CPR for Nurses: Essential Steps & Nursing Considerations.
CPR for Nurses: Essential Steps &Nursing Considerations.
Master the critical nursing considerations for CPR, covering pre-resuscitation assessment, emergency activation, and the crucial roles nurses play during a code blue and in post-arrest care.
Cardiopulmonary resuscitation (CPR) is an emergency procedure that combines
chest compressions and artificial ventilation to maintain blood circulation
and oxygenation in someone experiencing cardiac or respiratory arrest. It's
a crucial life-saving technique used when a person's breathing or heartbeat
has stopped.
Nursing Considerations:
Providing cardiopulmonary resuscitation (CPR) is a critical and high-stakes nursing intervention. The nursing considerations for a patient undergoing CPR can be divided into three phases: pre-resuscitation, during resuscitation, and post-resuscitation.
Pre-Resuscitation Considerations.
Assessment:
The first step is always a rapid and accurate assessment. Nurses must be able to recognize the signs of cardiac arrest, which include a sudden loss of responsiveness and the absence of normal breathing or a central pulse.
Scene Safety:
Ensure the environment is safe for both the patient and the rescuer.
Activation of Emergency Response:
Immediately activate the emergency response system or "call a code" to summon the resuscitation team.
Check for Advanced Directives:
If known, check for a "Do Not Resuscitate" (DNR) order or other advance directives. However, if the patient's status is unknown or unclear, CPR should be initiated without delay.
Preparation:
As a member of the healthcare team, a nurse's role often includes preparing the patient for the resuscitation effort, such as placing them on a firm surface and ensuring clear access to the chest.
Cardiopulmonary Resuscitation:Advanced Protocols for Nurses.
Once a cardiac arrest is confirmed and the emergency response team is activated, the nurse's role shifts to delivering high-quality resuscitation guided by the Advanced Cardiovascular Life Support (ACLS) protocol.
1. High-Quality Chest Compressions: The Priority.
While Advanced Life Support involves multiple interventions, effective chest compressions are the most crucial factor determining survival.
Rate & Depth: Deliver compressions at a rate of 100 to 120 per minute and to a depth of at least 2 inches (5 cm), but no more than 2.4 inches (6 cm).
Full Recoil: Allow the chest to fully recoil after each compression. This creates negative intrathoracic pressure, which is essential for blood return to the heart (venous return).
Minimize Interruptions: Compressions should not be interrupted for more than 10 seconds at a time (e.g., during rhythm analysis or defibrillation). The team should rotate compression providers every 2 minutes to prevent fatigue.
2. Rhythm Analysis and Defibrillation:
The defibrillator identifies the cardiac rhythm, dividing arrest into two paths:
Action: Defibrillate (Deliver a shock) immediately. Then, resume CPR for 2 minutes before the next rhythm check. Action: No Shock. Immediately resume CPR for 2 minutes. Focus on finding and treating reversible causes.

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