...Cardiopulmonary Resuscitation Slettalokken Gunnar, Rehn Tommy, Munkvik Morten, Rud Bjarne, Nymark Bernt, Lunde Per Kristian, Sjaastad Ivar, Sejersted Ole, Halle Jostein, Normal training response in skeletal muscle of post-infarction heart failure patients, European Journal of Sport Science , 2013. 2 (13), 231-239. Introduction/Purpose Congestive heart failure patients express an inability to exercise at the capacity of healthy individuals but more precisely experience reduced muscle fatigue resistance. This study was designed to elicit a clearer understanding as to whether skeletal muscle in CHF patients has a normal training response relative to both Coronary Artery Disease patients and healthy subjects following induced bouts of endurance training. Directly comparing the variables of a CHF group to a control group, in respect to aerobic capacity adaptations through endurance training, was the primary objective of this research. Researchers hypothesized, both CHF patients and normal subjects, would increase the aerobic capacity of the muscle in a similar manner. Methods 10 patients with post–infarction CHF and 13 healthy subjects were included in the study. An additional 9 people with coronary artery disease (left ventricular systolic function), were included as a second control group. Various quantitative measurements were collected, such as, ejection fraction, VO2 peak, mean peak torque, heart rate, CSA (cross sectional area of muscle), muscle fiber circumference/area...
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...issues in cardiopulmonary resuscitation (CPR) Mark Hilberman, Jean Kutner, Debra Parsons, and Donald J Murphy The Carbondale Clinic, Carbondale, Colorado, University of Colorado Health Sciences Center, St Joseph's Hospital, and the Colorado Collective for Medical Decisions, Denver, Colorado, USA Abstract Outcomes from cardiopulmonary resuscitation (CPR) remain distressingly poor. Overuse of CPR is attributable to unrealistic expectations, unintended consequences of existing policies and failure to honour patient refusal of CPR. We analyzed the CPR outcomes literature using the bioethical principles of beneficence, non-maleficence, autonomy and justice and developed a proposalfor selective use of CPR. Beneficence supports use of CPR when most effective. Non-maleficence argues against performing CPR when the outcomes are harmful or usage inappropriate. Additionally, policies which usurp good clinical judgment and moral responsibility, thereby contributing to inappropriate CPR usage, should be considered maleficent. Autonomy restricts CPR use when refused but cannot create a right to CPR. J7ustice requires that we define which medical interventions contribute sufficiently to health and happiness that they should be made universally available. This ordering is necessary whether one believes in the utilitarian standard or wishes medical care to be universally available on fairness grounds. Low-yield CPR fails justice criteria. Cardiopulmonary resuscitation...
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...Maternal Resuscitation Aim To understand and be able to practive resiscitation of the mother and promote the positive outcomes. Resuscitation of the Mother The approach to apparently lifeless patient is the cardiopulmonary resiscitation (ABCD) drill: Rapid assessment of the Airway, Breathing, and remedy of the problems with these as they are found (search for and correct reversible causes), moving through to remedy of the absence of Circulation. 1. Ensure a safe environment for patient and rescuer. 2. Shake and Shout, if no response, call for help and return to patient. 3. Turn patient on to her back and place wedge under right side of abdomen to relieve aortocaval compression. 4. Open the Airway: Remove any obvious obstruction from mouth. Perform chin lift by placing two fingers under the point of the patient’s chin and lifting the chin forward. Jaw thrust, performed by placing fingers behind patient’s jaw and lifting jaw forward. 5. Assess Breathing for 10 seconds: Look for chest movements. Listen for breath sounds. Feel for movement of air. If the person is breathing, turn her in to the recovery position. If there is absence of breathing in the presence of an open airway, take this as an absence of circulation. Give 30 chest compressions followed by two breaths. Breaths are delivered by taking a full breath and placing your lips around the mouth and blowing steadily into the mouth. If possible, a facemask and ...
