5 cycles of CPR alternating with defibrillation Epinephrine every 3 5 minutes

5 cycles of cpr alternating with defibrillation

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5 cycles of CPR alternating with defibrillation Epinephrine every 3-5 minutes One dose of vasopressin instead of epinephrine Anti-arrhythmic » Amiodarone » Lidocaine » Magnesium Intubation/airway management Management Hypothermia protocol (since there are no O2 blood flow in the body while in VT, the cells are dying, the hypothermia stop the internal injury that take place in the cells) » Mild hypothermia in comatose adults (32-34 °C within about 3-6 hrs of time of the arrest ) » Induction started as soon as circulation is restored » Maintained 12-24 hours Nursing Management for hypothermia protocol » Monitor appropriate level of cooling » Medication administration and monitoring (sedation [to calm the brain action and muscles] , paralysis [ to prevent shivering since shivering consumed o2 ]) » Monitoring and prevention of seizures, shivering » Monitor electrolyte imbalance » Correct hypotension » Treat infection » Monitor and treat hyperglycemia Ventricular Asystole o “Flatline” o Absent QRS complex, may be P waves for a short duration o Confirmed in two different leads o No heartbeat, no palpable pulse, no respirations therefore no defib o Etiology: Asystole Rapid Assessment of H ’s and T ’s o Hypoxia o Hypovolemia o Hydrogen ion (acid-base imbalance) o Hypo/hyperglycemia o Hypo/hyperkalemia o Hyperthermia o Trauma Amiodarone & Epinephrine may facilitate return of spontaneous pulse after defibrillation
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o Toxins o Tamponade accumulation of fluid around the heart muscle putting pressure on the organ o Tension pneumothorax o Thrombus ( coronary or pulmonary ) o Management High-quality CPR w/ minimal interruptions Identify underlying factors Intubation Establish IV access Epinephrine bolus (repeat 3-5 minutes) Vasopressin Call code* Conduction Abnormalities General Information Identify underlying RHYTHM [id the interpretation means rhythm and rate, do not give interpretation for 1 st degree block] o Regular Intervals between the R waves are regular o Irregular Intervals between the R waves are not regular ( RATE [ventricular] can be accurately determined by counting the small boxes in between Rs & dividing 1,500 by that number) Assess PR interval; may be caused by: o AV blocks occur when the conduction through the AV nodal or His bundle is decreased or stopped o Medications (CCB, BB, dig [can cause d/r ]) o Myocardial ischemia/infarction o Cardiomyopathy o Increased vagal tone Clinical Manifestations o Vary with resulting ventricular rate and severity of underlying disease process o Asymptomatic o Hemodynamic in stability Decreased perfusion to vital organs brain (confusion, LOC) , heart (pain, coronary artery perfusion ischemia) , kidneys (oliguria) , lungs (SOB) , skin (pallor) ) [ rarely occur in 1 st degree block] Treat the patient NOT the monitor Treatment based on hemodynamic effect of the rhythm Classification of AV Block’s o First-degree AV block (conduction problem in the SA node) o Second-degree AV block Type I (Wenckebach or Mobitz) o Second-degree AV block Type II (Mobitz II) o
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