BASIC RESUSCITATION

BASIC RESUSCITATION

1. 1 First Aid

   • is defined as the helping behaviours and initial care provided for an acute illness or injury
     • It could be provided for anyone in any situation
   • 2 Person who provides this kind of help
     • SHOLUD
       • 1. Recognize and prioritise the need of first aid
       • 2 . Provide care using appropriate competencies
       • 3.recognise limitations and seek additional care when needed
   • 3 Goals
     • Preserve life
     • Alleviate suffering
     • Prevent further illness or injury
     • Promote recovery

2. First Aid for medical emergencies

   • 1 .Positioning of the breathing but unresponsive victim
     • main the airway open
     • The patient must be in a supine position
       • 1 kneel beside the victim and make sure that both legs are straight
       • 2 Place the arm nearest to you out at right angles to the body
     • Optimal position for shock victim
       • caused by sudden loss of body fluids (such as in bleeding), serious injury, myocardial infarction (heart attack), pulmonary embolism, and other similar conditions
         • the best position is supine
   • 2 Oxygen administration for first aid
     • Administration of oxygen at the time of giving first aid might have potential adverse effects that could complicate the disease
       • supplemental oxygen should only be administered by first aid providers who have been properly trained in its use and if they can monitor its effects
   • First aid for trauma emergencies
     • Control of bleeding
       • the best way to reduce it is applying direct pressure to the lession. i can also help Localised cold therapy, with or without pressure
     • Cooling of burns
       • Cooling thermal burns will minimise the resulting depth of the burn
         • the best way to cool down the burn an clean it on is using water
   • Cervical spinal motion restriction
     • Spinal immobilisation is defined as the process of immobilising the spine using a combination of devices in order to restrict the motion
       • for that we use a collar neck

3. Nurse’s Role in the Modern Resuscitation Era

   • 1.Cardiopulmonary resuscitation (CPR)
     • Is an intervention performed to restore a person’s heartbeat
       • in order to preserve the function of vital organ and save the patients lives
   • starts extremely stressful experience for health professionals
     • 1 the operative must show effective communication between professionals and show competence
     • 2 the responsibilities of the nurse will depends of the knowledge, as well as skills
       • It is important to have fast Response Nurse
         • in order to stabilize the patient,
           • the rapid response nurse to the resuscitation team could help with
             • trauma interventions
             • the nurse must have habilities on
               • critical care and critical thinking
               • it must have two years of experience
               • qualities as the Competency for working on several different units
               • capacity of been independent during work
               • Self- directed
               • Assertive with a positive attitude
       • ACORDING TO Modern nursing roles during CPR
         • using external defibrillators
           • Early defibrillation improves survival following ventricular fibrillation and pulseless ventricular tachycardia
         • nurse’s involvement in CPR decision making (DNAR)
           • Doctors and Nurses have an important role
             • at the time of attempting or not resuscitation
             • thas is because as a nurse we are usually the first responders during an in-hospital cardiac arrest
               • and we always expend time with the petient and their family
         • understanding the drugs used during cardiac arrest response
           • it is important because it help us to educate the patient and the family
           • Administration of the correct drugs is an important aspect during the resuscitation
   • when a sudden death occurs 2
     • The CPR is the final hope for survival
       • Involves
         • chest compressions
           • which maintains circulation, and ventilation
         • ventilation of the victim
   • “code blue”

4. The 10 Commandments of Resuscitation

   • 1 commandment: first the patient, then the monitor
     • Eventhough the monitor help us to control the haemodynamic condition of the patients, we always have to pay more attention on the patient because is our main source of information
   • 2 commandment: check the pulse every 2 minutes
     • According with CPR the cardiopulmonary resuscitation cycles (compressions/ventilations) must occur at a constant rate of 30/2
       • this will help us to now if the patient needs an electric therapy or discharge
         • in order to reduce a neurological compromise for ischemia-reperfusion
   • 3 commandment: if the rhythm changes, check the pulse!
     • it help us to identify
       • whether the patient has either exhausted mitochondrial and cellular ATP reserves
       • has gone into a rhythm with good prognosis
     • if the pulse rhythm do not changes we could consider de 8 H AND 8 T
       • hypoxia; hypovolemia; hyper-/hypokalemia; hydrogen ion (acidemia); hypothermia; hypoglycaemia; hyperthermia, malignant hypervagal.
       • toxic (anaphylaxis/anaesthesia); tension pneumothorax; thrombosis/pulmonary embolism; thrombosis, coronary; tamponade, cardiac; trauma (haemorrhage, shock, cardiovascular injury); qT prolongation; pulmonary hypertension
   • 4 commandment: do not apply the algorithm in reverse. Wait-and-see management of exit arrhythmia
   • 5 commandment: do not defibrillate a PEA or asystole rhythm
     • Successful defibrillation occurs when it suppresses a chaotic, disorganised, or very accelerated rhythm
       • This may be achieved when there is sufficient ATP or else the heart goes into asystole and remains there because, without energy
       • and places the heart in transient asystole so that it can restart with an organised rhythm.
   • 6commandment: do not break the chain of survival
     • If we do all the steps carefully in an strict order , we work in group we may have a success on the resuscitation
       • these links are
         • early access
         • early CPR
         • ,early defibrillation
         • early advanced care
   • 7 commandment: in cardiac arrest, always apply three therapeutic options supported by level A evidence
     • 1Give compressions if there is cardiac arrest
     • 2give ventilations if there is respiratory arrest
     • defibrillate in case of ventricular fibrillation or PVT
   • 8 commandment: do not give amiodarone in cases of tachycardia with torsade de pointes (twisting of the points)
     • because this medicament it acts on different cell channels.
       • we know that It is considered class , III antiarrhythmic according to the VaughanWilliams classification
         • this medicament has arrhythmogenic effects, especially prolonging the QT interval and predisposes to helical polymorphic ventricular tachycardia or torsade
           • which could produce a haemodynamic instability that leads to cardiac arrest
   • . 9 commandment: give atropine only in case of symptomatic bradycardia
     • this medicaments blocks muscarinic receptors which it could produce a cardiac arrest
   • 10 commandment: assertive communication and clear messages
     • Advanced life support teams (Code Blue/Megacode) must be characterised by excellent communication and leadership, which among nontechnical skills, are key to resuscitation success.
   • practical, and easy-to-remember rules to be considered during resuscitation