Recent studies have shown patients suffering from cardiac arrest are treated with mild therapeutic hypothermia is now recognized as standard therapy in patients resuscitated from out-of-hospital cardiac arrest (OHCA) leading to unexpected death 1 in 1500 adults each year in this hi tech world (Zheng et al 2001). Therapeutic hypothermia (TH) may increase survival and reduce the amount of neurologic damage after cardiac arrest. According to the recent guidelines, comatose survivors of out-of-hospital ventricular fibrillation cardiac arrest should be cooled with internal or external cooling techniques to a target temperature of 32 °C to 34 °C (patients with in-hospital cardiac arrest or other primary rhythms may also be cooled. This target temperature should be maintained for 12 to 24 hours, and after this cooling period the patients should be rewarmed at a rate of 0.25 °C to 0.5 °C hour to normothermia. Significant survival and functional benefit impelling increased acceptance of use of TH.
Healthcare professionals in the hospital settings has been recommended in cardiac arrest (CA) patients since the publication of two randomized clinical trials in 2002, the results of which demonstrated a significant improvement in neurologically intact survival for comatose CA patients presenting with ventricular fibrillation (VF) or ventricular tachycardia (VT) Current guidelines suggest that mild therapeutic hypothermia should also be considered in patients presenting with other rhythms although this has been less well studied.
The aim of this research study is to review current literature reviews on therapeutic hypothermia post cardiac arrest ,its benefit for a neurological outcome, in shockable and non shockable rhythms, in and out of hospi...
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...perfusion and oxygen supply to the brain for few minutes post cardiac arrest resume of reperfusion releases some enzymes which changes intracellular ions and causes cell death.This leads to free radical production, cytotoxic cascade, nitric oxide that ceases further injury to neurons (Nolan et al 2008).Neurological deficit can be a evident post cardiac arrest reperfusion injury however this damage could be alleviated by therapeutic hypothermia recommended by holzer et al (2005). The mechanism of action of therapeutic hypothermia is tought to be mediated by prevention of cerebral reperfusion injury stated by mark luscombe, john c andrezowski (2006) consequently holzer et al ,(2005,2009) suggest if the reperfusion injury occurs following cardiac arrest then it is necessary to use TH to bring to an endto the development of injury and also to overcome the condition.
Targeted Temperature Management at 33 degree versus 36 degree after Cardiac Arrest (Neilsen et al)
While the respiratory and cardiovascular systems are most reliant on one another, all body systems require a functioning circulatory cycle in order to thrive. Blood circulation and consistent transfer of oxygen to cells is required to maintain cell and tissue life. Disturbances to this process will cause cells and tissues to die (Red Cross 48). This state of balance and functioning body systems is referred to as homeostasis, defined as a “condition of equilibrium in the body’s internal environment due to constant interaction of body’s many regulatory processes” (Tortura 8). Changes or disruptions to homeostasis are regulated by the Endocrine and Nervous systems of the body. The endocrine system is made up of glands placed throughout the body
Recognition, response and treatment of deteriorating patients are essential elements of improving patient outcomes and reducing unanticipated inpatient hospital deaths (Fuhrmann et al 2009; Mitchell et al 2010) appropriate management of the deteriorating patient is often insufficient when not managed in a timely fashion (Fuhrmann et al 2009; Naeem et al 2005; Goldhill 2001). Detection of these clinical changes, coupled with early accurate intervention may avoid adverse outcomes, including cardiac arrest and deaths (Subbe et al. 2003).
Hypothermia is a common problem in surgical patients. Up to 70% of patients experience some degree of hypothermia that is undergoing anesthetic surgery. Complications include but are not limited to wound infections, myocardial ischemia, and greater oxygen demands. The formal definition of hypothermia is when the patient’s core body temperature drops below 36 degrees Celsius or 98.6 degrees Fahrenheit. Thus, the purpose of the paper is to synthesize what studies reveal about the current state of knowledge on the effects of pre-operative warming of patient’s postoperative temperatures. I will discuss consistencies and contradictions in the literature, and offer possible explanations for the inconsistencies. Finally I will provide preliminary conclusions on whether the research provides strong evidence to support a change in practice, or whether further research is needed to adequately address your inquiry.
Early heart attack deaths can be avoided if a bystander starts CPR (cardiopulmonary resuscitation) within five minutes of the onset of ventricular fibrillation.
The term “failure to rescue” refers to a clinical scenario where hospital doctors, nurses, or caregivers fail to recognize symptoms. Responders do not respond adequately to clinical signs that would prevent harm (Morse, 2008, p.2). Dr. Jeffery H. Silber, Director of the Center for Health Outcomes and Policy Research, first coined the term “failure to rescue” in the 1990’s. He characterized the matrix of institutional and individual errors that contribute to patient deaths as “failure to rescue” (Aleccia, 2008). Since 1990, it has been well documented patients usually exhibit signs and symptoms of impending cardiac or respiratory arrest 6-8 hours before an arrest (Schein, Hazday, Pena, Ruben, & Spring, 1990). Buist, Bernard, Nguyen, Moore, and Anderson’s (2004) research reported similar findings. They found patients had documented clinically abnormal signs and symptom prior to arrest (Buist, et al., 2004). When certain abnormal signs and symptoms are identified early, critical bedside consultat...
