2-New CPR Guidelinsdifioses-2010

7/29/2019 2-New CPR Guidelinsdifioses-2010

1/18

Latest Trends In Nursing

IN EMERGENCY SETTING

IN MATERNAL AND CHILD DELIVERY

IN CHARTING STYLE

CA VACCINES


2/18

New CPR Guidelines-2010Oct. 18, 2010 -- New guidelines released by the

American Heart Association recommend that thethree steps of cardiopulmonary resuscitation (CPR)

be rearranged.

The new first step is doing chest compressionsinstead of first establishing the airway and thendoing mouth to mouth. The new guidelines apply toadults, children, and infants but exclude newborns.

The old way was A-B-C -- for airway, breathing andcompressions.

The new way is C-A-B -- for compressions, airway, andbreathing.


3/18

The old approachwas causing delays

in chest

compressions

which are crucial

for keeping the

blood circulating.

Why did CPR change from A-B-C to C-A-B?


4/18

No more looking, listening and feeling

*Push a little harder. How deep you should pushon the chest has changed for adult CPR. It was 1 to 2 inches, but now the Heart Association wants

you to push at least 2 inches deep on the chest.

*Push a little faster. AHA changed the wording too.Instead of pushing on the chest at about 100

compressions per minute, AHA wants you to pushat least 100 compressions per minute. At that rate30 compressions should take you 18seconds,

C-A-B


5/18

How to Do the New CPR

Here is a step-by-step guide for the new CPR:

1. Call help or ask someone else to do so.

2. Try to get the person to respond; if he doesn't, roll the

person on his or her back.

3. Start chest compressions. Place the heel of your hand on the

center of the victim's chest. Put your other hand on top of

the first with your fingers interlaced.

4. Press down so you compress the chest at least 2 inches in

adults and children and 1.5 inches in infants. ''One hundred

times a minute or even a little faster is optimal,

(That's about the same rhythm as the beat of the Bee Gee's song "Stayin' Alive.")

C-A-B


6/18

5. If you're been trained in CPR, you can now open the

airway with a head tilt and chin lift.

6. Pinch closed the nose of the victim. Take a normal

breath, cover the victim's mouth with yours to create

an airtight seal, and then give two, one-second breaths

as you watch for the chest to rise.7. Continue compressions and breaths -- 30 compressions,

two breaths -- until help arrives.

C-A-B

How to Do the New CPR


7/18

Latest Nursing notes/charting in US

D = DATA. What did you hear and what do you know to be true

(empirical evidence garnered thru the five senses and known facts).A = ASSESSMENT. So, as a nurse, what did you think of the above

data?

I = INTERVENTION. So, what did you do about the situation?

R = RESPONSE. How did your patient respond to your intervention?

S = SUBJECTIVE: what did the patient say?

O = OBJECTIVE: What are the known facts and what is theempirical info?

A = ASSESSMENT:

I = INTERVENTION;

P = Plan: What is the next step?


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Example:

Using the two templates, for example, the narrative would

read something like this:

D-Mary Hammond, States she has tried to relax but theheadache is getting worse.A-Mary Hammond grimaces as she talks. Given with

PRN Tylenol Q 6 hrs- HA.Mary Hammond has had a HA x 2hrs, could benefit fromprn Tylenol.I-Provide pt with 500 mg Tylenol.Response: Effective or Plan: F/u with Tylenol results in

half hour, contact attending if no relief.


9/18

PIE Charting

Think of it like this

P-problem-disease process (what is going on with your patient at

assessment)I-intervention-what you did to assist or implement to alleviate theproblem at hand

E-evaluation- how your intervention worked

Do your patient assessment:

Ex: Patient admitted with DOB, noted O2 sat at 85% on room air

P-DOB,sats90, no complaints of DOB at this time, Orders from Dr

recieved. Patient denys discomfort and Dob at this time will

continue to evaluate status.


10/18

Cont.

Put each situation into the PIE. It may takeawhile and there are many interventions ,there will be many problems , many

interventions, evaluations need to be specific for each

problem.

Interventions can be used for multipleproblems.


11/18

New Trends

CIMAVAX- Lung CA vaccine originated in Cuba

Gardasil- Cervical CA vaccine (against HPV)

Flu( Swine/AH1N1) and Pulmo vaccines


12/18

Good News!

1st Pediatric Liver Transplant in the Phils.- (Medical City, Jan.11)

- 3 y/o female Erika Buenaventura with

Billiary Atresia- 4.5 million pesos per transplant

But sad to hear that this child died after few months

not because of the transplant rejection but becauseof Dengue =(


13/18

Unang yakap Campaign

On December 7, 2009, the Department of Health

launched the Unang Yakap Campaign.

The DOH aims to cut down infant mortality in the

Philippines by at least half.

The campaign employs Essential Newborn Care

(ENC) Protocol as a strategy to improve the

health of the newborn through interventions

before conception, during pregnancy, at andsoon after birth, and in the postnatal

period.(evidenced based strategic intervention)
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14/18

ASSIGNMENT

Write your output in a yellow paper to be

submitted next meeting.

1. Know your ENC- Unang yakap campaign.

2. ENC- TIME BOUND INTERVENTIONS

3. ENC- NON-TIME BOUND INTERVENTIONS4. Unecessary interventions/procedures


15/18

The ENC Protocol provides an evidence-based, lowcost, low technology package ofinterventions that

will save thousands of lives. Based on health statistics, the Philippines is one of

the 42 countries that account for 90% of under-five mortality worldwide.

82,000 Filipino children under five years old dieevery year.

37% of them are newborn.

Majority of them (3/4) die within the first two daysof life. Mostly due to stressful events or conditionsduring labor, delivery and immediate postpartumperiod.
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16/18

Health Secretary Duque explained that the ENC Protocol involves

focusing on the first hours of life of the newborn with the manual

guiding health workers in providing evidence-based essential newborn

care.

\
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17/18

The guidelines categorize procedures into time-bound, non time-

boundandunnecessary procedures:

TIME BOUND PROCEDURES

Time bound procedures should be routinely

performed first immediate drying, skin-to-skin contact followed by clamping of the cord

after one to three minutes or until pulsations

have stopped, non-separation of the newbornfrom the mother and breastfeeding initiation.


18/18

NON TIME-BOUND PROCEDURES

Non time-bound intervention should only be

done after the first full breastfeed. These areimmunizations, eye care, Vitamin Kadministration and weighing. Washing must bepostponed by at least 6 hours as this will hinder

the crawling reflex.

UNNECESSARY PROCEDURES

The so-called unnecessary procedures include

routine suctioning, routine separation ofnewborns for observations, administration ofprelacteals like glucose, water formula andfootprinting.
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2-New CPR Guidelinsdifioses-2010

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