Nursing & health cardiopulmonary resuscitation survival guide

52 Pages·2012·3.548 MB·English

by  Godson, Nina

First published 2012 by Pearson Education Limited

Published 2014 by Routledge
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Copyright © 2012, Taylor & Francis.

The right of Nina Godson and Kelly Ryan to be identified as author of this work has been
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All rights reserved. No part of this book may be reprinted or reproduced or utilised in any form or by any electronic,
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our
understanding, changes in research methods, professional practices, or medical treatment may become necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any
information, methods, compounds, or experiments described herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any
injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or
operation of any methods, products, instructions, or ideas contained in the material herein.
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ISBN 13: 978-0-273-74402-3 (hbk)
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British Library Cataloguing­in­Publication Data 
A catalogue record for this book is available from the British Library n

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A catalog record for this book is available from the Library of Congress e

Typeset in 8/9.5pt Helvetica by 35
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INTRODUCTION 3
What do the letters CPR represent? 4
CARDIOVASCULAR SYSTEM – ANATOMY AND PHYSIOLOGY 5
The function of the heart 5
BASIC LIFE SUPPORT GUIDELINES (OUT OF HOSPITAL) 7
Step 1: approaching the casualty 7
Step 2: shake and shout 8
Step 3: if the casualty does not respond to your command 8
Step 4: c all for help and ask for an automated
defibrillator (AED) 9
Step 5: n o signs of life (no cardiac or respiratory output):
commence chest compressions 11
Step 6: rescue breaths 12
Step 7: m outh-to-nose ventilation (alternative to
mouth-to-mouth) 14
RESUSCITATION IN HOSPITAL 16
DECISIONS ON DNAR (DO NOT ATTEMPT RESUSCITATION) 22
INFECTION CONTROL / HAND WASHING 22
SCENARIO 1 (PATIENT BREATHING) 24
Road traffic accident 24
Top-to-toe assessment from a nursing student’s point
of view 25
SCENARIO 2 – PRIORITISING THE CARE OF SEVERAL
CASUALTIES 31
Road traffic accident: a collision has taken place
involving two motorists and a cyclist 31
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AIRWAY OBSTRUCTION – CHOKING ADULT 32
Mild airway obstruction 33
t Severe obstruction (patient conscious) 33
Severe obstruction (patient unconscious) 35
n Recovery position 35
RECAP QUIZ 39
e SCENARIO 3 – IN COMMUNITY (PATIENT NOT BREATHING) 40
Recap questions 40
SCENARIO 4 – BASIC LIFE SUPPORT IN HOSPITAL
t (PATIENT SHOWS NO SIGN OF LIFE) 42
n Recap questions – choose the correct action for each 42
CRASH TROLLEY 44
AIRWAY EQUIPMENT 45
o RECAP QUIZ: ANSWERS 47
SCENARIO 3: ANSWERS 48
c SCENARIO 4: ANSWERS 49
REFERENCES 50
USEFUL WEBSITES 50
While every effort has been made to ensure that the
content of this guide is accurate, no responsibility will be taken
for inaccuracies, omissions or errors. This is a guide only.
The information is provided solely on the basis that readers
will be responsible for making their own assessment and
adhering to organisation policy of the matters discussed
herein. The authors do not accept liability to any person
for the information obtained from this publication or for
loss or damages incurred as a result of reliance upon
the material contained in this guide.
Aim of this recap book:
(cid:127) To recap on the up-to-date guidelines set
out by the Resuscitation Council 2010 on
cardiopulmonary resuscitation.
(cid:127) To promote good practice.
(cid:127) To support nursing students in clinical
placement.
(cid:127) To use as an aide-memoire for Objective
Structured Clinical Examinations (OSCEs).
The most life-threatening situation a student
nurse could be called to is a casualty who is
not breathing. Early assistance is of the utmost
n importance to save the life of the casualty, as
brain cells that are starved of oxygen start to die
o within a few minutes. As a student nurse you
can artificially breathe for and pump oxygen
i
around the body until emergency help arrives.
t
A combination of chest compressions and
c rescue breaths are known as cardiopulmonary
resuscitation (CPR).
u
Up-to-date resuscitation skills and knowledge
are vital for student nurses to optimise survival
d
for the victims of cardiopulmonary arrest. The
o Nursing and Midwifery Council (NMC) Code of
Professional Conduct (2008) states that as a
r professional, you are personally accountable
for actions and omissions in your practice and
