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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
