E-CPR In Prolonged Resuscitation

The determination of the potential for cardiac arrest is readily apparent in some patients. Patients with the greatest potential for cardiac arrest require close scrutiny for the signs and symptoms of respiratory and hemodynamic instability. This investigation will attempt to determine the best methods of administering high quality chest compressions in CPR. The PICO(T) acronym represents a format that can be used to create an answerable research question. The PICO(T) formulated question for this investigation is: In adult cardiac arrest, will the utilization of automated chest compressions compared to physical chest compressions during cardiopulmonary resuscitation improve survival outcomes? PICO(T) components consist of patient population (P), intervention (I), comparison (C), outcome (O) and time (T). The PICO(T) components used to formulate the answerable research question are: Patient population: adults in cardiac

"Medic respond, stoppage," chirped the intercom. The call went out for an adult male found down, pulseless and apneic, by family at approximately 2200 hours. EMS personnel arrived on scene, performed quality CPR and followed appropriate ACLS algorithms, and found an organized rhythm with matching peripheral pulses at the third check. Per 2010 AHA guidelines, medics performed a 12 lead EKG, managed the patient 's hypotension with a fluid bolus, and managed the patient 's airway by endotracheal intubation (American Heart Association, 2011). The patient displayed no neurological response, the EKG revealed significant ST segment elevation in anterior and septal leads, and intubation was performed successfully without induction or paralytic

In this article published in the journal Dyanmics, also known as the journal for the Canadian Association of Critical Care Nurses, the authors review a retrospective cohort regarding the barriers for time to target temperature management in cardiac arrest patients who are treated with therapeutic hypothermia. The article authored by a both registerd nurses and medical doctors open by reviewing the benefits of therapeutic hypothermia. The article reviews two randomized controlled trials that showed that therapeutic hypothermia when compared to no intervention correlated with improved neurological survival in patients after cardiac arrest. Therapeutic hypothermia has a direct relation to patient survival with intact neurologic function; however

Charging to 200....Stand clear…Shocking! CPR....EMS providers experience the adrenaline and rush of a patient in cardiac arrest. Trying to bring dead back to life is not a simple task by far, especially with the limitations and resources of the field. But, what happens after the patient makes it to definitive care? Annually, around 300,000 adults in the United States experience out-of-hospital cardiac arrests (AHA), and EMS providers only see the results of the short term survival of the patient, but rarely the actual patient care and recovery after an arrest. Patients undergo intense, aggressive treatment and recovery measures in the hospital post-code. These patients have a variety of treatment regimens

DNACPR orders are of considerable concern to ambulance staff, the patient and their families in tackling requests at the end of life (NHS End Of Life Care Programme 2007). A study by Stone et al. (2009) showed nearly all participants had questioned whether interventions performed were correct for the patient when using cardiac life support on patients they thought were terminal. When a patient requires resuscitation and a DNACPR is in place immediate sharing of information is critical. At certain points in the patient care pathway incompatible systems may mean DNACPR requests are not being followed and inappropriate resuscitation being attempted.

American Heart Association (AHA) estimates that nearly 700 Americans die each day of sudden cardiac arrest (MI), or 250,000 every year, as many as 50,000 lives could be saved each year if certain critical interventions were made. (Freeman , 50) A patient who receives early life support measures and defibrillation within one to five minutes of arrest is much more likely to live and to retain normal brain function. The brain is often at a serious risk for irreparable brain damage related to anoxia and many other co-morbidities that are associated with cardiac arrest (MI). When a perfusing cardiac rhythm returns after a heart attack, the most important objective is to preserve brain function. The AHA and the Advanced Life Support Task Force of

This paper will be going over a scenario involving a real patient and what things could have been different with EMS care. It will also be covering what exactly cardiac arrest is and what rhythms produce it. And for every cardiac rhythm in cardiac arrest, there is a specific treatment plan paramedics can follow.

| Lesson Outline: Allocated teacher-NExplaining legal requirements : Duty of care: A duty of care is implied when the person who is requiring your assistance is in your workplace. E.g. patient, co-worker or visitor. Consent of an unresponsive patient is assumed in an emergency situation. (Crouchman, 2009; Milne & Mellman-Jones, 2010).Cultural awareness/sensitivity: We need to mindful of varying cultures when assisting patients, as different cultures prefer to be unexposed which is necessary when defibrillation is required. Eg, Muslims (Hattersley & Keogh, 2009). Confidentiality: Following an emergency situation it is vital to refrain from speaking to others outside the workplace about the patient to ensure the patient’s privacy and dignity. Think about how you would feel if you where in the patient’s situation. (Maeder, Martin-Sanchez, Croll, & Ambrosoli, 2012)?Limitations: Remember that once you start you can’t stop until you’re physically unable to or help arrivesDebriefing: Participating in the debriefing process is vital due to the enormity of the situation, enabling the nurse to express