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...NURS1131: Complex Care Nursing – written assessment Part 1: Media Annotation tool Time sequence | code | comments | 0-30 seconds | BARCG – did not assess patient appropriatelyGuideline 4 AirwayGuideline 5 BreathingGuideline 8 Cardiopulmonary Resuscitation.PTS (18 sec)PNTS – comm (23 sec) | DRS ABC- did not assess for any danger, assessed for response however failed to assess airway, breathing and circulation and jumped straight to compressions.Poor assessment of response inappropriate pain stimuli response technique.No code blue called by the second responder. | 30 – 60 seconds | PTS (39 sec)BARCG- Guideline 11.2 Protocols for advanced Life support. (59 secs) | Defibrillator pad were not attached properly.Rhythm was not assessed after the shock. | 60 – 90seconds | PTS (64 sec)PTS (80 sec) | Guardel airway was inserted with nil airway assessment. Pillow was also not removed for enhancing airway.Nil jaw thrust for airway. | 90 – 120 seconds | PTS (119 sec)PNTS – DM (119 sec) | Hands were off the chest and not ready for compression during doctors assessment. Delay compression. | 120 – 150 seconds | PNTS- SA (135 sec)PNTS – TM (149 sec) | Nurse with her arm crossed not taking any initiative of taking any roles.Task evident, no one initiated the scribe role until the doctor appointed one. All incoming nurses showed no initiative in taking any roles. | 150 – 180 seconds | PTS (158 sec)PTS (176 sec) PNTS DM, Comm, TM | Poor documentation, no record of first, second shock...
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...Sweden and the U.S. All but one of the study results recommend that “hands-only” CPR is at least equal or superior to “standard” CPR. Conclusions Guidelines should be established to teach bystander “hands-only” CPR nationwide, to increase public awareness of the effectiveness of “hands-only” CPR and start to teach out-of-hospital “hands-only” CPR. Introduction Sudden cardiac arrest is the leading cause of death in the United States (Neumar, Barnhart, Berg, Chan, Geocadin, Luepker,… Nichol, 2011). According to the American Heart Association (AHA), “Each year, emergency medical services (EMS) assesses nearly 360,000 out-of-hospital cardiac arrests (OHCA) in the United States” (Neumar, et al. 2011). Bystander initiated cardiopulmonary resuscitation (CPR) could mean the difference between life and death in many of these victims. The 2008 AHA Science Advisory Committee for the Public approved...
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...Needs The purpose of my training session was to give delegates a guidance of the skills and knowledge to understand Cardiopulmonary resuscitation (CPR) should it ever be required in an emergency situation. I felt that the simple knowledge of basic CPR is important for all to know for personal reasons. Training needs are identified in numerous ways. It maybe that an employee would be required to do a full first aid at work course within their working environment under Health & Safety legislation or just the companies preference to increase their provision. It maybe required under their occupation e.g. working with children that they are required to hold this qualification. The individual may simply have the desire or feel they lack the knowledge and skills should they ever be required. An individual may simply by deemed the best person to have first aid qualification because the come in to contact with many members of the public. As such one never knows when an emergency situation could arise and there might only you in the vicinity. Training Objectives My main aim for my course was to make this a realistic fun and interactive course but not to forget the seriousness of how important it is for everyone to know basic Cardiopulmonary Resuscitation. By making the course fun and interactive I hoped this would make everyone be able to remember the training in an achievable way...
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...clear that the word “family” draws upon much more than just blood relatives. In the health care setting a family can be viewed as the people who come together to support a patient during a health crisis. That support may be seen directly at the bedside, through conversations via phone, or helping to assist in the discharge process. As a nursing workforce it is our responsibility to understand how the roles of a family affect our individual patients, and work to incorporated those roles into their therapeutic environment. An issue in today’s emergency departments that continues to draw attention from aspects of the medical profession is the use of family presence during cardiopulmonary resuscitation. “While it appears that the evidence clearly indicates positive outcomes from family witnessed resuscitation (FWR), a majority of emergency departments fail to implement or even institute policies “(MacLean, et al 2003) . Lack of education, leadership support and patient understanding are just a few factors contributing to hospitals not participating in this patient centered approach. “Families seldom ask if they can be present unless they have been...
