13 hours ago Bedside Handover Report *Update this report in pencil and pass it forward to the next nurse during bedside handover. Identify: Patient/Family: Age & Sex: *Before approaching the bed, pause to highlight any sensitive issues for oncoming nurse Patient / Family or Emotional / Social / Diagnosis Situation Physician/Team: Code Status: Isolation ... >> Go To The Portal
For the charge nurse You give a handoff report twice: once at the beginning of the shift and one closer to the end. In the beginning, say the situation, any drips, and the plan for the patient. And if you anticipate that you’ll need help from her, this is the time to speak up.
Any lack of blood flow (i.e. a heart attack) will cause ventricular cells to be deprived of oxygen. When the cardiac myocytes become hypoxic, they become irritable and prone to firing when they shouldn’t, which leads to PVCs, VTACH, and even VFIB.
ACLS Cardiac Arrest VTach and VFib Algorithm. Apply defibrillator pads (or paddles) and shock the patient with 120-200 Joules on a biphasic defibrillator or 360 Joules using a monophasic. Continue High Quality CPR for 2 minutes (while others are attempting to establish IV or IO access).
It is nerve-wracking because you don’t want to miss important information, but you don’t want to give too much or too little information. Providing the right amount of information pertinent to each healthcare provider is what makes a handoff report great.
New evidence shows CPR gives VAD patients in cardiac arrest a 50 percent chance of survival.
What Data Elements Should Be Tracked for Resuscitation Events?Patient variables, e.g., age, gender, witness status, location of event, date/time of event, and/or comorbid conditions.Event variables, e.g., initial rhythm, essential interventions, and/or event times.More items...
CPR – 2 min. If the patient shows signs of return of spontaneous circulation, or ROSC, administer post-cardiac care. If a nonshockable rhythm is present and there is no pulse, continue with CPR.
The patient should be cooled to 32–36°C as soon as possible after ROSC using whatever technique is available in your institution, and kept cool for 24 hours. Control shivering as needed with sedation or paralysis and consider a non-contrast head CT to exclude intracranial hemorrhage.
The term "code blue" is a hospital emergency code used to describe the critical status of a patient. Hospital staff may call a code blue if a patient goes into cardiac arrest, has respiratory issues, or experiences any other medical emergency.
Any event in which a medical record containing sensitive patient information disappears constitutes a HIPAA violation. The code blue record also contains pressing information for the intensive care providers who accept the patient after the event.
The provider of CPR should ensure an adequate airway and support breathing immediately after ROSC. Unconscious patients usually require an advanced airway for mechanical support of breathing.
After resuscitation the team leader can provide analysis, cri- tique, and practice in preparation for the next resuscitation attempt. The team leader also helps team members understand why certain tasks are performed in a specific way.
Obtain a 12-lead ECG as soon as possible after the return of spontaneous circulation to identify patients with STEMI or a high suspicion of acute myocardial infarction(AMI).
Return of spontaneous circulation (ROSC) during chest compression is generally detected by arterial pulse palpation and end-tidal CO2 monitoring; however, it is necessary to stop chest compression during pulse palpation, and to perform endotracheal intubation for monitoring end-tidal CO2.
A team-based approach to the management of the post-ROSC (return of spontaneous circulation) patient focuses on initiation of therapeutic hypothermia, treatment of the underlying cause with transfer to the cath lab where appropriate, and management of the post-cardiac arrest syndrome.
Not to be too obvious, but one of the most important aspects of running a cardiac arrest is to determine if your patient has obtained a return of spontaneous circulation (ROSC). The palpation of pulses over the femoral or carotid artery has been a mainstay for decades.
Ventricular arrhythmias are those originating from the ventricles. Since the ventricles are responsible for pumping blood to the lungs and throughout the body, ventricular arrhythmias are often deadly.
Ventricular arrhythmias are usually caused by coronary artery disease (CAD). Any lack of blood flow (i.e. a heart attack) will cause ventricular cells to be deprived of oxygen. When the cardiac myocytes become hypoxic, they become irritable and prone to firing when they shouldn’t, which leads to PVCs, VTACH, and even VFIB.
VTACH is a tachycardic rhythm originating within the ventricles. This produces very fast heart rates which may or may not be perfusing.
Monomorphic VTACH originates from the same ventricular focus. This means that the same ventricular cells or region of cells are functioning as the pacemaker for this rhythm.
Polymorphic VTACH originates from multiple different ventricular foci.
QT prolongation is the main cause of Torsades and is defined when the QT interval is >440ms in men and >460ms in women.
VFIB is similar to polymorphic VTACH, but on a much wider scale. Essentially, all of the ventricular cells are irritable and it produces a disorganized chaotic arrhythmia that does not perfuse the body and is a CODE BLUE.