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CARDIAC EMERGENCIES IN THE GI LAB

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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  1. CARDIAC EMERGENCIES IN THE GI LAB DANIEL ROSENTHAL RN PRESIDENT WORKPLACE NURSES

  2. OBJECTIVES • IDENTIFY COMMON EMERGENCIES ENCOUNTERED • IMPLEMENT MEASURES TO RESOLVE EMERGENCY SITUATIONS • DISCUSS HIGHLIGHTS OF GUIDELINES 2005 CHANGES

  3. PATIENT FEELS WEAK PATIENT “PASSES OUT” PATIENT FALLS HYPOTENSIVE BRADYCARDIC LOW SPO2 SLOW RESPIRATIONS UNRESPONSIVE HYPERTENSIVE TACHYCARDIC COMMON OCCURRENCES PRE PROCEDURE POST PROCEDURE

  4. 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

  5. OK COACH! NOW WHAT ?

  6. ASSESS YOUR PATIENT! • AIRWAY : OPEN THE AIRWAY • BREATHING: GIVE 2 BREATHS • CIRCULATION: CHECK PULSE • DETERMINE IDENTIFIABLE TREATABLE REVERSIBLE CAUSE

  7. ACTIVATEEMERGENCY PLAN AND CALL EMS!

  8. 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

  9. Secondary survey • Establish IV access – give ordered meds • Check for Bleeding • Differential Diagnosis – identifiable reversible cause

  10. 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

  11. 2005 ECC GuidelinesGood CPR = Good Outcomes We need to focus on more circulation and minimize interruptions to compressions.

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

  13. 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!

  14. LONGER CYCLES (FOR ALL AGES) 30COMPRESSIONS 2 VENTILATIONS WITHOUT ADVANCED AIRWAY

  15. CONTINUE COMPRESSIONS UNTIL • THE PATIENT MOVES • EMS ARRIVES • THE PATIENT IS PRONOUNCED INTERRUPTIONS SHOULD BE 10 SECONDS OR LESS AND THENONLYFOR ADVANCED PROCEDURES.

  16. FOR MORE INFORMATION:DAN ROSENTHAL RNWORKPLACE NURSES54 Derbes DriveGretna, LA 70053(504) 367-5355workplacenurse@juno.com

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