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...University of Phoenix Material Health Care Museum This paper is a Health Care Hall of Fame Museum proposal, it’s composed of five exhibits Marine Hospital Service, Polio Vaccination, Cardio Pulmonary Resuscitation (CPR), Emergency Medical Services (EMS), and Electric Health Records (EHR). This part of the exhibit will cover the history, and how did it affect our current health care system. The second part talks about how does everything ties together. Part 1: Health Care Hall of Fame Museum Proposal |Development |Description |Analysis (How does the development affect the current U.S. health care system?) | |1. Marine Hospital |The "Decades Of Healthcare Service" (). In 1798, President John Adams signed into |The relevance of the Marine Hospital service is by the government recognized that | |Service |law the Act for the Relief of Sick and Disabled Seamen. Creating the Marine Hospital|the servicemen needed federal regulated healthcare. This service was centered to | | |Service. This plan marked the nation’s first pre-paid health insurance plan and was |providing medical care to our servicemen, it evolve to a big organization known as| | |the birth of the modern American medical system. During that time, twenty cents was |the Public Health Service. According to "U.s Department Of Health And Human ...
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...Withholding Information 14 Informed Choice 17 Forcing Information Upon Patients 20 The Nurses Role 22 Conclusion 25 References 26 Appendix 27 Glossary of terms CPR: Cardiopulmonary Resuscitation. DNACPR: Do Not Attempt Cardiopulmonary Resuscitation. NMC: Nursing & Midwifery Council. GMC: General Medical Council. BMA: British Medical Association. GP: General Practitioner Introduction The Aim of this module is to encourage me to enhance my personal and professional skills, to increase the efficacy of patient care and interaction. Also to make me more aware of the legal, professional and ethical implications of practice. The module allowed me to further develop my knowledge of these topics: Ethics & Accountability, Legal Aspects of Practice, finally Accountability & Professional Practice. I was then asked to submit an essay of 4500 words based on the following: “Critically analyse an aspect of care from your practice setting that encompasses the ethical, professional & legal role of the nurse. Issues of accountability should be incorporated into this essay”. Aspect of care The aspect of care I have chosen to include in my essay is the “Do Not Attempt Cardiopulmonary Resuscitation (DNACPR)” Adult Policy 2010 (please see Appendix 1). I decided to choose this topic as there was a situation on my ward recently where a patient discovered a DNACPR form in the front of her nursing notes. The patient...
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...ml 3. What you write is always past tense it's over and everything could be completely different by the time someone reads it. You conducted a microsystems assessment and the findings were. When you include an article the author reported, the study demonstrated, 4. Check your outlines you always need a running head, title page with the name of the paper, course name and number, your name, school name, instructor's name, date, headings and reference page is always by itself 5. Read your paper like you are not familiar with the topic (helps to get non-nurse folks to read) all those abbreviations we use like IV, CPR always have to be written out the first time then and only if you plan to use it again make the abbreviation cardiopulmonary resuscitation (CPR) , never begin a sentence with an abbreviation so if I've use CPR a dozen times already but I...
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...own records. Signed: Date: | PART C – to be completed by Lecturer: Comments to Student | | | | | | | | | | | | Recorded Mark: | | Lecturer: | | Date: | Content Page 1) Introduction 2) Objective 3) Information Source 4) Key search terms and Boolean Operators 5) Critical Appraisal Checklist 6) Conclusion 7) References Introduction Nurses are the front liners in many diverse ways of healthcare. Many a time, nurses stand as the primary contact person of witnessing a patient who collapse and reach a state of cardiac arrest (Heng, Seow & Tham, 2011). Therefore, the nurses’ response following that is crucial, showing how essential it is for a nurse to be well-educated with resuscitation skills to not only...
