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In: Nursing

is patient with Vatch has chest pain, unresponsive and pulseless what can we administer to the...

is patient with Vatch has chest pain, unresponsive and pulseless what can we administer to the patient IMMEDIATLEY! I know there are multiple treatments but im thinking defibrillation and amiodarone IV push. not sure if anything else

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Expert Solution

Chest pain , unresponsive and pulseless:

These symptoms may occur either in Heart attack or Cardiac arrest.  

Heart attack: An acute Myocardial infraction , some times fatal, caused by the sudden occurance of Coronary Thrombosis , which obstructs the blood supply to the heart and leads to necrosis of the heart muscle tissue .

Cardiac arrest: Sudden and complete cessation of the heart beat resuling in the loss of effective circulation of the blood.

In the case of Cardiac arrest , The person may complain about chest pain, then they become unconscious or not responding to any environmental stimuli (unresponsive) , not movement and pulseless and a gradual breathlessness also may develop.

In heart attack patient may remain conscious. But often heart attack may lead to Cardiac arrest.  

Immediate treatment for Cardiac arrest:

* Chest compression with a Defibrillator

or

* Cardio pulmonary resuscitation : 100 to 120 compressions a minute

- Before iinitiating Chest compression, check for any Do Not Resuscitation order ( DNR)

- Provide supine position to the patient

- Push hard and fast with an outstretched arm, keep perpendicular and , at the center of the chest .

* Unresponsive patients with normal breathing should place in a recovery position

Other Interventions:

* Targeted Temperature management ( TTM) to maintain a cooling temperature constantly , usually at 36 degree Celsius. It helps to prevent fever also in patient with Cardiac arrest.

* Oxygenation : Avoid excessive ventilation but maintain SpO2 94%

* Treat hypotension by administering

- IV Bolus, Normal saline or Ringer Lactate

- I.V infusion of Epinephrine for vasoconstriction and heart contactility

- Dopamine infusion : to strengthen heart muscles and its pumping.

- Infusion of Nor epinephrine: To increase blood pressure by vasoconstriction.

Electrocardiogram, Capnography, Endo tracheal intubation are some of the procedures to detect abnormalities and to support the patient.  

( * Antiarrhyyhmic drugs : Amiodarone or lidocaine can be used during Ventricular fibrillation).

Nightingale answered 2 years ago
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