Asunto(s)
Amiodarona/administración & dosificación , Antiarrítmicos/administración & dosificación , Paro Cardíaco/tratamiento farmacológico , Taquicardia Ventricular/tratamiento farmacológico , Fibrilación Ventricular/tratamiento farmacológico , Administración Intravenosa , Adulto , Enfermería de Urgencia , Paro Cardíaco/enfermería , Humanos , Infusiones Intraóseas , Guías de Práctica Clínica como Asunto , Taquicardia Ventricular/enfermería , Fibrilación Ventricular/enfermeríaRESUMEN
Although basic life support skills are not often needed in the surgical setting, it is crucial that surgical team members understand their roles and are ready to intervene swiftly and effectively if necessary. Ongoing education and training are key elements to equip surgical team members with the skills and knowledge they need to handle untimely and unexpected life-threatening scenarios in the perioperative setting. Regular emergency cardiopulmonary arrest skills education, including the use of checklists, and mock codes are ways to validate that team members understand their responsibilities and are competent to help if an arrest occurs in the OR. After a mock drill, a debriefing session can help team members discuss and critique their performances and improve their knowledge and mastery of skills.
Asunto(s)
Reanimación Cardiopulmonar/normas , Paro Cardíaco/enfermería , Paro Cardíaco/terapia , Enfermería de Quirófano/normas , Enfermería Perioperatoria/normas , Reanimación Cardiopulmonar/métodos , Lista de Verificación/métodos , Lista de Verificación/normas , Competencia Clínica/normas , Educación Continua en Enfermería , Electrocardiografía , Femenino , Paro Cardíaco/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Enfermería de Quirófano/métodos , Grupo de Atención al Paciente/normas , Enfermería Perioperatoria/métodos , Factores de Riesgo , Desarrollo de Personal/métodos , Taquicardia Ventricular/epidemiología , Taquicardia Ventricular/enfermería , Taquicardia Ventricular/terapia , Fibrilación Ventricular/epidemiología , Fibrilación Ventricular/enfermería , Fibrilación Ventricular/terapiaRESUMEN
O caso clínico sugere uma forma rara de canalopatia mista, cujo sintoma clínico e eletrocardiográfico indicava taquicardia ventricular polimórfica catecolaminérgica (TVPC). Porém, ao realizar o teste ergométrico, no pós-esforço, quando há predomínio do sistema nervoso parassimpático, nota-se a indução de eletrocardiograma (ECG) compatível com Brugada do tipo I. Outro aspecto importante foi a transmissão hereditária observada neste caso, em que os avós do paciente eram primos de primeiro grau e houve seis casos de morte súbita cardíaca (MSC) nas gerações subsequentes, com irmão que teve MSC aos 5 anos durante uma crise de choro, mostrando um importante fator genético e familiar relacionado às canalopatias.
The clinical case suggests a rare form of mixed channelopathy, whose clinical and electrocardiographic symptom suggested catecholaminergic polymorphic ventricular tachycardia (CPVT). However, when the exercise test was performed, during post-exercise, where there is a predominance of the parasympathetic nervous system, there was an electrocardiogram (ECG) induction compatible with Brugada type I. Another important aspect was the hereditary transmission observed in this patient, whose grandfathers were first cousins, and 6 cases of sudden cardiac death (SCD) were observed in subsequent generations and one brother had SCD at 5 years of age during a crying episode, showing an important genetic and familial factor related to channelopathies.
Asunto(s)
Humanos , Masculino , Adulto , Nadolol/administración & dosificación , Procainamida/administración & dosificación , Síndrome de Brugada/diagnóstico , Taquicardia Ventricular/enfermería , Canalopatías , Desfibriladores Implantables , Electrocardiografía , Muerte Súbita/prevención & controlRESUMEN
AIM: The study examines the experience of intensive care nurses in caring for patients in cardiac arrest, and their perceptions of introducing nurse-led defibrillation. METHOD: This was a descriptive, exploratory and qualitative study at an intensive care unit (ICU) of an acute regional hospital in Hong Kong. Twelve registered nurses were purposefully selected for interview. RESULTS: Although all the participants were trained in basic life support, only 50% were trained in advanced cardiac life support (ACLS), and those trained in ACLS described having limited opportunities to apply their defibrillation knowledge. Whilst participants believed that they were theoretically prepared to influence the patient's resuscitation outcomes, newly qualified nurses were reluctant to be accountable for defibrillation. In contrast, experienced nurses were more willing to perform nurse-led defibrillation. Support from management, cooperation between nurses and doctors, regular in-hospital 'real-drill' programmes, sponsorship for training, and the use of alternative defibrillation equipment should be considered to encourage nurse-led defibrillation in ICU settings. CONCLUSION: Nurse-led defibrillation is an approach of delivering prompt care to critically ill patients, and a way ahead for intensive care nursing in Hong Kong. Emphasis on a consistent policy to promote nurse-led defibrillation practice is needed.
Asunto(s)
Reanimación Cardiopulmonar/enfermería , Cardioversión Eléctrica/enfermería , Paro Cardíaco/enfermería , Unidades de Cuidados Intensivos , Adulto , Actitud del Personal de Salud , Competencia Clínica , Muerte Súbita Cardíaca/prevención & control , Paro Cardíaco/mortalidad , Humanos , Personal de Enfermería en Hospital/psicología , Taquicardia Ventricular/enfermería , Fibrilación Ventricular/enfermeríaRESUMEN
Ventricular tachycardia (VT) is a life-threatening cardiac dysrhythmia requiring emergency medical care. VT is readily recognized on the electrocardiogram. VT is usually caused by ischemic or structural heart disease, electrolyte disturbances, or the effects of drug therapy. Emergency treatment of VT follows the Advanced Cardiac Life Support (ACLS) algorithms for pulseless VT and stable and unstable VT with a pulse.
