C132 Effective Communication Task 1 Essay

hypertension. Therapeutic hypothermia (THT) has been considered an effective method for reducing ischemic injury of the brain due to cardiac arrest. But there are some opponents in the medical community who believe that broadening the scope of THT could be dangerous to patients. Although opponents do not seem to blame THT for adverse patient outcomes; the disagreement seems to be about the variables involved before hospital arrival, amount of time that it takes to administer THT in the ER, which therapies should be administered with THT and the need for more research that tracks adverse events. A study published by The American Journal of Emergency Medicine supports the widely held view that THT is an effective treatment for cardiac arrest

Markus Thalmann, the cardiac surgeon who saved the little girl from death by drowning in icy water, said that she was not the first hypothermia and suffocation case. However, she was the first one to survive. In her complicated rescue they tried to follow a checklist that stats that in such a case, a rescue team was required to tell the hospital to prepare for possible cardiac bypass and rewarming. So, what was so effective about this approach is that by the time the patient gets to the hospital, everything is ready and standing by. These kinds of cases are time sensitive. In such complicated cases, success requires having a huge number of equipment and people at the ready. So, even small simple checklist could help in complicated rescues and even bring people to life

Patient complained of being cold due to constriction of vessels and decreased blood supply. Therefore, Keep the patient warm in order to help dilate vessels and bring more blood supply with it.

In this article published in the journal Dyanmics, also known as the journal for the Canadian Association of Critical Care Nurses, the authors review a retrospective cohort regarding the barriers for time to target temperature management in cardiac arrest patients who are treated with therapeutic hypothermia. The article authored by a both registerd nurses and medical doctors open by reviewing the benefits of therapeutic hypothermia. The article reviews two randomized controlled trials that showed that therapeutic hypothermia when compared to no intervention correlated with improved neurological survival in patients after cardiac arrest. Therapeutic hypothermia has a direct relation to patient survival with intact neurologic function; however

Once the patient was wheeled into the operating room he was disoriented and confused. He had recently suffered a CVA (cerebrovascular accident) and was suspected to have suffered a stroke before his admission into Deaconess. He was also Hypoxic, which means regions of his body had been deprived of oxygen. The nurses then began to restrain the patient’s legs and arms, but due to the patient’s confusion a nurse had to verbally calm the him down. Following that, the patient was given lidocaine to numb him.

The European study followed 275 patients who suffered cardiac arrest due to VF. It compared the outcomes of patients being treated with mild hypothermia to standard normothermia (Holzer & Behringer, 2005). Patients in the hypothermia group were cooled to 32-34 °C over a median time of 105 minutes, and temperature was maintained for 24 hours (Lee & Asare, 2010). A favorable neurological outcome was seen in 55% of the hypothermia group compared to 39% of the normothermia group. Additionally, mortality in 6 months was 41% in the hypothermia group compared to 55% in the normothermia group (Lee & Asare,

Hypothermia is not a widely used treatment due to risk for complications associated with hypothermia such as pneumonia, seizures and infection.

Hinkle, Janice L., Kerry Cheever. Hinkle & Cheever: Brunner & Suddarth's Textbook of Medical-Surgical Nursing, 13th Edition. CoursePoint, 11/2013. VitalBook file.

Hypothermia protocol for the post cardiac arrest patient has been an evidence based practice of this therapy for about a decade now. This intervention, often used in the critical care setting, is now expanding to primary emergency responders as well. This paper will present some of the notable research that has been done on therapeutic hypothermia, and current use of this intervention.

According to the Association of Perioperative Registered Nurses (AORN, ) the perioperative RN, Operating Nurse or Nurse Circulator is the main patient advocate in the operating room and takes responsibility of all aspects of the patient’s condition and care. The role is very vital as this nurse’s duty is to ensure timely delivery of quality surgical care so that there are optimal outcomes achieved for each surgical patient. As the patient’s advocate, the perioperative nurse is medically trained to serve as the patient’s primary spokesperson. The perioperative nurse must communicate the needs of the patients especially while the patient is aware and sedated. The perioperative nurse pays close attention to the patient’s condition before, during

Intraoperative hypothermia has been associated with various adverse effects and is said to be preceding increased in-hospital morbidity and length of stay:

The second RCT, by Nielsen, et al. (2013), challenged the depth of TH needed for neurologic protection. The trial authors found no benefit of cooling unconscious OHCA patients to 33°C compared to cooling to 36°C at either hospital discharge or 180-day follow up. There was no harm established in cooling to 33°C, but none of the point estimates favored the 33°C group (Neilsen, et al., 2013). The TTM study was a landmark point in the TH literature. When it was published, the TTM study represented the largest study to date on the benefits of TH. It also provided insight into different TTM protocols. While the conclusions drawn were somewhat controversial at the time, the authors maintained that their study should not be interpreted to conclude that TH should be abandoned (Perchiazzi, et al., 2014).

Treatment of hypothermia focuses on managing and maintaining ABCs, rewarming the patient, correcting dehydration and acidosis, and treating cardiac dysrhythmias.

Depending on the situation, the nurse must recognize the signs and symptoms in order to respond appropriately. But essentially, the goal for ventricular fibrillation is to restore blood flow throughout the body as quickly as possible to prevent damage to the client’s brain and other organs. Therefore, immediate CPR and defibrillation is necessary for the client. And if the CPR is successful, nurse must follow the Current resuscitation guidelines recommend inducing mild hypothermia in comatose adults who experience cardiac arrest. Hypothermia is defined as a core body temperature of 32°C to 34°C (89.6°F to 93.2°F) (Morrison et al., 2010). Induction should be started as soon as possible after circulation is restored, preferably within 60 minutes, and maintained for 12 to 24 hours (Morrison et al., 2010). The nurse must initiate the application of ice packs in the axilla and groin as well as administration of iced normal saline or lactated ringer’s IV fluids 30 mL/kg until hypothermia is

From the birth of the recovery room in the 1940s to the postanesthesia care unit (PACU) of the 21th century, the look and function of this unit have been in a constant state of evolution. Throughout the six past decades, surgical procedures have become more extensive and complicated and thus require more specially prepared nursing staff and equipment for the care of the patient (Odom-Forren, 2013). The PACU of today is an intensive care specialty that provides care to wide range surgical patients. Many of these patients have more than one chronic condition, such as chronic obstructive pulmonary disease, diabetes mellitus, chronic pain, and chronic heart problems. In order to provide safe patient care, the PACU nurse needs to develop the ability to blend expert clinical knowledge that is based on experience, education, and collegial sharing with caring practices that comes from within and from being a nurse (Odom-Forren, 2013).