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Australian Ambulance Services

Australian Ambulance Services

 

 

 

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Australian Ambulance Services

Cardio-respiratory arrest clinical practice guidelines control the implementation of different nursing elements that are fundamental to the operation of a healthcare facility. Some of the common clinical management guidelines include general care, adult cardiac arrest, and respiratory distress and chest injuries among others. In particular, the paper will focus on resuscitation. Resuscitation guidelines are designed to ensure that processes such as ventilation, defibrillation, compression, and fluid therapy occur safely and quickly. The successive sections of the paper seek to analyze the key aspect of defibrillation in resuscitation. It will also address the role played by defibrillation in the guidelines. The case study for this paper is Ambulance Service Australia, one of the key ambulance services that operate within Australia.

Defibrillation refers to the process of administering resuscitation to a patient by delivering an electronic shock to the heart using a unique device. The defibrillator works by restoring regular contraction patterns within a heart that displays asymmetrical trends or in an individual with a heart attack. By introducing a massive electrical charge into the heart muscle, it depolarizes the muscle and stops the irregularity. This restores normalcy in the heartbeat rhythm. The method of operation for defibrillators differs depending on several aspects: cost, patient condition, as well as efficiency. Consequently, they can be implanted, external or transvenous. Advanced versions of the device called automated external defibrillators can be used by ordinary people with little or no training in nursing. Maintaining regular chest compressions in the process of administering CPR is one of the basic operations that should be administered in a professional way. The window of handling a heart attack is very small and therefore, it is necessary for a clinician or nurse to act rapidly. Chest compressions are a particularly vital section of CPR since they affect perfusion and this makes them a high priority as well as a first step when handling cardiac arrest.

Another major aspect of CPR is compression depth. The depth of compression contributes greatly towards providing high-quality CPR. Nearly all medical practitioners and nurses are aware that applying too much pressure on the chest seriously affects survival rates. Additionally, achieving a successful defibrillation requires increased compression depth. It also extends the duration when a fibrillating heart can respond to defibrillation. Clinicians are advised to let the chest completely draw back during compressions as this permits the heart to refill with blood. Hand placement is another significant aspect of CPR that determines the success of the efforts of nurses during an emergency. Chest compressions account for numerous numbers of patients in heart arrest as they produce a little but critical volume of blood surge to the brain and heart. This is realized through direct cardiac massage in addition to a thoracic pump device. In order to maximize blood flow, exceptional chest compression method is critical. Consequently, the excellence of the administered chest compressions is an essential determinant of effective resuscitation. If a patient displays insensitivity without a specific pulse or ordinary breathing, then the clinician should suppose that the patient is undergoing a heart attack, set in motion the emergency reaction system, and instantly begin chest compressions. Hand placement involves locating the sternum as well as other chest bones and muscles and applying the right pressure and skill to change the rhythm of a heartbeat. It requires numerous efforts and experiences with several patients before a nurse can grasp the hand placement techniques. The following section outlines the literature review material that involves published scholarly materials. The objective of the succeeding section is to describe the various journals and content that serve to refine the discussion on resuscitation and defibrillation.

Literature Review

Many researches over the last years have studied controlled preliminary defibrillation to administer CPR, as it has been linked to heightened rates of reinstallation of impulsive circulation or continued existence. For the last five years, several studies have investigated these processes. The goal of this particular research was to take on a literature review analyzing the progress of CPR before defibrillation in contexts outside the hospital.

Cardiopulmonary resuscitation (CPR) comprises of interventions administered in an attempt to restore a person’s heartbeat. In the current age, CPR initiatives do not conclude with restitution of impulsive circulation but also integrate endeavors to protect function of fundamental organs. The action of resuscitation is recognized as being an enormously traumatic experience for health experts. Resuscitation is a multifaceted subject that demands a multidisciplinary strategy and successful communication and teamwork in order to realize its objectives (Moule, & Albarran 2005, 45). During CPR, the major function of the multidisciplinary team is assumed by the nursing and medical personnel, as the rest provide support only when requested. Consequently, it is necessary for teams to display useful communication and expert capability. Nurses are commonly the first people to react to a cardiac attack and commence fundamental life assistance while waiting for the superior cardiac life assistance team to reach the facility.

