NURSING SERVICE STILL ON CARDIO RESPIRATORY By: Enf ª. Ana Paula S.

Cross Respiratory arrest • It's the sudden withdrawal of respiration, may be with or without heart failur e. RESPIRATORY FREQUENCY Adult - 15-20 Child WPRM - 20-25 WPRM Babies - 30-40 WPRM FACTORS allowing proper BREATHING Proper concentration of oxygen in inspired air , unobstructed air passages; Action muscular rhythmically active respiratory mus cles, circulation adequate blood. Diagnosis • Absence of respiratory movements; • Cyanosis (purplish blue lips, nails, not m andatory) • Dilation of pupils (not mandatory) • Unconsciousness. Causes of respiratory arrest • • • • • • Drowning burial Shock Trauma Poisoning Choking (foreign body) Objectives of respiratory care • Ensure a patent airway, provide supplemental oxygen and establish positive pre ssure ventilation, when spontaneous breathing is inadequate or absent. METHODS TO RESTORE BREATHING Mouth / mask Word of Mouth Using the Ambu The OB STRUC WAYS TO OCCURS RESPIR ACTOR IA Muscle relaxation (Language); Presence of Foreign Body. PROCEDURES FOR RELEASE For muscle relaxation; In the presence of foreign body; Sequence of care • Chin lift - The fingers of one hand are placed under the chin, which is slight ly drawn up, raising it earlier. The thumb of that hand depresses the lower lip to open the mouth. The thumb can also be placed behind the incisors, while simul taneously and gently lifted her chin. If mouth to mouth resuscitation is require d, the nostrils are closed with the thumb and forefinger of his other hand; • Draw the jaw - Find the angles of the jaw and pulls up the lower jaw forward. If the lips close the bottom can be retracted with the thumb. If mouth to mouth resuscitation is required, we must close the nostrils by placing your cheek agai nst them, blocking them. • Breath of mouth - Taken the previous measures put his mouth firmly over the mo uth of the victim. Blow into the mouth of the victim until you notice that your chest is moving. Next, let the victim exhale freely. We repeat this procedure 15 -20 times per minute. • mouth-nose breathing - place your mouth over the nose and close the mouth of t he victim. In children we can put your mouth on the nose and taking care not exp ire with excessive pressure.

Cardiac Arrest • The heart stops pumping blood to the body which thus ceases to carry oxygen to tissues. Diagnosis • No wrist (radial, femoral and carotid); • Cold, pale or bluish; • Respiratory arrest (frequent but not compulsory) • Unconsciousness; • Dilation of pupils (of ten, but not required) • In doubt, proceed as if it were. Sequence of care 1 - Place the victim lying on her back on a hard surface, 2 - Put your hands sup erimposed on the lower third of the sternum; 3 - Make compression on the sternum to the spine; The location of external cardiac massage is found by placing your hand two finge rs above the xiphoid process. CHEST Sternum xiphoid process ribs Borders Hands should be overlapping, interlocking fingers and only one hand in contact w ith the sternum. The compression causes the blood to circulate, thus replacing t he work would be done by the heart. • Position the hands of the rescuer. Treatment • We do 30 compressions to 2 breaths lung at a rate of 100 compressions per minu te, counting aloud, "and one and two, three, four and five and six, and ..., fan s! , fans! "so if the team working properly, at least 04 cycles must be complete d out of each minute of CPR. Cardiopulmonary resuscitation • The maneuvers aim to maintain the flow of oxygenated blood to vital organs, es pecially the brain. • Intervention in respiratory arrest should be aggressive to prevent the occurrence of cardiac arrest. • The CPR is divided into primary and support ALS (advanced basic life support includes opening the airway, artificial tion) and artificial circulation (chest compressions), this equire sophisticated equipment, but, dexterity and speed of euvers. life support). • The respiration (ventila procedure does not r execution of the man

• The VAS requires the improvement of techniques used in basic support in obtain ing vascular access route in the administration of fluids and drugs in cardiac m onitoring and the use of defibrillation. Necessary material in a PCR • Ambu mask; • Cannula guedell of different sizes; • Laryngoscope with blades of different sizes; • Laryngoscope unconventional; • Laryngoscope with articulated tip • Laryngoscope cable articulated • Optical Laryngoscopes;

• Magill forceps; • Wire guide; • endotracheal tube with cuff and without cuff, different numbering. Special material • Chest Compressor (rigid board) • Fan; • Cardiac monitor; • Defibrillator. • Ventilation with Ambu • • • • • • • AMOUNT OF OXYGEN SUPPLIED IN MOUTH-MOUTH-A-16% OPEN AIRWAYS - FILL YOUR LUNGS PI NCE Nostrils - SELECTION WITH THE MOUTH inflated for 2 SECONDS (10 A 12-MINUTE B Y EVERY 1 4-5 SEC) TO OBSERVE THE chest elevated-SE (700 A 1000 ML) RISK: gastri c distension IN FIRST TIME, GIVE TWO BLOWERS O2 INCREASE USE IF POSSIBLE IF POSS IBLE AMBU • • • • • THE POINT IS IN COMPRESSION, brisket, LEAVING FREE TWO FINGERS UP THE JUNCTION O F LATEST RIBS Compress the chest 4-5 CM (60-80mmHg) THEN, LIGHTEN THE HAND COMPL ETELY WITHOUT LOSING TOUCH REPEAT X 100 PER MINUTE interspersed with BREATH: 15 X 2 (1 OR 2 rescuers) COMPRESSION THORACIC PRIMARY ASSESSMENT AND CPR CHECKING THE CONSCIOUSNESS OPENING AIRWAY CHECKING THE BREATHING SEE-HEAR-SENT CHECKING THE BREATHING SEE-HEAR-SENT INFLATION 2 X NOTING SIGNS OF CIRCULATION: RESPIRAÇÃOPULSO-COUGH-MOV 15 X 2 2 FINGERS UP THE AP. Xiphoid 2 breaths 15 compressions S AFTER 4 CYCLES NOTING SIGNS OF CIRCULATION: RESPIRAÇÃOPULSO-COUGH-MOV Complications rib fracture. rarely fractured sternum. Pneumothorax Hemothorax onary contusions of the liver and spleen lacerations Fat embolism pulm

Situations that allow the interruption of resuscitation: • When there is no restoring circulatory, usually after 30 minutes of CPR, excep t for hypothermia; • Other factors must be considered and / or circumstances for this decision, predi

ctive of successful CPR, ie: • Background and history provided, • Cause of arres t, arrest mechanism, • Place of occurrence, duration of symptoms, duration of re suscitation pre and hospital. Situations where there is no indication to start CPR maneuvers: • Under conditions of irreversible diseases; • In the condition where there are obvious signs of deterioration of organs, characterizing biological death. Care after cardiac arrest • After resuscitation, the patient needs a continuous observation and rigorous, especially in relation to heart function, kidney and brain. • These patients sho uld preferably be kept in ICU. Questions? Questions?