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Overview
- This is based on actions IN a healthcare facility – as if you are the nurse and find an unconscious patient.
- In the community, the algorithm is slightly different, refer to the American Heart Association for details.
Nursing Points
General
- Patient found unconscious:
- Always assess first
- Determine responsiveness (sternal pressure, yelling)
- Check for carotid pulse (MAX 10 seconds)
- Know/ask if a neck injury is suspected
- If no pulse
- Call for help (Code Button, yell, call light)
- Send someone for AED
- Begin chest compressions at a rate of 100-120 beats/min
- Do NOT delay chest compressions
- During chest compression, do not stop unless instructed
- Minimizing chest compression interruptions is ESSENTIAL
- Push hard and fast
- Must allow for recoil
- Help arrives
- Another health care provider will open airway
- Use BVM to administer breaths after 30 compressions
- 30 : 2 ratio until secured airway
- Other health care providers should be attaching the defibrillator pads, ensuring IV access
- Do not use the pediatric/child defibrillator pads on an adult
- 2-minute cycle finishes
- Check carotid pulse
- Analyze rhythm (AED mode if no ACLS providers present)
- If shock advised
- Resume compressions while defibrillator charges
- Clear patient to administer appropriate shock
- Immediately resume compressions
- If pulseless and no shock indicated, immediately resume CPR
- Begin ACLS algorithms when advanced practitioners available
Nursing Concepts
- Clinical Judgment
- Perfusion
- Oxygenation

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Transcript

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