Cardiac Arrest NUR 210 Summer 2006

Cardiac Arrest Abrupt cessation of effective cardiac pumping activity, resulting in cessation of circulation. Cardiac standstill Ventricular fibrillation, etc.

Resuscitation Restoration of vital signs by mechanical, physiological, and pharmacological means.

Death Clinical death is defined as the absence of the vital signs. Biologic death refers to irreversible cellular changes.

Team Nurses MD’s ECG technicians Unit secretaries, etc

Assessment of Cardiac Arrest Absence of circulation: –Unconscious state preceded by less profound states of mental obtundation –Pulselessness – carotid or femorals –Dilated pupils (takes 45 seconds to longer than 1 minute) –Minimal or absent respirations – in early arrest, may be minimal activity

Complications of Resuscitation Injuries to the sternum, costal cartiledges, ribs, espohagus, stomach, liver, pleura and lung Permanent central nervous damage in a live client which renders the client dependent Medicological considerations

Post pacemaker instructions Signs of battery failure Report dizziness, weakness or fatigue, swelling of the ankles or legs, chest pain, or SOB Medic-Alert bracelet Avoid contact sports Airport security alert Most electrical appliances can be used

Instructions con’t Avoid transmitter towers and antitheft devices in stores Instruct that if unusual feelings occur when near any electrical devices to move 5 to 10 feet away and check the pulse

Implanted Cardiac Defibrillators Monitors cardiac rhythm and detects and terminates episodes of VT and VF Delivers 25 to 30 joules up to 4 times if necessary Electrodes placed in the right atrium and ventricle and apical pericardium Generator implanted in the abdomen

Teaching Report symptoms of fainting, nausea, weakness, blackouts, and rapid pulse rates to MD During shock discharge, client may feel faint of SOB Instruct to lie down or sit if they feel a shock Family to learn CPR

Teaching Maintain a diary of any shocks that are delivered; including date, time, preceding activity, # of shocks. Avoid electromagnetic fields directly over the ICD –can inactivate it. Medic-alert bracelet Notify MD if beeping sound is heard when near electomagnetic fields