Angelite Nurses: Cardiac Arrest

Cardiac Arrest

General information: sudden, unexpected cessation of breathing and adequate circulation of blood by the heart
Medical management

Cardiopulmonary resuscitation (CPR); see below
Drug therapy

Lidocaine, procainamide, verapamil
Dopamine (Intropin), isoproterenol (Isuprel), norepinephrine (Levophed): see also Drugs Used to Treat Shock, Table 4.9
Epinephrine to enhance myocardial automaticity, excitability, conductivity, and contractility
Atropine sulfate to reduce vagus nerve's control over the heart, thus increasing the heart rate
Sodium bicarbonate: administered during first few moments of a cardiac arrest to correct respiratory and metabolic acidosis
Calcium chloride: calcium ions help the heart beat more effectively by enhancing the myocardium's contractile force

Defibrillation (electrical countershock)

Assessment findings: unresponsiveness, cessation of respiration, pallor, cyanosis, absence of heart sounds/blood pressure/palpable pulses, dilation of pupils, ventricular fibrillation (if client on a monitor)
Nursing interventions: monitored arrest caused by ventricular fibrillation

Begin precordial thump and, if successful, administer lidocaine.
If unsuccessful, defibrillation.
If defibrillation unsuccessful, initiate CPR immediately.
Assist with administration of and monitor effects of additional emergency drugs.

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