Advanced Cardiac Life Support. a Guide for Nurses

In the event of an adult cardiac arrest, it is essential to be able to respond rapidly, providing safe and effective care. This new and updated edition of Advanced Cardiac Life Support provides the theoretical background to resuscitation as well as explaining the essential resuscitation skills required to manage an adult cardiac arrest- from the time it occurs until subsequent transfer to the ICU.

The emphasis is on the prevention of cardiac arrest with detailed information on the management of peri-arrest arrhythmias and acute coronary syndromes. Advanced Cardiac Life Support also discussed ethical and legal issues, record keeping, dealing with bereavement, audit, equipment and training- providing an essential quick reference tool for nurses and health care professionals.

• An evidence-based approach to emergency care based on the latest Resuscitation guidelines
• A succinct yet comprehensive guide to the management of cardiac arrest
• Written by an experienced resuscitation training offer who is also a qualified nurse and former CCU Charge Nurse

Contents

Foreword

Acknowledgements

Chapter 1 Resuscitation Service: An Overview

• Introduction
• Learning outcomes
• Concept of the chain of survival
• Cardiopulmonary Resuscitation: Standards for Clinical Practice and Training
• Role of the Resuscitation Council (UK)
• Principles of safer handling during CPR
• Chapter summary

Chapter 2 Resuscitation Equipment

• Introduction
• Learning outcomes
• Recommended minimum equipment for the management of an adult cardiac arrest
• Routine checking of resuscitation equipment
• Checking resuscitation equipment following use
• Chapter summary

Chapter 3 Recognition and Treatment of the Critically Ill Patient

• Introduction
• Learning outcomes
• Prevention of in-hospital cardiopulmonary arrest
• Clinical signs of critical illness
• Early warning scores and calling criteria
• Role of outreach and medical emergency teams
• Assessment and emergency treatment of the critically ill patient
• Chapter summary

Chapter 4 Principles of Cardiac Monitoring and ECG Recognition

• Introduction
• Learning outcomes
• The conduction system of the heart
• The ECG and its relation to cardiac contraction
• Methods of cardiac monitoring
• Problems encountered with cardiac monitoring
• Systematic approach to ECG interpretation
• Cardiac arrhythmias associated with cardiac arrest
• Peri-arrest arrhythmias
• Chapter summary

Chapter 5 Bystander Basic Life Support

• Introduction
• Learning outcomes
• Potential hazards when attempting BLS
• Initial assessment and sequence of actions in bystander BLS
• Principles of chest compressions
• Principles of mouth-to-mouth ventilation
• The recovery position
• Treatment for foreign body airway obstruction
• Chapter summary

Chapter 6 Airway Management and Ventilation

• Introduction
• Learning outcomes
• Causes of airway obstruction
• Recognition of airway obstruction
• Simple techniques to open and clear the airway
• Use of oropharyngeal and nasopharyngeal airways
• Insertion of the laryngeal mask airway (LMA)
• Insertion of the combitube
• Procedure for application of cricoid pressure
• Principles of tracheal intubation
• Methods for ventilation
• Chapter summary

Chapter 7 Defibrillation and Electrical Cardioversion

• Introduction
• Learning objectives
• Ventricular fibrillation
• Physiology of defibrillation
• Factors affecting successful defibrillation
• Safety issues and defibrillation
• Procedure for manual defibrillation
• Procedure for automated external defibrillation
• Synchronised electrical cardioversion
• New technological advances in defibrillation
• Chapter summary

Chapter 8 Advanced Life Support

• Introduction
• Learning objectives
• Background to the Resuscitation Council (UK) ALS algorithm
• Overview of the ALS algorithm
• Chest compressions
• Precordial thump
• Reversible causes
• Drug delivery routes
• Resuscitation drugs
• Use of pre-filled syringes
• Principles of external pacing
• Chapter summary

Chapter 9 Resuscitation in Special Situations

• Introduction
• Learning outcomes
• Life-threatening electrolyte abnormalities
• Hypothermia
• Drowning
• Acute severe asthma
• Electrocution
• Pregnancy
• Poisoning
• Trauma
• Cardiovascular collapse or cardiac arrest caused by local anaesthetic
• Chapter summary

Chapter 10 Anaphylaxis

• Introduction
• Learning outcomes
• Definition
• Incidence
• Pathophysiology
• Causes
• Clinical features and diagnosis
• Treatment of anaphylaxis
• Chapter summary

Chapter 11 Acute Coronary Syndromes

• Introduction
• Learning outcomes
• Pathogenesis of ACS
• Classification of ACS
• Diagnosis of ACS
• Immediate treatment of ACS
• Chapter summary

Chapter 12 Management of Peri-Arrest Arrhythmias

• Introduction
• Learning outcomes
• Principles of the use of the peri-arrest algorithms
• Adverse clinical signs associated with peri-arrest arrhythmias
• Management of bradycardia
• Management of a tachycardia
• Chapter summary

Chapter 13 Post-Resuscitation Care

• Introduction
• Learning objectives
• Goals of post-resuscitation care
• Initial assessment priorities
• Transfer to definitive care
• Measures to limit damage to vital organs
• Temperature control and therapeutic hypothermia
• Prediction of poor outcome
• Chapter summary

Chapter 14 Bereavement

• Introduction
• Learning objectives
• Ideal layout for the relatives room
• Breaking bad news
• Telephone notification of relatives
• Practical arrangements following a death
• Relatives witnessing resuscitation
• Chapter summary

Chapter 15 Ethical Issues in Resuscitation

• Introduction
• Learning outcomes
• Ethical principles that guide medical practice
• Historical background to DNAR decisions
• Importance of DNAR decisions
• Key messages in Decisions Relating to Cardiopulmonary Resuscitation
• Overview of the DNAR decision-making process
• Factors underpinning DNAR decisions
• Documentation of DNAR decisions
• Information for patients and relatives
• Chapter summary

Chapter 16 Resuscitation Records

• Introduction
• Learning outcomes
• Why maintaining accurate resuscitation records is important
• Examples of poor record keeping
• Factors underpinning effective record keeping
• Importance of auditing resuscitation records
• Legal issues associated with record keeping
• Audit and reporting standards
• Chapter summary

Chapter 17 Resuscitation Training

• Introduction
• Learning outcomes
• Why resuscitation training is important
• Principles of adult learning
• Resuscitation training methods
• Recommendations for resuscitation training for healthcare staff
• Training mannequins/models
• Resuscitation Council (UK) courses
• Chapter summary

Index

Author Information

Phil Jevon qualified as an RGN in 1986. He worked on CCU between the years 1987 and 1993 during which time he gained considerable experience in coronary care nursing. He has been the Resuscitation Officer/Clinical Skills Lead at The Manor Hospital, Walsall since 1993 and is an Honorary Clinical Lecturer at the Birmingham Medical School. While working on CCU and since then in his role as a member of the hospital cardiac arrest team, he has got considerable experience in advanced cardiac life support.