Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.
Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.
Adult Basic Life Support
Demonstration of how to give basic life support to anyone acutely injured or ill. Cardiac support, Advanced Trauma Life Support,
Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines chest compressions often with artificial ventilation in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person who is in cardiac arrest.
Advanced cardiac life support or advanced cardiovascular life support (ACLS) refers to a set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.
Adult Basic Life Support
Demonstration of how to give basic life support to anyone acutely injured or ill. Cardiac support, Advanced Trauma Life Support,
Advanced Cardiovascular Life Support (ACLS) is the pre-eminent resuscitation course for the recognition and intervention of cardiopulmonary arrest or other cardiovascular emergencies.
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Navigating Challenges: Mental Health, Legislation, and the Prison System in B...Guillermo Rivera
This conference will delve into the intricate intersections between mental health, legal frameworks, and the prison system in Bolivia. It aims to provide a comprehensive overview of the current challenges faced by mental health professionals working within the legislative and correctional landscapes. Topics of discussion will include the prevalence and impact of mental health issues among the incarcerated population, the effectiveness of existing mental health policies and legislation, and potential reforms to enhance the mental health support system within prisons.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
QA Paediatric dentistry department, Hospital Melaka 2020Azreen Aj
QA study - To improve the 6th monthly recall rate post-comprehensive dental treatment under general anaesthesia in paediatric dentistry department, Hospital Melaka
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
2. OBJECTIVES OF TODAY’S TEACHING:
.
At the end of session you will be able to:
• Define the CPR.
• Purposes of CPR
• Indications of CPR
• Treatable causes of cardio-respiratory arrest
• Pathophysiology of Cardiac arrest
• S/S of Cardiac Arrest
• Articles/Equipments required for CPR
• Sequence and Steps of CPR
• Nursing Responsibilities during CPR
3. INTRODUCTION
Cardiopulmonary resuscitation (CPR) is a
lifesaving technique useful in many
emergencies, including heart attack or near
drowning, in which someone's breathing or
heartbeat has been stopped.
4. DEFINITION
Angela Morrow RN
Cardiopulmonary resuscitation
(CPR) is a procedure used when a
patient’s heart stops beating and
breathing stops. It can involve
compressions of the chest or
electrical shocks along with rescue
breathing.
Mosby medical dictionary
CPR is a basic emergency
procedure for life support
consisting of artificial and manual
external cardiac massage.
5. PURPOSES OF CPR
To restore cardiopulmonary circulation by external cardiac massages (C).
To Maintain open and clear airway (A).
To maintain breathing by external ventilation (B).
To save the life of patient.
To prevent irreversible brain damage from anoxia.
To provide basic life support till medical and advance life support arrives.
6. INDICATION OF CPR
1. Shockable
- Ventricular tachycardia
- Ventricular fibrillation
- Pulseless ventricular
tachycardia
2. Non-shockable
- Asystole
- Pulseless Electrical Activity
1. Drowning
2. Stroke
3. Foreign body in Throat
4. Smoke inhalation
5. Drug overdose
6. Suffocation
7. Accident/injury
8. Coma
Respiratory Arrest
Cardiac Arrest
May be due to:
8. PATHOPHYSIOLOGY
CARDIAC ARREST
NO BLOOD OR TISSUE OXYGENATION
BRAIN SUSTAIN DAMAGE FOR 4 MIN
AFTER4-7 MINS,IRREVERSIBLE DAMAGE OCCURS
CPR
CAUSES BLOOD TO CIRCULATE TO BRAIN AND HEART
DELAYS BRAIN DEATH
ALLOWS HEART TO REMAIN RESPONSIVE TILL DEFBRILLATION
9. SIGN AND SYMPTOMS OF CARDIOPRESPIRATORY ARREST
No response
No breathing
No pulse
Loss of consciousness
10. COMPONENTS OF CPR (Cardiopulmonary Resuscitation)
A level of emergency medical care which is used
for victims of life threatening illness or injuries
until they can be given full medical care at a
hospital.
A set of all clinical interventions (airway
management , use of monitors , medicines and
post cardiac arrest care)
for the urgent treatment of cardiac arrest, stroke
and other life-threatening medical emergencies.
ACLS { ADVANCE CARDIAC LIFE SUPPORT }
BLS { BASIC LIFE SUPPORT }
11. COMPONENTS OF CPR (Cardiopulmonary Resuscitation)
Chain of survival guidelines by AHA
13. CPR PROCEDURE
.
Before you Begin : Check ;
1. Is the environment safe for the person?
2. Is the person conscious or unconscious?
3. If the person is unconscious, tap or shake the hid/her shoulder and ask
loudly “are you ok?”
4. If no response, call emergency number for help immediately.
5. Check pulse
Adults - Carotid pulse
Children- Brachial pulse
Infants - Femoral pulse, for 10 seconds, if no pulse, begin CPR
14. SEQUENCE OF CPR
ACLS - C A B D
BLS – C A B
•C (Circulation) –
Restore the circulation by external cardiac massage.
•A (Airway) –
Ensure an open airway.
•B(Breathing)) –
Start artificial ventilation of lungs.
• D (Drugs, Defibrillation) –
Use emergency medication and electric defibrillation.
15. POSITION OF CPR (SAME IN BLS AND ACLS)
Patient should be in supine position on a relatively hard
surface.
The person giving compressions should be positioned at high
enough above the patient.
The hands of rescuer must be held state at the elbow in order
to maximize the effect of the compressions.
