What are the main nursing measures after cardiopulmonary resuscitation?

Cardiopulmonary resuscitation is mainly used for people who need emergency treatment, generally in cases of unexpected shock or sudden cardiac arrest caused by physical illness. In these cases, emergency treatment and timely cardiopulmonary resuscitation are needed. Cardiopulmonary resuscitation can help patients restore their normal heartbeat. After cardiopulmonary resuscitation, some care measures must also be taken, including observing breathing and providing oxygen in time.

What are the nursing measures after CPR?

A comprehensive evaluation of the cardiovascular system and related factors should be conducted, and the cause of cardiac arrest should be carefully investigated, especially whether acute myocardial infarction and electrolyte imbalance exist, and timely treatment should be given.

If the patient is hemodynamically unstable, assessment of systemic circulating blood volume and ventricular function is warranted. Maintain breathing

After the restoration of spontaneous circulation, patients may have varying degrees of respiratory dysfunction, and some patients may still require mechanical ventilation and oxygen therapy. Prevent and treat cerebral hypoxia and cerebral edema

Also called brain resuscitation. Brain resuscitation is the key to the ultimate success of cardiopulmonary resuscitation. Under hypoxic conditions, the autonomic regulation function of cerebral blood flow is lost, and the maintenance of cerebral blood flow mainly depends on cerebral perfusion pressure. Any factor that leads to increased intracranial pressure or decreased mean arterial pressure of the systemic circulation can reduce cerebral perfusion pressure, thereby further reducing cerebral blood flow. For comatose patients, normal or slightly elevated mean arterial pressure should be maintained and increased intracranial pressure should be reduced to ensure good cerebral perfusion. Cooling

The high metabolic state after resuscitation or increased body temperature caused by other reasons can lead to a significant imbalance in the oxygen supply and demand of brain tissue, thereby aggravating brain damage. Therefore, after cardiac arrest resuscitation, body temperature changes should be closely observed and active cooling and fever reduction measures should be taken. The ideal body temperature is 33-34℃.

Dehydration

The use of osmotic diuretics combined with cooling treatment can reduce brain tissue edema and lower intracranial pressure, which helps to restore brain function. When treating dehydration, care should be taken to prevent excessive dehydration, so as not to cause insufficient blood volume and difficulty in maintaining stable blood pressure.

Prevent and treat convulsions

The hibernation drugs are used to control the convulsions of the limbs caused by hypoxic brain damage and the shivering reaction during the cooling process. However, there is no need for prophylactic use of anticonvulsants. Hyperbaric oxygen therapy: increases blood oxygen content and diffusion, improves brain tissue oxygen partial pressure, improves brain hypoxia, and reduces intracranial pressure. If conditions permit, it should be applied early.

Promote early cerebral blood perfusion

After cardiopulmonary resuscitation, anticoagulation therapy should be given to clear the microcirculation, and calcium channel blockers should be used to relieve cerebral vasospasm. Preventing and treating acute renal failure

If cardiac arrest lasts for a long time or hypotension persists after resuscitation, acute renal failure is likely to occur. This is particularly common in elderly patients with pre-existing kidney disease. Renal failure that occurs in the early stages of cardiopulmonary resuscitation is mostly caused by acute renal ischemia, and its recovery time is longer than that of nephrotoxicity.

Since large doses of dehydrating agents and diuretics are usually used, the clinical manifestation may be normal or even increased urine volume. When preventing and treating acute renal failure, attention should be paid to maintaining effective heart and circulatory function, and avoiding the use of drugs that are harmful to the kidneys. If anuria or oliguria persists after injection of furosemide, it indicates acute renal failure. At this time, it should be treated as acute renal failure.