By Philip Jevon
Resuscitation provider : an outline -- Resuscitation apparatus -- attractiveness and remedy of the severely unwell sufferer -- ideas of cardiac tracking and ECG acceptance -- Bystander easy lifestyles aid -- Airway administration and air flow -- Defibrillation and electric cardioversion -- complicated existence aid -- Resuscitation in certain events -- Anaphylaxis -- Acute coronary syndromes -- administration of peri-arrest arrhythmias -- Post-resuscitation care -- Bereavement -- moral concerns in resuscitation -- Resuscitation documents -- Resuscitation education
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However, these clinical signs of deterioration are often subtle and can go unnoticed. It is therefore essential that tools, which reflect best evidence, are developed and available to aid the practitioner to identify signs of deterioration. Ultimately this may prevent adverse events and improve patient outcomes. , 2004). Their sensitivity, specificity and reliability to predict clinical outcomes have yet to be convincingly proven (Cutherbertson, 2003; Parr, 2004). , 2005). , 2005). Early warning scores Comprehensive Critical Care (Department of Health, 2000) recommended the widespread implementation of EWS systems and outreach services.
4 Chest percussion. 6. Sit the patient forward and then percuss the posterior chest wall, omitting the areas covered by the scapulae. Ask the patient to move his elbows forward across the front of his chest: this will rotate the scapulae anteriorly and out of the way (Talley & O’Connor, 2001). It may be helpful to offer the patient a pillow to lean on 7. Again percuss from side to side, top to bottom, comparing both sides and looking for asymmetry. , 2003) 8. , 2005): • Resonant: air-filled lung • Dull: liver, spleen, heart, lung consolidation/collapse • Stony dull: pleural effusion/thickening 38 Advanced Cardiac Life Support: A Guide for Nurses Fig.
Resuscitation Council (UK), London. Rich K (1999) In-hospital cardiac arrest: pre-event variables and nursing response. Clinical Nurse Specialist 147–53. Schein RMH, Hazday N, Pena M et al. (1990) Clinical antecedents to inhospital cardiac arrest. Chest 98:1388–92. 46 Advanced Cardiac Life Support: A Guide for Nurses Sharpley JT, Holden JC (2004) Introducing and early warning scoring system in a district general hospital. Nursing in Critical Care 9(3): 98–103. Smith AF, Wood J (1998) Can some in-hospital cardio-respiratory arrests be prevented?