CARDIAC EMERGENCIES IN THE GI LAB

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CARDIAC EMERGENCIES IN THE GI LAB

• DANIEL ROSENTHAL RN
• PRESIDENT
• WORKPLACE NURSES

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OBJECTIVES

• IDENTIFY COMMON EMERGENCIES ENCOUNTERED
• IMPLEMENT MEASURES TO RESOLVE EMERGENCY
  SITUATIONS
• DISCUSS HIGHLIGHTS OF GUIDELINES 2005 CHANGES

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COMMON OCCURRENCES
PRE PROCEDURE
POST PROCEDURE

• PATIENT FEELS WEAK
• PATIENT PASSES OUT
• PATIENT FALLS

• HYPOTENSIVE
• BRADYCARDIC
• LOW SPO2
• SLOW RESPIRATIONS
• UNRESPONSIVE
• HYPERTENSIVE
• TACHYCARDIC

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6 HS 7 TS

• HYPOTHERMIA
• HYPOGLYCEMIA
• HYPOVOLEMIA
• H ION IMBALANCE
• HYPO/HYPER ELECTROLYTE
• HYPOXIA

• TABLETS/TOXINS
• TAMPONADE
• TENSION PNEUMO
• TRAUMA
• THROMBUS- CORONARY
• THROMBUS- CEREBRAL
• THROMBUS-PE

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OK COACH!

• NOW
• WHAT
• ?

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ASSESS YOUR PATIENT!

• AIRWAY OPEN THE AIRWAY
• BREATHING GIVE 2 BREATHS
• CIRCULATION CHECK PULSE
• DETERMINE IDENTIFIABLE TREATABLE REVERSIBLE CAUSE

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ACTIVATEEMERGENCY PLAN AND CALL EMS!
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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

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Secondary survey

• Establish IV access give ordered meds
• Check for Bleeding
• Differential Diagnosis identifiable reversible
  cause

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Identifiable treatable causes Hs Ts

• Hypovolemia
• Hypo/hyperglycemia
• Hypoxia
• H ion imbalance
• Hypo/hyper electrolyte status
• Hypothermia

• Toxins/tablets
• Tamponade
• Tension pneumothorax
• Thrombosis
• Coronary
• Cerebral
• Pulmonary

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2005 ECC GuidelinesGood CPR Good Outcomes

• We need to focus on more circulation and minimize
  interruptions to compressions.

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STUDY DATA SHOWS THAT IN CODES gt50 OF THE TIME
THERE ARE NO COMPRESSIONS BEING GIVEN!
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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!

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LONGER CYCLES (FOR ALL AGES)

• 30COMPRESSIONS
• 2 VENTILATIONS
• WITHOUT ADVANCED AIRWAY

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CONTINUE COMPRESSIONS UNTIL

• THE PATIENT MOVES
• EMS ARRIVES
• THE PATIENT IS PRONOUNCED

INTERRUPTIONS SHOULD BE 10 SECONDS OR LESS AND
THEN ONLY FOR ADVANCED PROCEDURES.
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FOR MORE INFORMATIONDAN ROSENTHAL RNWORKPLACE
NURSES54 Derbes DriveGretna, LA 70053(504)
367-5355workplacenurse_at_juno.com