GENERAL PROCEDURES AND TREATMENT MODALITIES

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PROCEDURE GUIDELINES 10-21 CONTINUED

Nursing Action

Using a manual resuscitation bag, with mask (left) or connected to an artificial airway (right).

NURSING ALERT
Ensure that good seal is maintained between face and mask so volume delivered
through compression of bag is not lost.

Cardiopulmonary Arrest
1. If respirations are absent after the airway 1. The airway helps prevent obstruction from
is open, insert an oropharyngeal airway prolapse of the tongue in an unconscious
and ventilate twice with slow, full breaths patient. If ventilation is difficult, confirm
of 1 to 1.5 seconds each. Allow 2 seconds that airway is unobstructed.
between breaths.
NURSING ALERT
Airways are not appropriate in a conscious patient or patients with a gag reflex
because stimulation of the oropharynx could cause vomiting and aspiration. Short
nasal pumps can be used in conscious patients with a gag reflex.

2. Breaths will have to be quickly interposed
between cardiac compressions. If the
patient needs only respiratory assistance,
watch for chest expansion and listen with
the stethoscope to ensure adequate
ventilation.
3. A rate of approximately 12 to 15 breaths
per minute is used unless the patient is
being given external cardiac
compressions.
Preoxygenation and Suctioning
1. If hyperinflation is being used with
suctioning, ventilate the patient before
and after each suctioning pass (including
after the last suction pass).
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2. Squeeze resuscitation bag with sufficient
force and at the rate necessary to
maintain adequate minute ventilation.
3. Continue squeezing bag at appropriate
interval until CPR is no longer required.
1. Hyperinflation before suctioning helps
prevent hypoxemia. Hyperinflation after
suctioning replaces O2 removed during the
procedure and helps to prevent
atelectasis. The larger tidal volumes may
also assist in mobilizing secretions and
promote surfactant secretion.