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The Steps of Customizing Verification Of Clinical Competencies For Critical Care Nursing Skill Identifier Si 8a Da Form 7653 Apr 2009 Apd Army on Mobile

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How to leverage The Verification Of Clinical Competencies For Critical Care Nursing Skill Identifier Si 8a Da Form 7653 Apr 2009 Apd Army ?

[Music].when the heart is beating in a.non-perfusing rhythm.such as ventricular tachycardia bt.or ventricular fibrillation vf.a defibrillator is used to shock the.heart back into a perfusing rhythm.the electrical shock of defibrillation.is commonly delivered through an.external defibrillator or automated.external defibrillator device.aed via adhesive pads applied to the.patient's chest.for an adult the preferred pad position.is the anterior lateral placement for.the aed.and manual defibrillator the anterior.posterior pad placement can also be used.with either device.with the aed pad placement may also.include the anterior left infrascapular.and anterior right infrascapular.locations.the anterior lateral or anterior.posterior pad placement is preferred for.pediatric patients.defibrillation briefly terminates.electrical activity in the heart.using monophasic single directional.current or biphasic.two directional current once the.defibrillation has disrupted the heart's.electrical activity.the normal cardiac pacemakers should.initiate the return of a spontaneous.organized perfusing cardiac rhythm.establish unresponsiveness and the.absence of respirations.by tapping on and shouting at the.patient while looking for chest rise and.fall.and signs of poor perfusion.immediately activate the code team or.the ems.tell healthcare team members to bring.the automated external defibrillator.aed and emergency cart to the bedside.ask healthcare team members to move the.patient's roommate away from the code.scene if possible.instruct healthcare team members to.remove excess furniture or equipment.from the room.check the patient's pulse for no longer.than 10 seconds.if it is present provide rescue.breathing deliver one breath.every 6 seconds 10 breaths per minute.and recheck the patient's pulse.every two minutes if the pulse is absent.begin.cpr if possible.place the patient on a hard flat surface.such as the floor.ground or a backboard ensure that the.patient is lying flat.perform chest compressions compressing.the chest at least.five centimeters two inches but no more.than six centimeters.2.4 inches maintain continuous chest.compressions at a rate between 100 and.120 per minute.allow full recoil of chest after each.compression.do not lean on the chest after each.compression.limit interruptions in chest.compressions to less than 10 seconds.after 30 chest compressions open the.patient's airway.ensure that the tongue the most common.cause of a blocked airway in an.unresponsive patient.is not obstructing the airway.depending on whether trauma is suspected.use the appropriate method to open the.airway.head tilt chin lift no trauma.jaw thrust without head extension.cervical trauma suspected.ventilate the patient at a ratio of 30.compressions to two breaths.deliver each breath over one second.watching for chest rise and fall.using one of the following methods for.one rescuer cpr.mouth to mouth method with a barrier.device for one rescuer cpr.mouse to mask method with a pocket mask.or cpr mask.for two rescuer cpr bag mask device.one rescuer opens the airway and seals.the mask to the patient's face.while the other rescuer squeezes the bag.attach the mouth to mask device or bag.mask device to a supplemental oxygen.supply if available.if the patient cannot be ventilated.insert an oral airway.apply the aed and follow the.manufacturer's instructions.when instructed by the aed verbal prompt.stop compressions for aed rhythm.analysis.if the aed advises a shock do not touch.the patient.press the shock button when prompted.resume cpr for two minutes immediately.after a shock is delivered or.the aed provides a no shock prompt leave.the aed.turned on and the pads attached it will.continue to analyze every two minutes.and provide a shock or.no shock prompt if the aed fails to.analyze or function properly.immediately resume cpr.continue cycles of 30 compressions to.two breaths.until a member of the code team takes.over or the patient starts to move.groan or cough upon arrival of the code.team.do the following provide the code team.leader with a brief.verbal report of events just before the.code including vital signs.medical diagnosis and code interventions.performed before the code team's arrival.have a healthcare team member bring the.patient's chart to the bedside or access.the patient's electronic chart.follow the directions of the code team.leader the code team leader will direct.the resuscitation.and delegate tasks as appropriate.depending on the organization's practice.the code team members continue the.resuscitative efforts.while healthcare team members assist as.needed.nurse or respiratory therapist manages.the patient's airway at the head of the.bed.the nurse or pharmacist assists with.obtaining preparing and administering.medications.monitors the patient's vital signs and.assists with procedures.such as obtaining iv access.the primary nurse assigned to the.patient or a designee and the pastoral.care provider.communicate with the family in the.patient's room or in the waiting area.a health care team member obtained.supplies from the emergency cart to hand.off to code team members.designated code team member documents.the events of the code healthcare team.members.and co-team members continue cpr.alternating.every two minutes when performing chest.compressions.the airway expert intubates the.patient's airway if ventilations are.inadequate.if respirations are absent and.ventilations are inadequate.assist the airway expert with.endotracheal et intubation as needed.have available laryngoscope handle.curved and straight blades.et tubes a stylet suction and tape or.an et tube holder ensure that the light.source on the laryngoscope is functional.the airway expert confirms airway.placement and ventilation.assist with confirming et tube placement.as needed by auscultating the epigastric.area.for a lack of breath sounds and then the.lungs for bilateral breath sounds.intubation personnel usually perform.secondary conformation.using a carbon dioxide detector.continuous waveform capnography.or ultrasound.after intubation assist with ventilation.and chest compression as needed.ventilate the lungs using a manual.resuscitation bag.at a rate of one breath every six.seconds ten breaths per minute.while continuous chest compressions are.performed.assist with defibrillation as needed.connect patient to a manual.defibrillator or.convert the aed into a manual.defibrillator.to assess the rhythm and allow manual.defibrillation.if using defibrillator paddles apply the.electrocardiogram.ecg electrodes and connect the ecg.monitoring lead wires from the.defibrillator to the patient.if aed pads are compatible with the.manual defibrillator.connect the aed pads to the manual.defibrillator.apply self-adhesive defibrillator pads.to the patient.in the appropriate locations per the.manufacturer's instructions.avoid placing pads over lead wires or.transdermal medication patches.if the cardiac rhythm is shockable.assist the code team with manual.defibrillation.if using defibrillator paddles place gel.pads.on the patient's right upper mid.clavicular and left.lower mid axillary chest wall and place.the paddles on the gel pads.if gel pads are not available use.conductive gel.a coat team member charges the.defibrillator to the appropriate energy.level.and discharges the device after.announcing clear.assist with establishing iv access as.needed with the largest possible iv.catheter and begin infusion of normal.saline solution.or lactated ringer solution.place the adult patient in the recovery.position when he or she is breathing.normally and has effective circulation.

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