Cardiac arrest refers to the sudden loss of heart function due to a fault in the transmission system electric. This interrupts the pumping mechanism of the heart and as a result the body is deprived of blood and oxygen. This condition is usually accompanied by stopping breathing and loss of consciousness. This is an extremely deadly situation with a very high mortality rate. In Australia, for example, only 10% of the approximately 20,000 people who suffer cardiac arrest each year survive. This is what a study conducted by the Victor Chong Cardiac Research Institute reveals. To avoid death and increased morbidity, immediate and appropriate emergency care is essential. Appropriate and timely cardiopulmonary resuscitation, including rapid defibrillation and quality post-arrest care, leads to higher survival rates and better neuronal outcomes. I watched the video on YouTube and compared the resuscitation performed to the ANZCOR guidelines as covered in our courses. Obviously, the team had several strengths and weaknesses. In this article, I will explore their practice based on standard guidelines and existing research. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get an original essay The video begins with a nurse entering a room to administer medication to a patient. She calls him and as she approaches, she discovers that the patient does not answer. She calls him again and says he's not breathing. She further stimulates the patient by touching them to ensure that they are unconscious and not just sleeping. Possible dangers are addressed as she examines the patient to determine any obvious cause of unconsciousness. According to the 2016 ANZCOR Basic Life Support Guidelines, she took the first steps by assessing the immediate danger to the patient and confirming their unconscious state (Grantham and Christiansen, 2016). The first error occurs when the nurse determines whether the patient is breathing instead of calling for help first. According to national guidelines, calling for help is considered paramount, among both trained and untrained personnel, before initiating CPR. This is because exercise involves many activities that cannot be carried out effectively by a single individual. Nehme and Andrew conducted a study and found that outcomes were improved when the first person on the scene called for help without delay. The nurse does not check the airway before assessing breathing. She should have checked for solids in the mouth or visible secretions, removed them, and then proceeded to open the airway using the chin lift with head tilt maneuver. According to Newel, this simple maneuver can make the airway patent again and help clear any obstacles present. This also facilitates the return of natural circulation. After opening the airway, a respiratory assessment should follow. The nurse uses the wrong technique to check breathing. She simply looks at him and touches his neck before concluding that he is not breathing. Unlike what she did, one must observe, listen and palpate respiratory signs as recommended by Kaihula and Sawe (Kaihula et al., 2018). This is usually done with the ear closer to the nose and the eyes looking at the chest to see the chest rise. It should be noted that panting and labored breathing should not be considered breathingeffective. These are present in patients still in the initial stages of cardiac arrest. In the absence of normal breathing, cardiopulmonary resuscitation should begin immediately. Unfortunately, in the video, the first nurse goes to get her team instead of starting the proper procedures. After they arrive, one of the nurses checks the radial pulse while another takes the BVM and gives six breaths before taking a break. They do not perform chest compressions at any time during their resuscitation attempt. The recommended approach to CPR is to initiate chest compressions and respirations at a ratio of 30:2 once respiratory failure has been established. According to recent protocols, checking the pulse is skipped. Indeed, studies by Johnson and Pearson found that it is difficult for both a layperson and a trained physician to confidently identify a pulse in the resuscitation process (Johnson et al., 2018). It is therefore recommended that rescuers perform chest compressions and rescue breaths rather than waste time looking for a pulse. Research has shown that chest compressions are the most important part of the CPR procedure. They mimic the pumping mechanism of the heart by increasing intrathoracic pressure, thereby pushing remaining oxygenated blood toward the tissues for oxygen