Protocol Department: NURSING Dept. Code: Protocol: CPR- Complications and Prevention Protocol Code: Version: 01 Approval Date: CCL 1. INSTRUCTIONS Complication Cause Assessment Findings Sternum and rib fracture Osteoporosis Malnutrition Improper hand placement Pneumothorax, hemothorax or both Документ1 Lung puncture from fractured rib. Paradoxical chest movement. Chest pain and tenderness that increase with inspiration. Crepitus. Palpation of movable bony fragments over the sternum On palpation, sternum feels unattached to surrounding ribs. Chest pain and dyspnoea. Decreased or absent of breath sound over affected lung. Tracheal deviation from midline. Hypotension. Hyperresonance to percussion over the affected area, along with shoulder pain. Preventive Measure’s While performing CPR: Ensure that hands are positioned properly. Don’t rest hands or fingers on patient’s rib. Interlock fingers. Keepbottom hand in contact with the chest, but release pressure after each compression. While performing CPR: Ensure that hands are positioned properly. Don’t rest hands or fingers on patient’s rib. Interlock fingers. Keep bottom hand in contact with the chest, but release pressure after each compression. Compress sternum at the recommended depth for the patient age. Page 1 of 4 Property of Bona Dea International Hospital. Not to be reproduced or reprinted for use outside BDIH without permission. Protocol Injury to heart and great vessels. (pericardial tamponade, atrial or ventricular rapture vessel laceration, cardiac contusion, punctures of the heart chambers) Improperly performed chest compression. Transvenous or transthoracic pacing attempts. Central line placement during resuscitation. Intracardiac drug administration Jugular vein distention. Muffled heart sound. Pulses paradoxus. Electrical alternans (decreased electrical amplitude of every other ORS complex) Adventitious heart sound. Hypotension. Electrocardiogram changes( arrhythmias, st segment elevation, T wave inversion, and marked decrease in QRS voltage) Organ laceration (primarily liver and spleen) Документ1 Forceful compression. Sharp edge of fractured rid or xiphoid process. Persistent right upper quadrant tenderness (liver injury). Persistent left upper quadrant tenderness (spleen injury). Increasing abdominal girth. Perform chest compression properly While performing CPR: Ensure that hands are positioned properly. Don’t rest hands or fingers on patient’s rib. Interlock fingers. Keep bottom hand in contact with the chest, but release pressure after each compression. Compress sternum at the recommended depth for the patient age. Page 2 of 4 Property of Bona Dea International Hospital. Not to be reproduced or reprinted for use outside BDIH without permission. Protocol Aspiration of stomach contents. SN Gastric distention and elevated diaphragm from high ventilatory pressures Fever, hypoxia and dyspnea Auscultation of wheezes and crackles Increased white blood count. Change in colour and odor of lung secretions STEPS N/A 2 Intubate early. Insert nasogastric tube and apply suction, if gastric distention is marked. RATIONALE N/A COMMUNICATION This policy & procedure will be communicated to the appropriate BDIH personnel via the following channels: This policy will be placed in the BDIH DMS Distributed via Document Management System (BDIH DMS) Distributed via Hospital Information System (BDIH HIS) Relevant Directors, Heads of Clinical Departments and Managers Review cycle: 3 years 3 REFERENCES 3.1 Lippincott NURSING PROCEDURE SEVENTH EDITION 4 REVISIONS Документ1 Page 3 of 4 Property of Bona Dea International Hospital. Not to be reproduced or reprinted for use outside BDIH without permission. Protocol Version Date Action* Person Signature *Action is one of the following: Creation/Revision/Approval Version Документ1 Date Reviewer Signature of Reviewer Page 4 of 4 Property of Bona Dea International Hospital. Not to be reproduced or reprinted for use outside BDIH without permission.
