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Initial assessment

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VOL: 97, ISSUE: 41, PAGE NO: 41

PHIL JEVON, RESUSCITATION OFFICER, MANOR HOSPITAL, WALSALL

The term cardiac arrest implies a sudden interruption of cardiac output. It may be reversible with appropriate treatment (Handley, 1999). The patient will collapse, lose consciousness, stop breathing and will be pulseless. He/she may also present with a short grand mal convulsion which lasts only a few seconds.

The term cardiac arrest implies a sudden interruption of cardiac output. It may be reversible with appropriate treatment (Handley, 1999). The patient will collapse, lose consciousness, stop breathing and will be pulseless. He/she may also present with a short grand mal convulsion which lasts only a few seconds.

Diagnosis of cardiac arrest is clinical: the patient is unconscious, is not breathing and has no pulse. Other clinical features such as pupil size, cyanosis and pallor are unreliable, so practitioners should not waste precious time looking for them (Skinner and Vincent, 1997).

The interventions that contribute to a favourable outcome following a cardiac arrest can be conceptualised as a chain: the 'chain of survival' (Resuscitation Council (UK), 2001). This chain has four links, each one being only as strong as the weakest one: early access (to the cardiac arrest team); early basic life support; early defibrillation; early advanced life support.

As nurses are often first on the scene of a cardiac arrest, they have an important role to play in this chain of survival. In the event of a cardiac arrest, it is most important that an accurate diagnosis is quickly made and that resuscitation procedures are instigated following local protocols and national guidelines.

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