t must always be able to justify your decisions.
n The Resuscitation Council guidelines 2010
also state:
i
4 INTRODUCTION
‘It is important that those who may be present at the scene
of a cardiac arrest . . . should have learnt the appropriate
resuscitation skills and be able to put them into practice.’
This survival guide helps guide you through the important
practical procedures and theory required for correct
cardiopulmonary resuscitation (CPR) with additional advice
on related procedures such as the recovery position, the
choking patient and top-to-toe survey.
Note: please ensure that you have had your CPR update
(practical and theory) at the establishment where you are
studying, as this is only a recap book.
■ WHAT DO THE LETTERS CPR REPRESENT?
Cardio (heart)
Pulmonary (lungs)
Resuscitation (attempt to restart the heart)
THE FUNCTION OF THE HEART 5
Cardiovascular System – Anatomy and Physiology
To understand the theory behind the procedure of cardiopulmonary
resuscitation you need to understand the anatomy and
physiology of the cardiovascular system (see Figure 1).
Figure 1 The structure of the heart
Activity: See if you can revise the structure of the heart and
its functions to help you understand how cardiopulmonary
resuscitation works, using Figure 1 above and referring to
your anatomy and physiology book.
■ THE FUNCTION OF THE HEART
The heart acts as a pump that pushes blood around the body
by rhythmic contractions. Blood vessels act as a vehicle,
6 CARDIOVASCULAR SYSTEM – ANATOMY AND PHYSIOLOGY
carrying the blood around the body (see Figure 2). The term
Cardiac is a term used in relation to the heart.
Figure 2 The circulatory pathway
(cid:127) The cycle begins in the right atrium, where the blood flows
through a valve called the tricuspid, to the right ventricle.
(cid:127) From the right ventricle the blood is pumped out to
the pulmonary semilunar valve and travels through the
pulmonary artery to the lungs.
STEP 1: APPROACHING THE CASUALTY 7
(cid:127) From the lungs, blood flows back through thepulmonary
vein to the left atrium.
(cid:127) The blood travels through a valve called themitral valve
to theleft ventricle, and is then pumped through the
aortic semilunar valve to theaorta.
(cid:127) The aorta divides and the blood is shared between major
arteries which supply the upper and lower body parts.
(cid:127) The blood travels in the arteries to the smaller arterioles,
then to thecapillaries which provide nutrition to each cell.
(cid:127) The deoxygenated blood travels to the venules, which
lead into veins, to the inferior and superior vena cava.
(cid:127) The final stage is where the blood travels back to the
right atriumwhere the process begins all over again.
Source: Waugh and Grant (2006)
Basic life support guidelines (out of hospital)
■ STEP 1: APPROACHING THE CASUALTY
Firstly, always check the area for any signs of danger before
approaching the casualty. There is no point in endangering
yourself and adding to the casualties. See Figure 3.
Figure 3 A few examples of danger
TTiipp When checking the area for signs of danger you must
always approach the casualty with caution: he/she might
be pretending to have collapsed in order to initiate an attack.
8 BASIC LIFE SUPPORT GUIDELINES (OUT OF HOSPITAL)
■ STEP 2: SHAKE AND SHOUT
When the area is safe, attend to the casualty by kneeling
by their side and shaking their shoulders, at the same time
shouting in their ear, ‘Are you alright?’ If there is more than
one casualty, prioritise the care for casualties involved, for
example: a patient who has no signs of life will need immediate
attention, rather than a casualty who has a graze on the hand.
TTiipp Make sure you talk to them close to their ear and not too far
away, as they may be semi-conscious and not hear you!
If the patient responds to your call, then continue to perform
a top-to-toe assessment of the casualty and then place the
casualty in the recovery position (this will be explained later,
see below).
TTiipp Reassess the casualty continually until emergency help arrives.
■ STEP 3: IF THE CASUALTY DOES NOT RESPOND TO
YOUR COMMAND
If possible turn the casualty on his/her back, firstly check the
airway, and look into the casualty’s mouth to see whether
there is any obstruction. If there is an object close to the front
of the mouth you may try to remove it, but if it is further back
you should leave the object in place as you may be at risk of
pushing it further down or the casualty may bite down on
your fingers.
Then look, listen and feel for signs of life for 10 seconds!
Do this by firstly placing one hand on the casualty’s forehead
and place the finger tips from the other hand under the
casualty’s chin. Tilt the forehead and chin backwards, to
open up the airway.
TTiipp This is known as ‘head tilt – chin lift’.