Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Ventricular fibrillation  and pulseless ventricular tachycardia are treated identically because they are generally caused by the same mechanisms and respond to the same interventions.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Restoration of adequate cardiac function is the defining factor of return of spontaneous circulation, but restoration of good neurologic function is the defining factor of successful resuscitation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The main usefulness of echocardiography is diagnostic, especially in patients with PEA. Echocardiography distinguishes organized pulseless cardiac activity that does or does not result in mechanical heart contraction.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
For ongoing resuscitation of arrest rhythms that fail to respond to CPR and defibrillation, intravenous or intraosseous access should be obtained so that vasopressor therapy can be administered and repeated every 3 to 5 minutes.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
ScvO2 also helps to detect return of spontaneous circulation (ROSC) rapidly without interruption of chest compressions, because ROSC will result in a rapid increase in ScvO2 as oxygen delivery to tissues dramatically increases.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
ScvO2 values normally range from 60% to 80%. During cardiac arrest and CPR, these values range from 25% to 35%, indicating greatly enhanced oxygen extraction of tissues owing to the inadequacy of oxygen delivery during CPR.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Central venous oxygen saturation, ScvO2, can be used to monitor resuscitative measures. The mixed venous blood oxygen saturation in the pulmonary artery (SvO2) represents the oxygen remaining in the blood after systemic extraction.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
PETCO2 monitoring is valuable in patients after return of spontaneous circulation to monitor endotracheal tube placement, titrate minute ventilation to avoid hyperventilation and detect sudden hemodynamic deterioration.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Return of spontaneous circulation (ROSC) causes immediate and significant increases in PETCO2. Therefore, PETCO2 monitoring can detect ROSC at any time during the chest compression cycle, providing valuable guidance.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
PETCO2 monitoring also can aid in the diagnosis and treatment of PEA. Patients in a state of PEA with mechanical heart activity may have pulsatile flow that simply cannot be detected by palpation of a pulse.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Resuscitation after cardiac arrest is likely to fail if PETCO2 values of 10 mm Hg or more are not achieved. Therefore, values less than 10 mm Hg should prompt the clinician to enhance the quality of CPR.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
PETCO2 depends on CO2 production, alveolar ventilation, and pulmonary blood flow (ie, cardiac output) and correlates well with coronary perfusion pressure and cerebral perfusion pressure during CPR.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
The partial pressure of CO2 in exhaled air at the end of expiration (PETCO2) can be a reliable indicator of cardiac output during CPR. This is most reliably measured through waveform capnography after endotracheal intubation.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Electrocardiographic monitoring during cardiac arrest indicates the presence or absence of electrical but not mechanical activity. It also does not provide reliable information regarding the effectiveness of CPR.

Nursing Tip of the Day! - Critical Care Nursing

Category: Critical Care Nursing 
Dependent lividity and rigor mortis develop after hours of cardiac arrest. Temperature is an unreliable predictor of duration of cardiac arrest because it does not decrease significantly during the first hours of arrest.