Being hypothermic or having frostbite on any parts of your body can be very dangerous. It is very easy to get caught off guard and not be prepared for the effects to your body that hypothermia and frostbite create. If not handled properly you could have limbs amputated or you could even die. The statements made throughout this paper have told us how to treat and prevent hypothermia. They have also told us how to be wary of frostbite and the damage it can do to our bodies. Be aware of hypothermia and frostbite anywhere you go and never get caught of guard and unprepared.
Cardiac arrest is one of the leading causes of increased morbidity and mortality rates throughout the nation. There are over 177,000 reported deaths in the United States and Canada per year. The immediate initiation of bystander CPR upon occurrence can increase the survival rate by 4 times compared to patients who do not receive the lifesaving technique. Unfortunately, less than 5% of bystanders engage in these actions when needed. Explanations for the low rates have been reported as low socioeconomic status, physical hindrances, emotional and religious beliefs, and knowledge deficits. However, advanced practice nurses have the knowledge and skills necessary to improve the rate of bystander CPR within all environments. In this paper, I will discuss bystander CPR
This can be seen in the case study as ethical and legal arise in resuscitation settings, as every situation will have its differences it is essential that the paramedic has knowledge in the areas of health ethics and laws relating to providing health care. The laws can be interpreted differently and direction by state guidelines may be required. Paramedics face ethical decisions that they will be required to interpret themselves and act in a way that they believe is right. Obstacles arise such as families’ wishes for the patients’ outcome, communicating with the key stakeholders is imperative in making informed and good health practice decision. It could be argued that the paramedics in the case study acted in the best interest of the patient as there was no formal directive and they did not have enough information regarding the patients’ wishes in relation to the current situation. More consultation with the key stakeholders may have provided a better approach in reducing the stress and understanding of why the resuscitation was happening. Overall, ethically it could be argued that commencing resuscitation and terminating once appropriate information was available is the right thing to do for the
The company provides innovative solutions to combat postoperative conditions such as hypothermia. Medical research indicates that 60 to 80 percent of all postoperative recovery room patients are clinically hypothermic. Hypothermia is caused by a patient’s exposure to cold operating room temperatures that are required by surgeons to control infection, and for the personal comfort of the surgeon. Hypothermia can also be a result of heat loss due to evaporation of the fluids used to scrub patients, evaporation from exposed bowel, and breathing of dry anesthetic gases. Dr. Augustine’s personal experience in the operating room convinced him that there was a need for a new system to warm patients after surgery.
A do not resuscitate order for patients who have emergency surgery is an “independent risk factor for poor surgical outcome and postoperative mortality” (Kelley , 2014 pg 1 para 3) and the probability of returning patients to their previous level of functioning is higher for CPR performed during the peri-operative period (Kelley , 2014).
Mohr, M., & Kettler, D. (1997). Ethical aspects of resuscitation. British Journal of Anaesthesia, 253.
CPR is (cardiopulmonary resuscitation). This procedure is used to restore blood circulation and breathing in a person who is in cardiac arrest. All the cells in a human body require oxygen to survive, they also require a good supply of nutrients and removal of all waste products. In your lungs oxygen enters your blood and carbon dioxide is removed, this process is called gas exchange. Cardiac arrest is when your heart completely stops beating. Although your heart stops, this is not the same as a heart attack . a heart attack may lead to cardiac arrest. There are many causes that can put you in a state of cardiac arrest like, drugs, poising and over – dosing on medications, traumatic injury such as a motor vehicle accidents of any kind or any significant amount of blood loss and also anaphylaxis (and allergic reaction to anything) can also lead to cardiac arrest. If any of these happen blood will stop circulating throughout the body. Breathing begins to decrease most of the time you stop breathing for several minutes. The purpose of CPR is to keep oxygen in the blood so it can continue to flow, throughout the body to keep the vital organs alive. CPR will not restart someone’s heart, it just keeps the blood flow circulating until official help arrives , once you come across someone that isn’t breathing you should first see if the scene is clear before you go to help the person( always remember DR ABC always make sure you are not in any DANGER check for a RESPONSE from the person you’re doing CPR on shake them gently . make sure the AIRWAY is clear by kneeling by the persons head and tilting there head backwards . check if the person is BREATHING by placing your ear above their mouth and looking at their chest for normal breathin...
... patients with heart failure: Impact on patients. American Journal of Critical Care, 20(6), 431-442.
According to the Pittsburg Protocol, death is currently defined as the irreversible cessation of neurological or cardiopulmonary function.1 More specifically, brain death is defined as the irreversible cessation of the entire brain (including the brain stem), and cardiac death is defined as irreversible cessation of circulatory and respiratory functions.1 Even though the definitions seem clearly defined, issues have developed in regards to the amount of time allotted before declaration of death after cardiac arrest and regarding the possibility of resuscitation.