Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

SKILL 16-5

Performing Cardiopulmonary

Resuscitation (CPR) (Continued)

Comments

8. If you are unable to ventilate or the chest does not rise dur-
   ing ventilation, reposition the patient’s head and reattempt
   to ventilate. If still unable to ventilate, begin CPR. Each
   subsequent time the airway is opened to administer breaths,
   look for an object. If an object is visible in the mouth,
   remove it. If no object is visible, continue with CPR.


9. Check the carotid pulse, simultaneously evaluating for
   breathing, coughing, or movement. This assessment should
   take at least 5 seconds and no more than 10 seconds. Place
   the patient in the recovery position if breathing resumes.


10. If patient has a pulse, but remains without spontaneous
    breathing, continue rescue breathing at a rate of one breath
    every 5 to 6 seconds, for a rate of 10 to 12 breaths per
    minute.


11. If the patient is without signs of circulation, position the
    heel of one hand in the center of the chest between the nip-
    ples, directly over the lower half of the sternum. Place the
    other hand directly on top of the first hand. Extend or
    interlace fingers to keep fingers above the chest. Straighten
    arms and position shoulders directly over hands.


12. Perform 30 chest compressions at a rate of 100 per minute,
    counting “one, two, etc.” up to 30, keeping elbows locked,
    arms straight, and shoulders directly over the hands. Chest
    compressions should depress the sternum 1^1 ⁄ 2 to 2 inches.
    Push straight down on the patient’s sternum. Allow full
    chest recoil (re-expand) after each compression.


13. Give two rescue breaths after each set of 30 compressions.
    Do five complete cycles of 30 compressions and two
    ventilations.
    14.Defibrillation should be provided at the earliest possible
    moment, as soon as AED becomes available.Refer to Skill
    16-6: Automated External Defibrillation and Skill 16-7:
    Manual External Defibrillation.


14. Continue CPR until advanced care providers take over, the
    patient starts to move, you are too exhausted to continue,
    or a physician discontinues CPR. Advanced care providers
    will indicate when a pulse check or other therapies are
    appropriate (AHA, 2006, p. 34).


15. Remove gloves, if used. Perform hand hygiene.

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