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

A comprehensive overview of sudden cardiac death (scd), including its causes, risk factors, and management. It delves into the clinical presentation and collaborative care of patients experiencing scd, emphasizing the importance of rapid cardiopulmonary resuscitation (cpr) and defibrillation. The document also outlines the roles and responsibilities of team members during a code blue event, highlighting the importance of effective communication and teamwork. It further explores the use of drugs like epinephrine and amiodarone in resuscitation efforts, as well as the identification and management of reversible causes of cardiac arrest. The document concludes with a discussion of post-cardiac arrest care and supporting families.

Typology: Lecture notes

2023/2024

Uploaded on 10/23/2024

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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