Cardiac emergencies in the gi lab
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CARDIAC EMERGENCIES IN THE GI LAB. DANIEL ROSENTHAL RN PRESIDENT WORKPLACE NURSES. OBJECTIVES. IDENTIFY COMMON EMERGENCIES ENCOUNTERED IMPLEMENT MEASURES TO RESOLVE EMERGENCY SITUATIONS DISCUSS HIGHLIGHTS OF GUIDELINES 2005 CHANGES. PATIENT FEELS WEAK PATIENT “PASSES OUT” PATIENT FALLS.

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CARDIAC EMERGENCIES IN THE GI LAB

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Cardiac emergencies in the gi lab

CARDIAC EMERGENCIES IN THE GI LAB

DANIEL ROSENTHAL RN

PRESIDENT

WORKPLACE NURSES


Objectives

OBJECTIVES

  • IDENTIFY COMMON EMERGENCIES ENCOUNTERED

  • IMPLEMENT MEASURES TO RESOLVE EMERGENCY SITUATIONS

  • DISCUSS HIGHLIGHTS OF GUIDELINES 2005 CHANGES


Common occurrences

PATIENT FEELS WEAK

PATIENT “PASSES OUT”

PATIENT FALLS

HYPOTENSIVE

BRADYCARDIC

LOW SPO2

SLOW RESPIRATIONS

UNRESPONSIVE

HYPERTENSIVE

TACHYCARDIC

COMMON OCCURRENCES

PRE PROCEDURE

POST PROCEDURE


6 h s 7 t s

HYPOTHERMIA

HYPOGLYCEMIA

HYPOVOLEMIA

H+ ION IMBALANCE

HYPO/HYPER ELECTROLYTE

HYPOXIA

TABLETS/TOXINS

TAMPONADE

TENSION PNEUMO

TRAUMA

THROMBUS- CORONARY

THROMBUS- CEREBRAL

THROMBUS-PE

6 H’S & 7 T’S


Ok coach

OK COACH!

NOW

WHAT

?


Assess your patient

ASSESS YOUR PATIENT!

  • AIRWAY : OPEN THE AIRWAY

  • BREATHING: GIVE 2 BREATHS

  • CIRCULATION: CHECK PULSE

  • DETERMINE IDENTIFIABLE TREATABLE REVERSIBLE CAUSE


Activate emergency plan and call ems

ACTIVATEEMERGENCY PLAN AND CALL EMS!


Secondary survey

Secondary survey

  • Place airway device - oral airway, Ambu bag,O2delivery device

  • Confirm open airway – chest rises

  • Confirm oxygenation SPO2, CO2 monitoring

  • Confirm circulation – pulse check, ECG monitoring

  • Rhythm identification- shock VF/VT


Secondary survey1

Secondary survey

  • Establish IV access – give ordered meds

  • Check for Bleeding

  • Differential Diagnosis – identifiable reversible cause


Identifiable treatable causes h s t s

Hypovolemia

Hypo/hyperglycemia

Hypoxia

H+ ion imbalance

Hypo/hyper electrolyte status

Hypothermia

Toxins/tablets

Tamponade

Tension pneumothorax

Thrombosis

Coronary

Cerebral

Pulmonary

Identifiable treatable causes H’s & T’s


2005 ecc guidelines good cpr good outcomes

2005 ECC GuidelinesGood CPR = Good Outcomes

We need to focus on more circulation and minimize interruptions to compressions.


Study data shows that in codes 50 of the time there are no compressions being given

STUDY DATA SHOWS THAT IN CODES >50% OF THE TIME THERE ARE NO COMPRESSIONS BEING GIVEN!


Highlights of 2005 guidelines

HIGHLIGHTS OF 2005 GUIDELINES

  • EMPHASIVE CIRCULATION

  • NO JAW THRUST FOR NON-MEDICAL PROVIDERS. Airway/breathing higher

  • GIVE BREATHS OVER 1 SECOND – UNTIL THE CHEST BEGINS TO RISE

  • HYPEVENTILATION KILLS!


Longer cycles for all ages

LONGER CYCLES (FOR ALL AGES)

30COMPRESSIONS

2 VENTILATIONS

WITHOUT ADVANCED AIRWAY


Continue compressions until

CONTINUE COMPRESSIONS UNTIL

  • THE PATIENT MOVES

  • EMS ARRIVES

  • THE PATIENT IS PRONOUNCED

INTERRUPTIONS SHOULD BE 10 SECONDS OR LESS AND THENONLYFOR ADVANCED PROCEDURES.


Cardiac emergencies in the gi lab

FOR MORE INFORMATION:DAN ROSENTHAL RNWORKPLACE NURSES54 Derbes DriveGretna, LA 70053(504) [email protected]


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