In the clinical setting it is more likely to witness a patient suffering from respiratory arrest than cardiac arrest. Because of this it is just as important for healthcare providers to understand the proper way to manage and treat a patient who is suffering from respiratory failure.
The first three steps taken when a nurse, doctor, or patient care technician finds a patient is to make sure their scene is safe. Once scene safety has been confirmed the healthcare provider checks for patient responsiveness and scans the patient’s chest for visible chest rise. If the patient is unresponsive and not breathing the healthcare provider should activate the emergency response system and send for an AED. Following that the healthcare provider should check for a carotid pulse. Check the pulse for at least 5 seconds but no longer than 10 seconds.
If there is a strong pulse, but the patient is not breathing, the patient is experiencing respiratory failure and needs to be treated immediately before their condition deteriorates.
Grab an ambu-bag and connect it to oxygen. Turn the oxygen all the way up. The healthcare provider should then position themselves at the head of the patient’s bed. Obtain a good seal with the mask over the patient’s mouth and nose using the C – E technique. To confirm the mask has a seal gently squeeze the bag with the hand not holding the mask in place. While squeezing the bag scan the patient’s chest for chest rise. If you are unable to visualize chest rise you may need to reposition the mask or place an oral pharyngeal airway or a nasal pharyngeal airway.
Once the ambu-bag ventilations are effective, noted be visible chest rise, deliver each ventilation over one second every 5 to 6 seconds. If the patient has an endotracheal tube in place the ventilations are delivered less frequently, one breath every 6 to 8 seconds. Be sure to only squeeze the ambu-bag until there is visible chest rise. Squeezing the bag to hard and long could increase intrathoracic pressure or cause gastric inflation. Gastric inflation can lead to emesis and then aspiration of gastric contents. The patient’s pulse should be rechecked every 2 minutes.
Respiratory arrest is a critical situation. Knowing the proper way to ventilate the patient and being able to stay calm are both key components of the resuscitative efforts. For more information go to American Heart Association ECC classes .
