Cardiac Arrest PDF

Cardiac Arrest Sudden, unexpected loss of heart function, breathing, and consciousness Unable to pump and circulate blood to the body’s organs and tissues Sudden cardiac arrest – from electrical disturbance in the heart  Causes Ventricular Fibrillation – most common Ventri...

Cardiac Arrest Sudden, unexpected loss of heart function, breathing, and consciousness Unable to pump and circulate blood to the body’s organs and tissues Sudden cardiac arrest – from electrical disturbance in the heart  Causes Ventricular Fibrillation – most common Ventricular Tachycardia Progressive Bradycardia Asystole PEA / Electromechanical Dissociation Diagnoses common: – MI – Massive PE – Hyperkalemia – Hypothermia – Severe Hypoxia – Medication overdose Symptoms Cardiac arrest symptoms are sudden and drastic: Sudden collapse Loss of consciousness No pulse Absence of BP No breathing / Ineffective respiratory gasping Dilated pupils Seizure Pallor-ashen gray Cyanosis Pathophysiology Global ischemia Consequences at the cellular level – Direct cellular damage – Edema formation – brain Decreased ATP production – Loss of membrane integrity – Efflux of K – Influx of Na+ and Ca2+ – Excess Na+ – Edema – Excess Ca2+ – Mitochondrial damage, Increase NO production, and activates proteases Diagnostic Tests and Procedures EKG/ECG (Electrocardiogram) Simple, painless test that records the heart's electrical activity Used to detect and locate the source of several heart problems How fast the heart is beating and the heart's rhythm (steady or irregular) Strength and timing of electrical signals as they pass through each part of the heart Echocardiography Painless Uses sound waves to create pictures of the heart Information about the size and shape of the heart and how well the chambers and valves are working Can detect areas aren't contracting normally due to poor blood flow or injury from a previous heart attack. Stress echocardiography shows whether you have decreased blood flow to your heart  Cardiac Magnetic Resonance Imaging Uses radio waves and magnets to create detailed pictures of the heart Creates images of the heart as it is beating, producing both still and moving pictures of the heart and major blood vessels Doctors use cardiac MRI to get images of the beating heart and to look at the structure and function of the heart.  Cardiac Catheterization Used to diagnose and treat certain heart conditions Catheter is put into a blood vessel in the arm, groin (upper thigh), or neck and threaded to the heart Sometimes a special dye is injected to make the internal structures of the heart and blood vessels be visualized on x rays The dye can show whether a plaque has narrowed or blocked any of the coronary arteries Emergency Assessment & Management Cardiopulmonary Resuscitation Current resuscitation protocol recommendations: 1. Quick recognition of sudden cardiac arrest 2. Activation of Emergency Response System 3. Performance of high-quality CPR 4. Rapid cardiac rhythm analysis and defibrillation Airway (look, listen, and feel) Breathing (mouth-to-mouth/bag valve mask) Circulation (chest compressions)  Drug Therapy Lidocaine, procainamide, verapamil Dopamine, isoproterenol, norepinephrine Epinephrine Atropine sulfate Sodium bicarbonate Calcium chloride Defibrillation  For People Who Have Survived Sudden Cardiac Arrest If you've already had SCA, you're at high risk of having it again Implantable cardioverter defibrillator (ICD) reduces the chances of dying from a second SCA. Surgically placed under the skin in your chest or abdomen The device has wires with electrodes on the ends that connect to your heart's chambers. If it detects a dangerous heart rhythm, it gives an electric shock Nursing Interventions Monitor arrest caused by ventricular fibrillation: Begin precordial thump and if successful, administer lidocaine If unsuccessful, defibrillate If defibrillation unsuccessful, initiate CPR immediately Assist with administration of and monitor effects of additional emergency drugs