delivery. Effective compressions are performed with the rescuer on the patient's right side (if right-handed) and the compressing hands on the sternum, preferably in the middle of the nipple line. They should be hard and fast with the aim of 100 to 120 compressions per minute but allowing the chest wall to move back before performing successive compressions. The depth of compressions should be at least 2 inches with minimal interruptions (Ewy, 2016). Every 30 compressions, two breaths should be administered by another member of the team using bag-valve-mask equipment. The adequacy of ventilation should be assessed by looking for the rise of the chest when air is pumped. If no ascent occurs, airway patency should be reassessed. This compression breathing cycle should continue with minimal interruptions and a maximum duration of no more than 10 seconds. I noted that this particular team relies primarily on defibrillation for patient resuscitation. As soon as they arrive, one of them brings the machine and they immediately analyze the rhythm. Ideally, defibrillation comes into play after the first cycle of CPR. Compressions are stopped and pads placed on the chest to analyze the heart rhythm as recommended by the latest guidelines. In this case, it happened after the first six breaths. However, they correctly analyzed the rhythm and identified the appropriate moment for a shock. They make another analysis and shock error a second and third time immediately after the first. The pads are taken back and then brought back after a brief moment of ineffective practice. The correct practice is that after the first defibrillation, CPR should continue for another two minutes before repeating the scan and shock. These should alternate until the patient recovers. There is also drug abuse in the video. An unknown quantity of epinephrine is administered after the fourth shock. This is bad timing according to national guidelines. Nolan states that the first dose of adrenaline should be administered after an initial successful defibrillation and a second round of CPR. The correct dose is 1 mg but the manager does not talk about it. If they had used adrenaline in such a wayconstant, the second dose should have been administered after two successful cycles of CPR. They also make the mistake of giving amiodarone immediately after the dose of adrenaline. Amiodarone is an acceptable medication in the resuscitation scenario. In fact, they gave the correct dose of 300 mg, approved by the European Resuscitation Council. Additionally, it is administered when the heart rhythm is shockable, as in this patient. However, they did not take into account that it is administered after three rounds of defibrillation with good CPR and not at the same time as adrenaline. However, the routes of administration were correct. The response team does not attempt to determine the probable cause of the patient's cardiac arrest. This is a protocol whereby the etiology of the arrest must be established in order to manage it and avoid future encounters. Jimenez says the first step should be to assess whether the reason for admission is the cause of the cardiac arrest, then other factors taken into account. Body temperature is checked to rule out hypothermia and a bedside blood sugar test is performed as hypoglycemia is a known culprit in arrest cases. Pulse oximetry should also be performed to ensure that the partial pressure of oxygen is above 90 and also analyze other gases in the arteries. Chest conditions that may trigger cardiac arrest in a patient are assessed by listening to the breathing sounds of the lungs and also observing the symmetry of the rise of the chest during ventilations. Naloxone, an opioid antagonist, is given to patients to reverse the disease in case it is caused by opioid toxins present in the body. Potassium imbalance should have been assessed by blood electrolyte analysis. Due to the poor quality of the intervention, the team does not have access to post-resuscitation care. The only thing I see them reassessing is the patient's pulse, which is absent at the end of the video. With effective CPR and defibrillation, a pulse is usually obtained after a certain number of cycles. Pulse adequacy is checked and further reassessment of airway and spontaneous breathing. In most cases, the patient is put on oxygen and transferred to the intensive care unit. Intensive care care for patients after cardiac arrest has been shown to significantly improve patient outcomes. In the ICU, the physiological state of the heart is monitored using a 12-lead electrocardiogram. Additionally, blood