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

COMMON OCCURRENCES

PATIENT FEELS WEAK

PATIENT “PASSES OUT”

PATIENT FALLS

HYPOTENSIVE BRADYCARDIC LOW SPO2 SLOW

RESPIRATIONS UNRESPONSIVE HYPERTENSIVEHYPERTENSIVE TACHYCARDICTACHYCARDIC

PRE PROCEDUREPRE PROCEDURE POST PROCEDUREPOST PROCEDURE

6 H’S & 7 T’S

HYPOTHERMIA HYPOGLYCEMIA HYPOVOLEMIA H+ ION

IMBALANCE HYPO/HYPER

ELECTROLYTE HYPOXIA

TABLETS/TOXINS TAMPONADE TENSION PNEUMO TRAUMA THROMBUS-

CORONARY THROMBUS-

CEREBRAL THROMBUS-PE

OK COACH!

NOWNOW

WHATWHAT

??

ASSESS YOUR PATIENT!ASSESS YOUR PATIENT!

AIRWAY : OPEN THE AIRWAYBREATHING: GIVE 2 BREATHSCIRCULATION: CHECK PULSE

DETERMINE IDENTIFIABLE TREATABLE REVERSIBLE

CAUSE

ACTIVATEEMERGENCY PLAN

AND

CALL EMS!EMS!

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

Secondary survey

Establish IV access – give ordered meds

Check for Bleeding Differential Diagnosis – identifiable

reversible cause

Identifiable treatable causes H’s & T’s

Hypovolemia Hypo/hyperglycemia Hypoxia H+ ion imbalance Hypo/hyper

electrolyte status Hypothermia

Toxins/tablets Tamponade Tension

pneumothorax Thrombosis1. Coronary

2. Cerebral

3. Pulmonary

2005 ECC GuidelinesGood CPR = Good Outcomes

We need to focus on more circulation and minimize

interruptions to compressions.

STUDY DATA SHOWS THAT IN CODES >50% OF THE

TIME THERE ARE NO COMPRESSIONS BEING

GIVEN!

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!

LONGER CYCLES

(FOR ALL AGES)

30COMPRESSIONS2 VENTILATIONSWITHOUT ADVANCED AIRWAY

CONTINUE COMPRESSIONS UNTIL

THE PATIENT MOVES EMS ARRIVES THE PATIENT IS PRONOUNCED

INTERRUPTIONS SHOULD BE 10

SECONDS OR LESS AND THEN ONLYONLY FOR ADVANCED PROCEDURES.

FOR MORE INFORMATION:DAN ROSENTHAL RN

WORKPLACE NURSES54 Derbes Drive

Gretna, LA 70053(504) 367-5355

workplacenurse@juno.com