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1. Nurse initiating ESO will document - ANSWER ✔ 1. Life threatening
condition
2. Precipitating factors
3. Specific ESO implemented
4. Patient response
5. When and which physician was notified
2. What is the mechanism of action in synchronized cardioversion
mode? - ANSWER ✔ The current is delivered on the 'R' wave of the
ECG to reduce the chances of inducing V Fib
3. What safety precautions should be taken during cardioversion? -
ANSWER ✔ Press the SYNC button between each delivery of energy,
,check for a ▼ above each detected QRS, and hold down the shock
button until energy is delivered
4. What is the procedure for cardioversion? - ANSWER ✔ Turn on
defibrillator, apply pads, engage synchronization mode, select
appropriate energy level (200 Joules) , charge defibrillator, state 'all
clear', press and hold 'shock' button until shock delivered
5. Code Blue Team Members: - ANSWER ✔ 1. 1st responder: Call for
help, begin CPR i. Once relived from compressions, may become
recorder (RN only)
6. ESO are initiated: - ANSWER ✔ For life-threatening patient
conditions in the absence of the physician or specific orders
7. Adequate CPR - ANSWER ✔ 1. Push hard
2. Full chest recoil
3. Minimize interruptions
4. 100-120 compressions/min
5. 15 L O2 by bag mask (10 breaths per min)
6. 30:2
8. ETCO2 monitoring - ANSWER ✔ Use to assess quality of CPR and
evaluate return of rosc
,9. How many breaths with advanced airway? - ANSWER ✔ 1 breath
every 6 seconds
10. Targeted temperature management - ANSWER ✔ Should be used on
all patients not following commands or purposeful movement within 120
mins after ROSC
11. What is a rapid bolus? - ANSWER ✔ Fluids administered in 5-15
mins
12. Non invasive cardiac monitoring - ANSWER ✔ Device that uses
bioreactane to determine cardiac output and is implemented where
available by RRT or ICU RN to determine fluid responsiveness and
guide fluid resuscitation
13. Passive leg raise - ANSWER ✔ Position patient flat on their back,
and their legs are elevated to 45 degrees.
14. These interventions are instituted for all emergency situations
outlined in the ESO Standardized Procedure: - ANSWER ✔ 1.
Obtain intravenous (IV)/intraosseous (IO) access
2. Begin IV infusion of normal saline (NS) at keep vein open (KVO). If
IV access is unavailable: Lidocaine, Epinephrine, Atropine, and
, Naloxone (Narcan) may be administered via endotracheal route at doses
of 2-2 1/2 times the IV dose.
3. If IV access is unavailable, Naloxone (Narcan) may be administered
IM at the same dose as IV administration
4. Flush the IV line with 20mL of NS after each IV medication given
and elevate the extremity if applicable.
5. In applicable situations, obtain oxygen (O2) saturation
6.Monitor and document ETCO2 for code blue events.
7. Titrate oxygen to patients' response.
15. Signs (objective): - ANSWER ✔ Tachypnea, apnea, respiratory
depression, tachycardia, bradycardia, arrhythmias, hypotension,
decreased O2 saturation, dyspnea, change in level of consciousness,
increased intracranial pressure (ICP), status epilepticus
16. Symptoms (subjective) - ANSWER ✔ Dizziness, lightheadedness,
chest pain, shortness of breath (SOB), chest pain, weakness, cold,
diaphoresis, heart palpitations, anxiousness