EMERGENCY MEASURES

+ INTUBATION + CPR + EMERGENCY DRUGS

 INTUBATION
is a medical procedure in which a tube is placed into the
windpipe (trachea) through the mouth or nose. In most
emergency situations, it is placed through the mouth.
Whether you are awake (conscious) or not awake
(unconscious), you will be given medicine to make it easier
to insert the tube.
The decision to intubate is sometimes difficult. Clinical
experience is required to recognize signs of impending
respiratory failure. Patients who require intubation
have at least one of the following 5 indications:
INABILITY TO MAINTAIN
AIRWAY PATENCY
• Swelling of upper airway as in anaphylaxis or
infection
• Facial or neck trauma with oropharyngeal bleeding or
hematoma
DECREASED CONSCIOUSNESS AND
LOSS OF AIRWAY REFLEXES
• Failure to protect airway against aspiration -
Decreased consciousness that leads to regurgitation
of vomit, secretions, or blood
FAILURE TO VENTILATE
• End result of failure to maintain and protect airway
• Prolonged respiratory effort that results in fatigue or
failure, as in status asthmaticus or severe COPD
FAILURE TO OXYGENATE
• End result of failure to maintain and protect airway
or failure to ventilate
• Diffuse pulmonary edema
• Acute Respiratory Distress Syndrome
• Large pneumonia or air-space disease
• Pulmonary embolism
ANTICIPATED CLINICAL COURSE
OR DETERIORATION
• Uncooperative trauma patient with life-threatening injuries
who needs procedures or immediate CT scanning
• Stab wound to neck with expanding hematoma
• Septic shock with high minute-ventilation and poor
peripheral perfusion
• Intracranial hemorrhage with altered mental status and
need for close blood pressure control
 NURSING RESPONSIBILITIES
• PREPARE THE MATERALS TO BE USE
• ASSIST WITH SUCTIONING ANG VISUALIZING
• ENSURE PATIENT SAFETY WHILE DOING THE
PROCEDURE
• ANTICIPATE THE NEED TO SEDATE
 CPR
Cardiopulmonary resuscitation (CPR) is an emergency
procedure that combines chest compressions often with
artificial ventilation in an effort to manually preserve intact
brain function until further measures are taken to restore
spontaneous blood circulation and breathing in a person
who is in cardiac arrest.
EMERGENCY
DRUGS
DIAZEPAM (VALIUM)
• 10mg/amp
• Sedate
• Anti seizure
MIDAZOLAM
• 5mg/amp
• Sedate
• Anti seizure
PHENOBARBITAL
• 130mg/amp
• Sedate
• Anti seizure
EPINEPHRINE
• 1mg/amp
• Arrest
• Anaphylactic
ATROPINE SO4
• 1mg/amp
• Bradycardia
• Raise arm
SODIUM BICARBONATE
• 1mg/ml
• Acidotic
• IV bolus
NOREPINEPHRINE
• 4mg/amp
• Hypotension
• Septic
DOPAMINE HCL
• 200mg/amp
• Hypotension
• Renal or Cardiac
AMIODARONE
• 150mg/amp
• Ventricular Arrhythmias
• IV push / Drip
ISOSORBIDE
• 10mg/amp
• Angina, MI
• IV Drip
D50 WATER
• 50%/amp
• Hypoglycemia
• IV push
THANK YOU