Code Blue: Understanding Sudden Cardiac Death and Resuscitation, Lecture notes of Nursing

Download Code Blue: Understanding Sudden Cardiac Death and Resuscitation and more Lecture notes Nursing in PDF only on Docsity!

CODE BLUE

Learning Objectives

 (^) Describe the precipitating factors, the clinical presentation, and the collaborative care of patients who are at risk for or have experienced sudden cardiac death.  (^) Identify and discuss the clinical presentation and collaborative care of a patient during a Code Blue.

Sudden Cardiac Death

 (^) History is an important predicter  (^) Reports a mother or father with sudden cardiac death  (^) Should be alerted to the possibility that the patient may have a similar predisposition or condition.

Etiology and Pathophysiology

 (^) cardiac function is disrupted abruptly, causing immediate loss of CO and cerebral blood flow.  (^) death usually occurs within 1 hour of the onset of acute symptoms  (^) ventricular tachycardia, ventricular fibrillation, major cause in the majority of cases  (^) less commonly, aortic stenosis, hypertrophic cardiomyopathy or extreme bradycardia

Risk Factors

It is difficult to predict:  (^) male sex (especially Black men)  (^) family history of premature atherosclerosis,  (^) tobacco use  (^) diabetes mellitus  (^) hypercholesterolemia  (^) hypertension  (^) cardiomyopathy.

Nursing and Collaborative

Management Sudden Cardiac

Death

 (^) Survivors  (^) Diagnostic workup r/o MI  (^) Cardiac monitoring  (^) Cardiac catheterization, PCI or CABG surgery  (^) Lethal ventricular dysrhythmia that has a high incidence of recurrence  (^) Implantable cardioverter–defibrillator (ICD)  (^) Amiodarone may be used in conjunction with an ICD to decrease episodes of ventricular dysrhythmias.  (^) 24-hour Holter monitoring, exercise stress testing

Code Blue

 (^) to indicate a patient requiring resuscitation or otherwise in need of immediate medical attention  (^) most often as the result of a respiratory or cardiac arrest  (^) cardiac arrest in hospital areas are common  (^) delayed treatment is associated with a lower survival rates

Team Members

1. Team leader
2. Compressor
3. Airway manager
4. AED/Monitor/Defibrillator
5. IV/IO medications provider
6. Time recorder ( spiritual care, security, primary nurse)

BLS

Guidelines

BLS

 (^) Effective Compressions

ALS

Guidelines

ACLS Asystole PEA V Fib V Tach

Epinephrine

CPR Quality

 (^) Push hard (at least 2 inches [5 cm]) and fast (100-120/min) and allow complete chest recoil  (^) Minimize interruptions in compressions  (^) Change compressor every 2 minutes, or sooner if fatigued  (^) If no advanced airway, 30:2 compression-ventilation ratio (BVM)  (^) Quantitative waveform capnography – If Petco2 is low or decreasing, reassess CPR quality.

Drug Therapy

 (^) Epinephrine IV/IO dose: 1 mg every 3-5 minutes  (^) Amiodarone IV/IO dose: First dose: 300 mg bolus. Second dose: 150 mg. (VT/VF)  (^) or Lidocaine IV/IO dose: First dose: 1-1.5 mg/kg. Second dose: 0.5-0.75 mg/kg.(VT/VF)

Reversible Causes

 (^) Hypovolemia  (^) Hypoxia  (^) Hydrogen ion (acidosis)  (^) Hypo-/hyperkalemia  (^) Hypothermia  (^) Tension pneumothorax  (^) Tamponade, cardiac  (^) Toxins  (^) Thrombosis, pulmonary or coronary