The lack or delay in appropriate treatment for individuals who experience a sudden cardiac arrest has created a major public health disparity. Research into pre-hospital treatment and subsequent implementation has historically seen neglect by the medical and scientific community creating vast differences in survivability of cardiac arrests between demographic groups. In 2010, the American Heart Association and Emergency Cardiovascular Care program developed the 2020 impact goal to reduce death from cardiovascular disease and stroke by 20% and double out-of-hospital cardiac arrest (OHCA) survival rates (http://circ.ahajournals.org/content/121/4/586#sec-1). This has prompted a massive influx of research into the disparities that exist and an

“When a patient’s breathing and heartbeat stop, clinical death occurs. This condition may be reversible through CPR and other treatments. However, when the brain cells die, biological death occurs. This usually happens within 10 minutes of clinical death, and is not reversible. In fat, brain cells will begin to die after 4 to 6 minutes without fresh oxygen supplied from air breathed in and carried to the brain by circulating blood. Cardiovascular pulmonary resuscitation (CPR) consists of the actions you take to revive a person- or at least temporarily prevent biological death- by keeping the person’s heart and lungs working.” (Limmer& O’Keefe, 2012, p. 1124)

Without early intervention on average 360,000 people out of the hospital succumb to cardiac arrest. “ Cardiac arrest and sudden death account for 60 percent of all deaths from coronary artery disease”,(Bledsoe, Porter, & Cherry, 2011,2007,2004, p. 1229)There are several causes of sudden cardiac arrest. Most are caused by ventricular fibrillation. “During ventricular fibrillation, the ventricles do not beat normally. Instead they quiver rapidly and irregularly.” When this occurs, the heart pumps very little and blood does not get circulated throughout the body. “ Most of the cases found with sudden cardiac death are related to undetected cardiovascular disease.("Sudden Cardiac Death," 2015, para. 2)Sudden cardiac arrest are immediate and drastic that includes sudden collapse, no pulse, not breathing, and loss of consciousness. “Four rhythms produce pulseless cardiac arrest: ventricular fibrillation, rapid ventricular tachycardia, pulseless electrical activity and asystole.”("Circulation ," 2005, p. IV-58)Other signs and symptoms that could occur prior to sudden cardiac arrest, include fatigue,

EPR has been perfected over the years. The concept of EPR was first developed in 1984 by Dr. Peter Safar and Col Ronald Bellamy at the Safar Center for Resuscitation Research. The first study was conducted on pigs back in 2002 by Hasan B. Alam at the University of Michigan Hospital. This study tested nine pigs that were induced with uncontrolled lethal hemorrhage (ULH) which simulated a gunshot or stab wound. Out of the nine pigs tested, seven survived the surgery. The pigs were observed for six weeks following the surgery. Of the surviving pigs, all of them were neurologically intact ( Alam,

Cardiovascular disease is a common cause of death in the United States. More than 350,000 cardiac arrests occur outside of a hospital; the overall survival rate in these cases is 9.5% though it can vary greatly from community to community. The likelihood of surviving a cardiac arrest depends on an efficient cardiac system of care.

A Do not resuscitate (DNR) order is a legal document written by a licensed physician, which is developed in consultation with the patient, surrogate decision maker, and attending physician. This document indicates whether the patient will receive resuscitative care, cardiopulmonary resuscitation (CPR), or advanced medical directives, in the setting of cardiac and/or respiratory arrest. A DNR can also be referred as a no code when identifying a patient’s resuscitation status. If a patient has an existing DNR it allows the resuscitation team, taking care of the patient, to either withhold or stop any resuscitation measures, and therefore respect the patient’s wishes. Historically, DNR orders did not become active in the care of patients until 1974, when it was identified that patients who received CPR, and survived, had significant morbidities (Braddock & Derbenwick-Clark, 2014). Braddock and Derbenwick-Clark further noted, the American Heart Association (AHA) recommended that physicians, in consultation with the patient, family, and or surrogate, place on the patients chart when CPR was not indicated. This documentation is now what we refer to as the DNR order and has become the standard to allow autonomous respect for patients, and their families, to make informed medical decisions. Therefore, the purpose of this paper is to discuss the legal aspects, ethical issues, and the application surrounding the DNR order.

This essay focuses on the use of oxygen as a treatment for myocardial infarction and how this approach has changed. It will also look at pre-hospital care pathway changes adopted by clinicians within the ambulance service, hospitals and the guidance behind this.