oxygen levels are maintained above 94% and constant monitoring of CO2 levels. Room temperature and blood sugar are also tightly regulated. There is a lack of leadership within the team, hence the disorder seen in the video. Team members do not have clearly defined roles on site. This causes some to stand idly by and hinder movement while other members work. In one case, two people want to perform defibrillation at the same time. There is poor communication in the team. This is seen when several people speak with a particularly anxious nurse, which disrupts everything. At one point, one of them decides to leave the scene before the patient is stabilized. No one keeps track of events and medications administered. This is a group of individuals who do not know their guidelines and have never participated in teambuilding exercises. Poor coordination of resuscitation increases the risk of deviating from standard guidelines and produces poor patient outcomes, as shown in the video. Keepkeep in mind: this is just a sample. Get a personalized article from our expert writers now. Get a Personalized Essay In conclusion, cardiopulmonary resuscitation is a life-saving practice when performed correctly. This applies to lay people as well as healthcare professionals in hospitals. This not only avoids death, but also avoids other conditions associated with lack of oxygen during the arrest period. Because of its importance, this practice should be regulated by guidelines that provide the best procedures on how to go about it. These procedures must be taught to the entire population and promoted to doctors for effective emergency care. Additionally, skills should be improved through simulations, leadership exercises and team building, as they positively influence the quality of resuscitation. References Abella, BS (2014). The importance of the quality of cardiopulmonary resuscitation. Current Opinion in Critical Care, 19(3), 175-180.Adamson, B. (2016). Sharing best practices: basic life support with defibrillators. British Journal of School Nursing, 11(2), 75-78. Ali, MU, Fitzpatrick-Lewis, D., Kenny, M., Raina, P., Atkins, DL, Soar, J., ... and Sherifali , D. (2018). Effectiveness of antiarrhythmic drugs in shockable cardiac arrest: a systematic review. Resuscitation. Council, AR and Council, NZR (2016). ANZCOR Guideline 7: Automated external defibrillation as part of basic critical care. Ewy, G.A. (2016). Chest compression only, cardiopulmonary resuscitation in case of primary cardiac arrest. Circulation, 134(10),695-697.Ho, AMH, Chung, DC, Mizubuti, GB and Wan, S. (2016). Cardiopulmonary resuscitation by chest compression only. Anesthesia and Analgesia, 123(5), 1330. Gough, CJ and Nolan, JP (2018). The role of adrenaline in cardiopulmonary resuscitation. Critical Care, 22(1), 139. Grantham, H. and Christiansen, R. (2016). Update on resuscitation for general practitioners. Australian Family Physician, 45(12), 879. Hörburger, D., Haslinger, J., Bickel, H., Graf, N., Schober, A., Testori, C., ... & Haugk, M. (2014). Where no guidelines have been conducted before: retrospective analysis of resuscitation in the 24th century. Resuscitation, 85(12), 1790-1794. Jiménez-Jáimez, J., Peinado, R., Grima, EZ, Segura, F., Moriña, P., Muñoz, JJS, ... & Monserrat, L. (2015). Diagnostic approach to unexplained cardiac arrest (from the FIVI-Gen study). The American journal of cardiology, 116(6), 894-899. Johnson, B., Runyon, M., Weekes, A., and Pearson, D. (2018). Team cardiopulmonary resuscitation: prehospital principles adapted to resuscitation in the event of cardiac arrest in the emergency room. The Journal of Emergency Medicine, 54(1), 54-63. Kaihula, WT, Sawe, HR, Runyon, MS, & Murray, BL (2018). Assessment of cardiopulmonary resuscitation knowledge and skills among health care providers at an urban tertiary referral hospital in Tanzania. BMC Health Services Research, 18(1), 935. Lee, SH, Kim, DH, Kang, TS, Kang, C., Jeong, JH, Kim, SC, & Kim, DS (2015). The uniform chest compression depth of 50 mm or more recommended by current guidelines is not suitable for all adults. The American Journal of Emergency Medicine, 33(8), 1037-1041. Leman, P. and Morley, P. (2016). Updated resuscitation guidelines for 2016: a summary of recommendations from the Australian and New Zealand Resuscitation Committee. Emergency Medicine Australasia, 28(4), 379-382.Levinson, M. and Mills, A. (2014). Cardiopulmonary resuscitation – time for a paradigm shift? Medical Journal of Australia, 201(3), 152-154.Li, C., Xu, J., Han, F., Walline, J., Zheng, L., Fu,, 6(3), 179.