unknown (complex clinical incident discussion and reflection)

Arresting Cardiac Arrest

in Medical-Surgical Units

Introduction

A recent assignment to the Medical-Surgical Unit provided for a rewarding learning experience in the practice of rapid response in in-hospital cardiac arrest situations . The patient was brought into the Medical-Surgical Unit from the Operating Room . The vital signs of the patient were stable until arrival to the unit . Within a few minutes in the unit the patient began to complain of intense chest pains . The patient rated the intensity of the chest pains at 8 , from a scale of 1 to 10

, with 10 ' being the strongest . The patient also began complaining of difficulty in breathing and was increasingly getting agitated . The vital signs were once again evaluated . Heart rate was 130-150 beats /minute . Blood pressure was 150 /90 . Through this thorough and careful monitoring and evaluation of the patient (Mimick and Harvey 2003 , it was determined that the patient was very close to a full blown cardiac arrest . The bedside nurse was quick to alert the Rapid Response Team who arrived at the unit within 5 minutes (Lippincott , Williams and Wilkins 2007 . The team proceeded to reconfirm the vitals that were recorded . It was concluded that the cardiac arrest may be averted through the administration of medication that stabilize the patient within minutes . The Rapid Response Team would have not been able to prevent the complete onset of the cardiac arrest if not for the vigilance of the bedside nurse . This case was easily averted because the conditions were deemed linear (Mimick and Harvey 2003 . This only means the conditions of this case pointed to the obvious . However , in many instances , conditions remain ambiguous , particularly in the Medical-Surgical Unit , where patients are unable to articulate their conditions accurately . The nurses in this unit are left to assess the situation precisely to be able to provide care for patients before and after surgery (Medical-Surgical Nursing This reaction is meant to discuss and explain the importance of having the appropriate skills to identify subtle changes signaling deterioration in condition , particularly in the onset of cardiac arrest in Medical-Surgical patients . It is also meant to enumerate the lessons learned in having the opportunity to witness such an incident during nursing practice

Identifying Subtle Changes in Patient 's Condition

There are several important points to consider in assessing the onset of cardiac arrest (LeMone and Burke 2007 . The bedside nurse should have the right skills to identify even the most insignificant change in a patient 's condition . These skills are vital in to accurately intervene before a situation becomes irreversible (White 2005 . Almost half of all in-hospital cardiac arrests are reversible if only symptoms and signs are properly detected . Some signs are evident as early as 6-24 hours before the actual arrest (Fincher 2007

The Australian Nursing and Midwifery Council , established in 1992 (ANMC , provides the guidelines to proper intervention of nurses in cases when prompt assessment of a precipitating condition is required Particularly in Medical-Surgical Units , nurses have to play an important...