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...Original article | Published 3 February 2011, doi:10.4414/smw.2011.13157 Cite this as: Swiss Med Wkly. 2011;141:w13157 Do not attempt resuscitation: the importance of consensual decisions A qualitative study Lorenz Imhofa, Romy Mahrer-Imhofa, Christine Janischb, Annemarie Kesselringc, Regula Zuercher Zenklusend a b c d Zurich University of Applied Sciences ZHAW, Institute of Nursing, Winterthur, Switzerland Department of Education, Training and Professional Development, Stadtspital Waid Zurich, Switzerland Institute of Nursing Science, University of Basel, Switzerland Department of Medicine, Pourtalès Hospital, Neuchâtel, Switzerland Correspondence: Lorenz Imhof PhD RN Zurich University of Applied Sciences Institute of Nursing School of Health Professions Technikumstr. 71 CH-8401 Winterthur Switzerland lorenz.imhof@zhaw.ch pivotal. Therefore, leadership by experienced senior physicians and nurses is needed and great efforts should be made with regard to multidisciplinary education. Key words: decision-making; multidisciplinary collaboration; end-of-life issue; resuscitation orders Introduction Since the 1980s, “do-not-attempt-resuscitation (DNAR)” orders have become common in medical practice. DNAR orders are given for 50–60% of patients who die a non-sudden death, with wide variations among countries. DNAR orders apply to only 19% of hospitalised patients in Italy, but to as many as 83% in Sweden and 86% in Switzerland [1, 2]. The frequency of DNAR decisions in...
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...Swimming Survival Whenever learning swimming it is very important to not only get better in a fitness aspect and a way of staying healthy, but one of the most important things to learn about while swimming is swimming to survive. According to the U.S. Centers for Disease Control and Prevention, in 2004, there were 3,308 unintentional drowning’s in the United States, an average of nine people per day. Also according to the American Academy of Pediatrics it is estimated that for each drowning death, there are 1 to 4 nonfatal submersions serious enough to result in hospitalization. Children who still require cardiopulmonary resuscitation (CPR) at the time they arrive at the emergency department have a poor prognosis, with at least half of survivors suffering significant neurologic impairment. There are many different instances in which the ability to swim affectively can save yours or somebody else’s life in a certain situation. Some of these situations include flood, ocean, river or even your basic swimming pool can all produce its own level of hazards or obstacles that can potentially cause saver injury or death. One technique that will help in some of these situations according to essortment.com is back floating also known as "sculling," the back float is performed by lying flat on your back with your feet relaxed and slightly apart. Your arms are at your sides moving slowly side-to-side. If you feel yourself sinking, raise your chin putting your head further back in the...
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...Advance Directives Advance directives are medical documents that are created by the patient that assist health care providers, and loved ones provide care and make decisions for the patient. Four types of advance directives exist including a Living Will, Durable Power of Attorney (DPOA), Uniform Anatomical Gift Act, and Do Not Resuscitate (DNR) orders (Fremgen, 2009). This paper will discuss one type of advance directives, the DNR order. The DNR order alerts medical professionals not to perform cardiopulmonary resuscitation (CPR), per the patient’s request. This means that health care professionals will not attempt emergency CPR if the patient’s breathing or heartbeat stops (Smith.). Advance directives and DNR orders are important to have drawn up by the patient because in the event they are unable to speak for themselves, an order is put in place stating their wishes. This helps in assisting family members and health care professionals in making decisions when the end of life is inevitable. Advantages and Disadvantages of a DNR Order When it comes to making this difficult decision, there are many advantages and disadvantages of a DNR order. The advantages as stated in the report called, “Recording “Do Not Resuscitate” and other Life-Sustaining Orders in the Out-of-Hospital Setting” are: * Available to all patients * No personal discomfort * Deals with a range of treatment * Easy to maintain * No loss of privacy (Pace, 2002). For example, when a person...
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...for airway movement (rise and fall, and feeling a pulse (which is usually the carotid pulse) for a ten second period. The possible causes of pulseless electrical activity is remembered as the six Hs and the six Ts. The six Hs are as followed: hypovolemia, hypoxia, hydrogen ions (acidosis), hyperkalemia/hypokalemia, hypoglycemia, and hypothermia. The six Ts are also as followed: toxins (drug overdose), cardiac tamponade, tension pneumothorax, thrombosis (myocardial infarction, pulmonary embolism), tachycardia, and trauma (hypovolemia due to blood loss). The diagnosis of pulseless electrical activity comes when you see electrical activity on the device capable of electrocardiography but the person does not produce a pulse. Cardiopulmonary resuscitation is initiated immediately,...
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