CARDIOPULMONARY

ARREST

CARDIOPULMONARY
ARREST
• Assessment: Cardiac Arrest, Respiratory
Arrest.
• Nursing Diagnoses.
• Planning: BLS Provider Class.
• Implementation: Initiate CPR,
Medications.
• Evaluation: Rhythms and ACLS
Simulator.

CARDIOPULMONARY
ARREST
• Client quickly loses
consciousness usually within 15
seconds.
• At one minute, brain stem
function ceases and respirations
become agonal, pupils are fixed
and dilated.

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 CARDIAC ARREST
Client Conditions:
• Lethal Cardiac Arrhythmias:
– Ventricular Fibrillation/Pulseless
Ventricular Tachycardia
– Asystole
– Bradycardia
– Pulseless Electrical Activity (PEA)

RESPIRATORY ARREST
Client Conditions:
• Pneumonia
• Drug Overdose
• Drowning or Near-
drowning
• Neurologic Disorders
• Accidents

NURSING DIAGNOSES
• Impaired Spontaneous Ventilation
• Impaired Gas Exchange
• Impaired Tissue Perfusion,
Cardiopulmonary
• Decreased Cardiac Output
• Risk for Aspiration/ Injury
• Decisional Conflict

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 PLANNING
• Code team members:
– MD Code leader.
– Anesthesia.
– Critical care and ER nurses.
– Primary care nurse of client.
– Code Recorder and other nursing unit staff.
– IV therapy, NA’s, Nursing Supervisor,
Respiratory therapy.

NURSING
IMPLEMENTATIONS
• Determining unresponsiveness.
• Calling a code, initiate EMS.
• Supporting respiratory/cardiac
function, ABC and D’s of CPR.
• Support of significant other.
• TREAT patient, not monitor.

MEDICATIONS
OXYGEN:
• essential component of cardiac
resuscitation and emergency cardiac
care.
• Bag-mask ventilation is emphasized
as method of choice for initial
ventilatory support.

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 MEDICATIONS
EPINEPHRINE:
• natural catecholamine.
• can produce ÏSystolic/Diastolic BP.
• Ï electrical activity in myocardium.
• dose: 1mg IV q3-5 minutes.

MEDICATIONS
ATROPINE:
• enhances both sinus node
automaticity and AV conduction by
blocking vagal stimulation in heart.
• dose: 0.5-1mg IV q3-5minutes not to
exceed 2mg (0.03mg/kg).

MEDICATIONS
LIDOCAINE:
• suppresses ventricular arrhythmias
by Ð automaticity.
• dose: 1-1.5mg/kg IV bolus to max
dose 3mg/kg, drip: 1-4mg/min

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 MEDICATIONS
AMIODARONE (CORDARONE):
• used suppression of ventricular
arrhythmias and SVT.
• dose: 150mg IV bolus over 10 minutes
followed by drip at 1mg/min over 6 hours
(360 mg IV).

MEDICATIONS
MAGNESIUM SULFATE:
• helps reduce the incidence of post MI
ventricular arrhythmias.
• used to treat torsades de point.
• dose: 1-2 Gm in 10cc D5W over 1-2 min
IV push or IVPB.

MEDICATIONS

Dopamine:
• vasoactive agent.
• indicated for hemodynamically
significant hypotension(SBP<90).
• dose: IV drip 1-20 mcg/kg/min.

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 MEDICATIONS
ADENOSINE:
• slows conduction thru AV node.
• very short half-life (<10 seconds).
• dose: initial 6 mg rapid bolus, if no
response in 1-2 min, a repeat 12 mg bolus
can be given.
• Drug is given rapid IV push.

EVALUATION
• Review several examples of rhythm strips
and 12-lead EKGs.
• Identification of arrhythmias using
ACLS Simulator.
• Work through several code scenarios
using ACLS Simulator.

EKG Graph & Analysis

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Normal Sinus Rhythm

Sinus Bradycardia

Sinus Tachycardia

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Sinus Arrhythmia

Atrial Fibrillation

Atrial Flutter

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Ventricular Tachycardia

Ventricular Fibrillation

Idioventricular Rhythm

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 Asystole

Complete Heart Block

Review
• Cardiac vs Respiratory Arrest.
• Nursing diagnoses.
• Nursing implementations.
• Medications.
• Common cardiac rhythms.
• ACLS Simulator practice.

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