The Journal of cardiovascular nursing
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Maintaining adequate oxygenation to promote vital organ functions represents a common challenge for the critical care nurse. Critically ill patients with impaired cardiac function may be particularly vulnerable to tissue oxygen deprivation because they have limited ability to increase oxygen delivery when oxygen demands increase. ⋯ Interventions that enhance patient tolerance to nursing procedures by supporting the balance between oxygen supply and demand promote physiologic adaptation and may prevent complications associated with hypoxia such as cardiac dysrhythmias, hypotension, and cardiac arrest. This discussion will focus on the principles of tissue oxygenation, the effects of nursing interventions on oxygen demand, and interventions that may enhance patient tolerance to routine nursing interventions.
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Recovery from nontraumatic cardiac arrest depends on the presence of all the elements in the chain of survival. Early defibrillation is critical because ventricular fibrillation is the most common initial dysrhythmia of sudden cardiac arrest, defibrillation is the only treatment, and survival from ventricular fibrillation is determined by time. Out-of-hospital studies have demonstrated that defibrillation provided by first responders improves survival. ⋯ Improvement in in-hospital survival rates from cardiac arrest is not as evident as in the emergency medical services community. Medical centers need to assess response times to cardiac arrest and implement AED programs. All nurses should learn to use an AED as part of basic life support training.
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The author presents an overview of basic life support for pediatric and adult victims of prehospital cardiac arrest. Current guidelines regarding the practice of basic life support are included, with emphasis on controversial or unresolved aspects of basic life support and lay rescuer cardiopulmonary resuscitation. This article concludes with a list of recommended questions for research activities.
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Developing and revising the American Heart Association guidelines for advanced cardiac life support.
Cardiovascular nurses are active participants in implementing emergency cardiac care (ECC) guidelines as advanced cardiac life support (ACLS) providers and instructors. Cardiovascular nurses should play a key role in the ECC guidelines revision process. The article discusses the process of the most recent ECC guideline developments and revisions and describes subsequent changes to ACLs protocols.
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The purpose of this research utilization article is to familiarize cardiovascular nurses with the Brain Resuscitation Clinical Trials (BRCTs) I and II and discuss the application of these trials to nursing practice. The BRCTs are a series of studies that examine the effects of selected interventions on neurologic outcome after cardiac arrest.