16. PROCEDURE OF CPR……………..contd
• APPROACH SAFELY
• CHECK RESPONSE
• SHOUT FOR HELP
• CHEST COMPRESSIONS( C)
• CALL 108
• OPEN AIRWAY(A )
• CHECK BREATHING (B)
• 2 RESCUE BREATHS
IMPORTANT STEPS TO FOLLOW
17. CPR ( STEPS )……SAME FOR BLS AND ACLS
Kneel as close to side of patient’s chest just as possible.
Palpate the Xiphoid process .
Place the palm of one hand on the lower half of the
sternum , 2 inches(5 cm) from the tip of Xiphoid process.
Place other hand on the top of first hand .
Interlock fingers
Compress the chest ;
Rate – 100-120/min Depth - 2-2.4 inches
Compression: ventilation = 30:2
Push hard and fast. Allow complete chest recoil and minimize
interruption in compressions
C - COMPRESSIONS
18. CPR…….IN CONT
HEAD TILT – CHIN LIFT :
- Non health care workers IN ADDITION TO BLS AIRWAY MANAGEMENT:
- Bag-Mask Ventilation
JAW THRUST MANEUVER ;
- in case of suspected neck injury - Endotracheal Intubation
HEAD TILT – CHIN LIFT + JAW THRUST
- For health care workers
A – AIRWAY ( BLS)
19. CPR (IN CONT…………….)
Look , listen and feel for normal breathing or agonal breathing.
AGONAL BREATHING :
described as heavy, noisy or gasping breathing.
recognize as a sign of cardiac arrest .
RESCUE BREATHS
Pinch the nose.
take a normal breath.
place lips over the mouth.
blow until the chest rises.
take about 1 second .
Allow chest to fall. REPEAT.
B - BREATHING
20. IN CONT……………..
D- DEFIBRILLITION
Defibrillation is a process in which an
electrical device called a defibrillator deliver a therapeutic dose of electric shock to the heart, to stop
an arrhythmia resulting in the return of a productive heart
rhythm.
Specially used in :
- Ventricular fibrillation
- Pulseless ventricular tachycardia
D- DEFIBRILLITION, DRUGS
21. IN CONT……………..
D- DEFIBRILLITION
Key issues in Defibrillition :
Paddle Site :
Rt Intraclavicular region(2nd or 3rd intercostal space)
Lt. lower Axillary region(4th or 5th ICS, mid axillary line)
Paddle Size :
adult –– 8cm - 13 cm
Wave form patterns :
Monophasic – Current deliver in one direction
Energy level = > 360 J
Biphasic - Current deliver in two directions
Energy level = 120-200 J
D- DEFIBRILLITION, DRUGS
22. IN CONT……………..
STEPS FOR DEFIBRILLATION :
Test defibrillator for fully battery charge
Switch on power button.
Change and select paddle mode
Assess rhythm
Press paddles firmly over the chest
Deliver the shock
Resume CPR
23.
24. IN CONT……………..
1. ADRENALINE – Main drug used during resuscitation from cardiac arrest.
- 1 mg I/V every 3-5 mins
2. AMIODARONE – an antiarrythmic drug
First Dose – 300mg IV bolus After 5 mins. Second Dose – 150 mg II/V
OR
LIDOCAINE - First Dose – 1-1.5 mg/kg IV , Second Dose – 0.5-0.75 mg/kg IV
3. ATROPINE - Single dose of 3 mg is sufficient to block vagal
tone completely
4. DOPAMINE - Primary uses: bradycardia, hypotension
Dose: 2-20mcg/kg/min infusion
D - DRUGS
26. NURSING MANAGEMENT
PRE- PROCEDURE RESPONSIBILITIES :
1. To recognize the signs of cardiac arrest.
2. Call for help. The cardio-pulmonary resuscitation must be
initiated within 4 minutes in order to prevent permanent brain
damage.
3. Have the Resuscitation cart ready with all equipments and
necessary drugs at the bedside.
4. Make the oxygen sources and suction machine available at bed
side.
5. Clear the airway of false teeth, vomitus, food materials etc.
27. NURSING MANAGEMENT
DURING PROCEDURE RESPONSIBILITIES :
1. Monitor airway breathing and circulation .
2. Assist with intubation and securing ETT.
3. Keep the oxygen sources ready in working codition.
4. Insert IV cannula start IV drugs and fluids as prescribed.
5. Insert gastric tube to facilitate gastric decompression .
6. Suction when necessary.
7. Monitor the oxygen saturation level frequently .
8. Keep the defibrillators and cardiac monitor ready at the patient bedside.
28. NURSING MANAGEMENT
POST PROCEDURE RESPONSIBILITIES :
• Insert gastric tube to facilitate gastric decompression post intubation as
required.
• Arrange the used articles and equipments at their designated space,after
proper cleaning and disinfection.
• Document medication administered including dose and the time.
• Teach the co-workers and less experienced staff.
• Provide psychological support to patient and to the relatives.
30. CONCLUSION
CPR is the responsibility of team of personnel and not one person in isolation. For
cardiac arrest we strive to prevent when possible, treat effectively when challenged
and support humanly when death is eminent……..
31. WHAT DID YOU LEARN FOR?
1. When should CPR be used?
2. What is the first thing you or someone else should do before beginning CPR?
3. What do the CAB stands for?
4. What do you do if spinal injury is suspected
5. Which pulse to be palpated in case of adults and in case of children?
6. Which is the most important drug in resuscitation?
7. What is the ratio of compressions: ventilation?
8. What do you understand by the term DNR?
Editor's Notes
Cardiac Temponade is compression of heart caused by fluid collecting in the sac surrounding the heart.