CPR is administered for all heart attacks except where a “Do Not Resuscitate” (DNR) or “do not attempt resuscitation” directive has been awarded for a specific patient. Even though a heart attack may happen in all wards and departments in a hospital setting, they are most popular in sectors such as the Coronary Care Unit (CCU), the Accident and Emergency Department (ED), and the Intensive Care Unit (ICU). Clinicians who work in the cardiac section are more regularly concerned with CPR compared to other units because of to the significance of the unit’s interest. Nurses are deemed the essential people in the achievement of the complete system of coronary medicine. When unexpected death happens, CPR is the final alternative for existence, and entails chest compressions and ventilation of the patient that upholds circulation pending normal ventilation and circulation has been brought back through definitive healing. The essential skills for carrying out CPR are instructed during the duration of nursing schooling, both hypothetically and practically (Ornato, & Peberdy 2005, 59). It has been realized that education in medical schools is frequently unproductive in generating specialists with the capability of performing high quality CPR. Consequently, the prerequisites for the CCU personnel are greatly influenced by CPR guidelines.

Over the years, with the amendment of CPR guidelines, the functions of the multidisciplinary team personnel are constantly subjected to change. Elements, such as enhancement in nursing education, augmented needs for qualified nurses because of the demands of specialized areas in medicine, and an enhanced identified in the independence of the nursing position have contributed to a transformation in nurses’ duties during CPR (Thygerson & Gulli 2005, 187). Consequently, the conventional roles of nurses during CPR that kept them responsible for restricted duties, for instance, preparing the medicine ordered and evaluating the patients’ vital indicators have changed; therefore, the nurse has developed into a more dynamic member of the multidisciplinary group. Both nurses and physicians play significant roles in deliberating do-not-attempt resuscitation (DNAR) directives with surrogates and patients (Baker, & Grantham 2009, 67). Even though nurses are secluded from the consultation process, several nursing elements sustain the participation of nurses in CPR making decisions. However, because of lengthy working hours, nurses work in close contact with long- term care patients, and in the process, collect a massive experience considering nursing skills and techniques. They are normally the first personnel to respond in the event of an in-hospital cardiac arrest. Therefore, they are the ones to decide whether to administer CPR or hold back from giving it. Therefore, nurses as well as other medical staff need to be fully aware of the benefits and settings of administering CPR as well as using defibrillators. Ambulance Service Australia

Conclusion

Administering CPR is perhaps one of the basic techniques that all nurses and physicians learn while in medical schools. Defibrillators play a major role in saving patients with heart problems especially those suffering from cardiac arrest. All these processes involving cardiac conditions are controlled by clinical management guidelines (Koike, Tanabe & Ogawa 2011, 34). In particular, ambulance services such as Ambulance Service Australia operate using these guidelines while handling patients that display heart complications. Resuscitation in itself entails several other sub-sections such as hand placement, rate, ratios, and other compressions. Understanding the most appropriate way of implementing resuscitation methods such as CPR and defibrillation is an important skill particularly for nurses and clinicians (Paradis 2007, 34). The case study of an Australian ambulance service revealed that staff in the particular agency had insufficient knowledge on the best way to administer resuscitation techniques.

 

References

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Baker, P, W, & Grantham, H, J, M 2009, Resuscitation of patients in ventricular fibrillation from the perspective of emergency medical services, New York: Nova Science Publishers.

Koike, S, Tanabe, S, Ogawa, T, Akahane, M,, Yasunaga, H,, Horiguchi, H,, Matsumoto, S, Imamura, T 2011, Immediate defibrillation or defibrillation after cardiopulmonary resuscitation, Pre-Hospital Emergency Care.

Moule, P, & Albarran, J, W 2005, Practical resuscitation: Recognition and response, Oxford, UK: Blackwell Pub.

Ornato, J, P, & Peberdy, M, A 2005, Cardiopulmonary resuscitation, Totowa, N.J: Humana Press.

Paradis, N, A 2007, Cardiac arrest: The science and practice of resuscitation medicine, Cambridge, UK: Cambridge University Press.

Thygerson, A, L, Gulli, B, American Academy of Orthopaedic Surgeons, American College of Emergency Physicians, & National Safety Council 2005, AED: Automated external defibrillation, Sudbury, Mass: Jones and Bartlett.

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