During CPR we should consider and correct reversible causes of cardiac arrest these factors are typically remembered as the Hs and Ts.
A variety of disease processes can lead to a cardiac arrest; however, they usually boil down to one or more of the “Hs and Ts”;
- Hypoxia (give oxygen).
- Hypovolaemia (correct with IV fluids).
- Hypothermia (especially consider in cases of drowning – check with a low-reading thermometer).
- Hyperkalaemia (or hypokalaemia, hypocalcaemia, acidaemia, or other metabolic disorder). ECG may be characteristic of hyperkalaemia. Give IV calcium chloride for hyperkalaemia, hypocalcaemia and calcium-channel blocking drug overdose.
- Hydrogen Ions* (acidosis).
- Tension pneumothorax (consider if trauma or previous attempts to insert a central venous catheter).
- Tamponade (cardiac) – particularly in cases of trauma.
- Toxins or Tablets – consider reversal agents. See toxbase or the BNF.
- Thromboembolism (coronary or pulmonary) – consider thrombolytic drugs but these may take up to 90 minutes to work.
*Hydrogen Ions and Trauma are recent additions to the advanced life support guidelines on reversible causes. Consideration should also be made to hypoglycemic cardiac arrest.
The Advance Life Support Manual (7th Edition) by the Resuscitation Council is the recommended pre-reading for the Advance Life Support course.
Lucozade is no longer as effective at treating hypoglycemia
Due to changes in its recipe and a significant reduction in glucose, Lucozade will not be as effective as a treatment for hypoglycemic patients.
Recipe changes to Lucozade Original Energy product line mean it will no longer be as effective at treating hypoglycemic patients – this is due to a 50% reduction in glucose based carbohydrates. Healthcare Professionals should seek guidance from their local specialist team on alternative treatment protocols.
This change applies to all Lucozade Energy Flavours. New products started appearing on shelves in April 2017. However, for a short time, both the new and old recipe will be available.
Previously, 100ml of Lucozade Original contained 17g of carbohydrate; this was reduced to 8.9g in April 2017.
According to Diabietes.co.uk, patients who experience a hypoglycemic episode are advised to consume 15-20g of sugar when treating low blood sugar, but this will no longer be equivalent to 100ml of Lucozade.
Lucozade Ribena Suntory, which also makes Ribena and Orangina, among other drinks, is lowering its sugar content by replacing these sugars with low-calorie sweeteners, such as aspartame.
You can also visit www.lrsuntory.com/health for more information on Lucozade’s changing nutritional values or speak to your local diabetes specialist team.
Shift Planner for Nurses, Students & Support Staff
Shift planning is essential for safe care, some people using a piece of paper others have their thoughts well arranged in their head, either way everybody does it.
This shift planner has been designed with newly qualified nurses and student nurses in mind but would be suitable for anybody to use.
You can download our Shift Planner for FREE. You are free to download, print and distribute our shift planner as you wish. You will need a PDF reader on your PC to download.
The planner has been created with two primary columns, one for your main nursing priorities and one to remind you to hand over jobs to the next shift. It also features a small key and area for general notes. Due to limited space we have only included enough room to plan up to eight patients, if you need more we encourage you print doublesided.
We encourage you to make comments or suggestions in the comments section below. The most popular will be implemented in a version 2.
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