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RT is repsonsible for what during the code?
airway, breathing responsiblities
primary nurse is repsonsible for what during the code?
give code team info like what is the code status, gets chart, call primary doc (not the same one that comes to the code), interacts w/ family
what are the other nurses repsonsible for what during the code?
'doing'- giving meds, defibillate, can do CPR-but that can be deligated to PCT, ect.
what does the nurse supervisor do during the code?
she is in the room doing crowd control, also supervising reading for the ecg on code chart
treatment for bradycardia
Symptomatic pt (lightheaded, decreased BP, decreased HR)
-give atropine IV
-oxygen should be applied as well (remember pt could be lightheaded, etc.)
-consider external pacing
-if atropine give a good HR but pt is still hypotensive replace fluids rather than 2nd round of atropine
what does atropine do for the pt?
increases their HR
what are PVCs?
an ectopic foci (excitable group of cells) in the ventricles discharges an impulse b4 the SA node does
- it is a heart cell issuse, not an AV node issuse, and is abnormal
what do u need to know about PVCs?
that they are ventricular, wide and out of place
for frequent PVCs (> 6/min) ur going to do what?
-amiodarone IV ( or lidocaine, but amiodarone is # 1)
-admin oxygen
-check why theyre having them ( hypoxic, electrolyte problems, digitalis admin, surgery, infection, trauma)
how to v tach waves and v fib waves differ?
v tach will be big up and down waves
vs. v fib are caotic or like itchy
V tach wave presentation are life threatening if not resovled, what are u going to do for ur pt WITH a PULSE
give
- amiodarone
-lidocaine
-synchronized cardioversion (sedate pt 1st)
what is v tach?
an ectopic foci in the ventricles that becomes the pacemaker of the heart
- not as efficent and decreased C.O.
what is v fib?
noraml electrical conduction is replaced by choatic activity in the ventricle
what is the treatment for v fib or PULSELESS v tach?
-check for respnsiveness, activate code blue, call for defibrillator
-begin CPR untill defibrillator is available
-defibrillate as soon as available- DON'T wait
-check for pulse
-defrbrillate (was no pulse)
-check for pulse
-defrbrillate (was no pulse)
-start IV ( if none, and continue CPR)
-give epi
-defrbrillate (was no pulse)
-if u get one now admin amiodarone or liocaine
what is asystole?
no electrical activity is happening. no pacemaker is firing.
what is the treatment for asystole? (remeber what happening) and PEA?
-check for responsiveness, call code, call for defibrillator in case u get something back
-begin CPR (not defirulation b/c there is no electrical activity-what were u going to convert?)
-start IV and admin epi and atropine
-above gives u time to consider the cause
-again this is not a CA or MI issue but more like a hypovolemia, hypoxia, acidosis, k imbalance thing
what is PEA
the pt has electrical activity on the monitor but no heart beat
what is the difference in intervention betw/ synchronized cardioversion and the defibrillator?
the defibrillator the charge is given right away, where the synchronized cardioversion waits till the R wave to avoid triggering v-fib if it were to firing during a vulnerable period ( T wave)
what does amiodarone do?
increases the PR and the QT intervals ( ventriclare filling and contraction), suppresses arrhythmias
- IV admin is part of the advanced cardiac life support guidelines
what does lidocaine do?
controls ventricular arrrhythmias