This document provides guidance on treating various causes of cardiac arrest in the ICU setting. It outlines monitoring parameters for high quality CPR and lists potential causes of cardiac arrest including hypoxia, hypovolemia, acidosis, electrolyte imbalances, hypothermia, hypoglycemia, drug overdoses, tamponade, tension pneumothorax, thrombosis, and trauma. For each cause, it recommends specific treatments such as fluid boluses, vasopressors, fibrinolytics, or procedures like needle decompression of tension pneumothorax.

1. CHAKRADHARHOSPITALS
ICU NURSING
PROVIDING HIGH QUALITY NURSING CARE

4. ACLS BLS

10. HIGH QUALITY CPR
• MONITORING OF HIGH QUALITY CPR
– INTER ARTERIAL PULSE PRESSURE <
20mmhg
– PULSE WAVE CAPNOGRAPHY WITH END
TIDAL CO2 < 10mmhg

11. • HYPOVOLEMIA
• HYPOXIA
• HYDRROGEN ION
ACIDOSIS
• HYPER OR
HYPOKALEMIA
• HYPOTHERMIA
• HYPOGLYCAEMIA
• TABLET
• TAMPONADE
• TENSION
PNEUMOTHORAX
• THROMBOSIS (PUL
, CORONARY )
• TRAUMA

12. H
• HYPOXIA
– CONFIRM B/L CHEST RAISE ,VBS
– CHECK O2 SOURCE
– ADVANCED AIRWAY
• HYPOVOLEMIA
– SET IO IV ACCESS
– GIVE FLUID BOLUSES
– REASSESS

13. H
• HYDROGEN ION ACIDOSIS
– RESPIRATORY ACIDOSIS DON’T
HYPERVENTILLATE
– METABOLIC ACIDOSIS START SODA BICARB
• HYPER HYPOKALEMIA
– HYPERKALEMIA
• CALCIUM CHLORIDE 10 % 10ML IN 5 MINS
– HYPOKALEMIA
• POTASSIUM CHLORIDE 20mmol
• MAGNESIUM SULFATE 50 % SOLN 5 ML(10
MMOL IN 30 MINS)

14. • Hyper/Hypothermia
– If too hot, cool down
– If too cold, warm up
• Hypo/Hyperglycemia
– Accu-check and correct if needed.
H

15. • Tablets (drug OD, accidents)
– Support circulation while you find an antidote or rever
reverse drug. (poison control)
• Tamponade
– (chest trauma, chest malignancy, recent central line insertion,
JVD, narrow pulse pressure, electrical alternans etc…)
– Pericardial centesis
• Tension Pneumothorax
– (chest asymmetry, tympani, diminished breath sounds, high
peak pressures, JVD, tracheal deviation, severe respiratory
distress etc…)
– Vent tension in chest
– Support ventilation and oxygenation with BVM and intubate as
necessary
T

16. • Thrombosis (coronary or pulmonary)
– Consider fibrinolysis for suspected coronary or
pulmonary embolus.
– CPR is not a absolute contraindication for
fibrinolysis.
• Trauma
– Inspect body completely. Remove all clothes.
– Secure airway
– Control external bleeding with tamponade while
concurrently delivering volume with isotonic
crystalloids and blood products.
– Look for internal bleeding (tap the abdomen if
suspicious for internal bleed)and take to
T