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