (code blue) nurses IV nurse
How is a code blue called in the clinical setting?
dial 7111
state “code blue” room number, floor
repeat twice and hang up
bring crash cart to bedside and place red cone outside of the room
In order, list what actions must be done prior to the code team arrival
1) assess ABCD
2) notify code team
3) position flat supine (remove pillow and HOB= 0 degrees)
4) ABC interventions (insert oral airway? IV access?)
5) start compressions (ensure board underneath patient)
Which clients are at risk for a cardiac arrest?
arrhythmias pulmonary embolism aspiration tension pneumothorax hypoxemia acidosis electrolyte imbalance anaphylaxis hypovolemia multiple trauma
What are signs/symptoms of impending arrest?
cool, clammy skin or profound diaphoresis
changes in LOC
unrelieved chest pain
altered respiratory patterns - colour changes
metabolic and electrolyte imbalances (acidosis, hypercalcemia, hyper/hypokalemia)
What are the phases of an arrest and code management?
Phase I: 1st and 2nd responder + CPR
Phase II: Code team - drugs and early defibrillation
How does the ABCD differ for the 1st responder and the code blue team?
1st responder: Airway, breathing, circulation, defibrillation (need for) Code blue team: Airway - intubation Breathing - ventilation Circulation - cardiac rhythm analysis D - differential diagnosis of cause
What are the roles of the code team members: team leader, defibrillator operator, recorder, intubationist, medication nurse
team leader: physician or ICU nurse (stands at foot of bed)
defibrillator operator - Dr. or ICU nurse delivers shock
recorder - designated at start of code to record events and interventions; must also know dosing meds e.g. next epi is due - it’s been 3 minutes
intubationist: Dr. or RT performs intubation
medication nurses: one at crash cart getting meds ready, one at bedside giving meds
What is the most appropriate nursing intervention for a cardiac arrest due to ventricular fibrillation (VFib) or ventricular tachycardia (VTach)?
early and immediate defibrillation
What ECG changes would indicate a VFib dysrhythmia?
Don’t need to know this for the final
irregular rhythm
rate 300+
not recognisable QRS duration
P wave not seen
What ECG changes would indicate Pulseless electrical activity (PEA)?
Don’t need to know this for the final
ANY organized or semiorganized rhythm that lacks a palpable pulse (excluding VF, VT and asystole)
