Role of Nursing in the protocols and guidelines of Cardiopulmonary Resuscitation PDF

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Role of Nursing in the protocols and guidelines of Cardiopulmonary Resuscitation

Cardiorespiratory arrest (CPA) is defined as the sudden and unexpected, potentially reversible cessation of spontaneous respiration and circulation. Its direct cause in 60% of cases is coronary artery disease. At the hospital level, in the United States it is estimated that the number of patients treated annually by PCR is 370,000 to 750,000 To reverse CRP, Cardiopulmonary Resuscitation (CPR) is used, which comprises a set of standardized maneuvers and sequential application within the so-called Chain of Survival (Table 1), replacing spontaneous breathing and circulation and attempting to recover, so that there is a reasonable chance of recovering higher neurological functions2. Table 1. Chain of Survival. Link

objective

Action

1st Link

Beginning of basic care and

Recognition of the victim's status

Advanced activation.

and alerts the emergency services.

Supply of oxygen to the tissues

Quick start of basic CPR maneuvers,

and, in particular, to the central

which are essentially mouth-to-mouth

nervous system during the

ventilation and cardiac massage

duration of the CRP

External. This phase of CPR is a

2nd Link

precarious support that saves time to be able to apply advanced CPR. 3rd Link

Recovery of cardiovascular and

Monitoring and beginning of the

respiratory function, improving

application in situ of specific

the oxygen supply as much as

protocols for the emergency in

possible and correcting the

question.

electrical disturbances present. 4th Link

Stabilization of the patient.

Transfer and admission to therapy units intensive

1

In Spain, it is estimated that each year more than 24,500 people are susceptible to CPR, which results in an average of one cardiac arrest every 20 minutes and causes 4 times more deaths than traffic accidents3. The success of resuscitation depends on a series of factors such as: suitable personnel, teamwork, timely and precise coordination; and time, which will determine the probability of survival6. One of the professionals who will be part of the resuscitation team is the nursing staff, so below we detail what are the functions of these professionals in CPR. -

Nursing role in CPR

As a member of the resuscitation team: -

Initial CPR Professional: The nurse is the one who generally responds initially in CPR, for this reason it is essential that they are prepared and updated in the CPR procedure, with training courses being essential.

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Defibrillator management: Nurses must know how to properly handle the use of the defibrillator since early defibrillation results in optimal results.

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Airway management and ventilation: All nurses should be familiar with oral intubation and effective use of bag-mask ventilation.

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Management of routes, drugs and probes: Nurses play an important role in managing tubes, placing IVs, and administering medications, as well as ensuring that medications are maintained.

As personnel in charge of resuscitation documentation: Accurate documentation (the dose of the drugs administered, the time of the seizures and their magnitude and CPR guidelines) is essential in CPR if we want to carry out an effective and controlled activity. As a CPR hospital referral staff: the nurse can be the reference person in the hospital setting on CPR maneuvers As a CPR instructor: Many nurses are in charge of instructing various health professionals in CPR maneuvers7.

As we have commented previously, the professionals who generally respond initially in CRP are usually nurses, since they are the professionals who are closest to the patient79. For this reason, it is essential that the nursing staff know the basic resuscitation maneuvers as a fundamental link in the chain of survival1. -

Justification

CPR continues to be one of the main maneuvers in which nursing professionals play a leading role, since on many occasions it is the first professional to act in this field. As we have seen in the introduction, the high incidence of CRP worldwide makes it necessary to have sufficiently trained and trained nursing professionals to respond to this emergency situation. To this end, at a general level, numerous guide protocols are published periodically that allow to check and update the knowledge about CPR performance and in which the role of the different members that make up the resuscitation team is determined. For this reason, and given the importance that the nurse has in CPR maneuvers, the present work aims to assess the presence of nursing professionals in the different CPR protocols and guides as well as the various functions assigned to them .

1. goals -

To evaluate the role of nursing in the protocols and guidelines published on CPR.

2. Methodology To carry out this work, a bibliographic search of the main protocols and guides published on CPR in the Americas and Asia has been carried out in order to establish a comparison of the figure and function of the nursing professional in said documents. As exclusion criteria, it has been established that each guide or protocol is the last update made, rejecting those guides that have not been reviewed with a

seniority period of more than five years. In addition, those guidelines or protocols directed at pediatric patients have not been included. The following terms have been used as descriptors: guideline (guidelines), clinical protocols (clinical protocols) and cardiopulmonary resuscitation (cardiopulmonary resuscitation)

Nursing role in each guide or protocol. Hospital

Plan

for

Cardiopulmonary

Resuscitation and Life Support of the Health Service. Goals: This hospital plan was developed and launched in 2007 in order to help reduce mortality, the consequences and the costs caused by CPR in hospital institutions. In this plan, these are the functions in which the nursing staff is reflected: -

The first function assigned to the nurse is the CPR cart review. Once the review has been carried out, the responsible person must sign the corresponding control record.

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Assistance to the patient during the transfer to the ICU, once the patient is resuscitated.

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Activation of the shutdown alarm by voice call or the emergency bell.

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Nurse as the first respondent in CPR in both the instrumental and advanced unit.

Within the Patient at Risk of Cardiorespiratory Arrest protocol included in this plan, the nursing functions are: -

The nurse advises the responsible doctor or the on-call doctor if the patient meets any of the following conditions: Three or more of the following data. • Respiratory rate ≥ 25 or...