Asunto(s)
Tratamiento de Urgencia/normas , Taquicardia Ventricular/enfermería , Algoritmos , Electrocardiografía , Humanos , Evaluación en EnfermeríaRESUMEN
The ICD is a common therapy for treatment of ventricular arrhythmias and prevention of sudden cardiac death. After ICD therapy, 50% of survivors are known to have significantly elevated anxiety, depression, anger, and fear in getting back to normal physical activities. Despite these problems, few interventions to improve adjustment have been rigorously evaluated within a clinical trial format. This article reports the short-term efficacy of a structured weekly educational telephone intervention (8 weeks) delivered by expert cardiovascular nurses to recipients of an ICD. To test these effects, a two-group (n = 84/group) randomized clinical trial design was used with measures at baseline (hospital discharge), 1 month, and 3 months after ICD therapy. The study sample were first time ICD recipients for secondary prevention of sudden cardiac arrest. Primary outcomes included (1) physical functioning (Patient Concerns Assessment [PCA], Short-Form Health Survey [SF-12], ICD shocks), (2) psychological adjustment (State-Trait Anxiety Inventory [STAI]), Centers for Epidemiologic Studies-Depression (CES-D), (3) knowledge (Sudden Cardiac Arrest [SCA] knowledge assessment), and (4) health care use (emergency room visits, outpatient visits, hospitalizations). The intervention group, as compared to the control group, significantly reduced mean PCA symptoms at 1 month (11.3-8.8 vs 9.7-9.3, respectively, P < 0.02), and reduced state anxiety (36.1-31.9 vs 33.1-33.0, respectively, P < 0.08), and enhanced knowledge (21.8-22.4 vs 21.4-21.7, respectively, P < 0.02) at 3 months. The intervention did not significantly impact short-term health care use. A structured telephone intervention delivered during the first 8 weeks after ICD therapy by expert cardiovascular nurses decreased ICD related physical symptoms and anxiety, and increased SCA knowledge over 3 months.
Asunto(s)
Desfibriladores Implantables , Paro Cardíaco/enfermería , Enfermeras Clínicas , Educación del Paciente como Asunto/métodos , Taquicardia Ventricular/enfermería , Teléfono , Adaptación Psicológica , Anciano , Ansiedad/enfermería , Ansiedad/psicología , Muerte Súbita Cardíaca/prevención & control , Desfibriladores Implantables/psicología , Depresión/enfermería , Depresión/psicología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Conocimientos, Actitudes y Práctica en Salud , Paro Cardíaco/psicología , Hospitalización/estadística & datos numéricos , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Evaluación de Procesos y Resultados en Atención de Salud , Atención Primaria de Salud/estadística & datos numéricos , Autocuidado/psicología , Rol del Enfermo , Taquicardia Ventricular/psicología , Revisión de Utilización de RecursosAsunto(s)
Muerte Súbita Cardíaca/prevención & control , Desfibriladores , Primeros Auxilios/enfermería , Taquicardia Ventricular/enfermería , Fibrilación Ventricular/enfermería , Reanimación Cardiopulmonar/educación , Reanimación Cardiopulmonar/enfermería , Humanos , Pronóstico , Resultado del TratamientoRESUMEN
In the third and final paper in this series on the interpretation of electrocardiograms we look at ventricular and atrioventricular arrhythmias. This paper complements and builds upon cardiac rhythm recognition discussed in the two previous papers and presents some of the more life-threatening arrhythmias that nurses may come across in ward environments.
Asunto(s)
Electrocardiografía/métodos , Bloqueo Cardíaco/diagnóstico , Evaluación en Enfermería/métodos , Taquicardia Ventricular/diagnóstico , Complejos Prematuros Ventriculares/diagnóstico , Electrocardiografía/enfermería , Bloqueo Cardíaco/enfermería , Humanos , Taquicardia Ventricular/enfermería , Complejos Prematuros Ventriculares/enfermeríaRESUMEN
Electrophysiologic technology developed over the past 20 years has improved the life expectancy of patients who have survived sudden cardiac death events. Use of an implantable cardioverter defibrillator (ICD) continues to increase as more indications for the device are researched. Patients with ICDs will be cared for in the postanesthesia care unit following cardiac and noncardiac surgery and require PACU nurses to be knowledgeable about this advanced and changing technology as well as provide for emotional and psychological needs.
Asunto(s)
Desfibriladores Implantables , Enfermería Posanestésica/métodos , Taquicardia Ventricular/cirugía , Anciano , Muerte Súbita Cardíaca/etiología , Muerte Súbita Cardíaca/prevención & control , Desfibriladores Implantables/provisión & distribución , Diseño de Equipo , Humanos , Esperanza de Vida , Masculino , Rol de la Enfermera , Selección de Paciente , Cuidados Posoperatorios/métodos , Cuidados Posoperatorios/enfermería , Pronóstico , Calidad de Vida , Tasa de Supervivencia , Taquicardia Ventricular/complicaciones , Taquicardia Ventricular/enfermería , Resultado del TratamientoRESUMEN
Sudden cardiac death (SCD) remains a significant problem despite an overall reduction in other cardiac related deaths in recent years. Research supports the use of the implantable cardioverter defibrillator (ICD) as an effective means of treating dangerous ventricular tachydysrhythmias to prevent SCD. The issue that demands increasing attention is the psychologic experience of ICD recipients. Although the ICD is clearly a technological success, there is evidence that recipients experience strong physical and emotional reactions to the device. Such quality of life issues are worthy of a multidisciplinary effort directed at facilitating patient acceptance and adaptation to technology that although potentially life-saving, may also be unpredictable and anxiety provoking.