Responding to Unresponsive Patient: Airway-Breathing-Chest - Essay Example

Running head: responding to unresponsive patient 18th June Declaration or general definition ofthe statement The new update of American Heart Association which has changed from the latest guideline known as ABC (airway- breathing- chest) to the recent guideline CAB (chest, airway and breathing) sequence which will be applied in the paper. This can only be done by chest compressions which currently have shown 22% of lives being saved from the American Heart Association; the method has shown improvement than the mouth –to mouth resuscitation. Additionally, when dealing with unconscious patient, DRAB which involves Danger, Response, Airway and Breathing survey should be conducted. This should be done to the patient so that the unresponding patient can be revived from the coma state. The cause of unresponsive state of the patient is mainly caused by the low blood supply in the body of the individual which is insufficient to reach to the brain and to the heart thereby causing the individual to be unresponsive or otherwise faint. Throughout the study, some practices should not be done to the patient for example slapping the patient , giving of drink and food to the patient who is unresponsive should not be done among others will lead to other complications. Introduction When a patient is not responding or unconsciousness, it is impossible for one to talk or do any activity and this is commonly known to be a coma state or in other word comatose state. It is important for one to be aware of do’s and don’ts concerning the patient either a grown up or a child. Other patients have changes in awareness where they do not become unconscious where their mind is altered thus being termed as altered mental status or changed mental status. The patient becomes confused leading to yelling, production of foam from the mouth among others. The change of mental status should be treated as a medical emergency since it is a condition that can lead to death in a quicker manner (Cooke, 2009). In other times the patient may be awake but less alert where if asked questions like their name may lead to inability to answer the questions which indicate a change in the mental status. When a asleep, the patient can respond to noise and other disturbances like shaking of their head or hands thus leading to waking up but in the case of an individual who is not responding or otherwise who is in unconscious mood the individual will not cough or clear his or her throat. This condition can lead to death if care and other medical attention are not conducted quickly since in most cases the patient airway may be blocked thus leading to instant death if first aid is not carried. The state of an individual not able to respond may be caused either by usage of drugs that are not prescribed by the doctors like hard drugs or others like alcohol, major illness or injury in the brain. Other individuals may experience fainting either when playing or working where it leads to a state of one being unconscious where the state is caused by dehydration (Biros, 2009). This means that the patient has low blood sugar or low blood pressure which is a condition which has to be checked by doctors so that they can diagnose and illustrate what should be done in case of a coma. Incase of fainting breathing very fast may lead to fainting and other coughing very hard and for a long time may lead to one fainting. When an individual is in a coma state, an individual may show some symptoms like confusion where he or she can not recognize what happened, other individual may be experiencing severe headache, others are unable to speak and move their body parts, rapid heartbeat, weakness in the entire body where unless carried an individual will not be able to move or stay upright thus the need to take care and handle the patient in a manner that will not cause pain after the recovery (Kothari, 2006). This paper seeks to discuss what is previously and presently known and not known about how to respond in front of a patient who is not responding. Literature review According to American Heart Association (2014) guideline for the CPR, nurses move from airway –breathing- chest (ABC) to chest, airway and breathing sequence (CAB) since the guideline proofed that it is the best to use when a patient is in a coma mood and thus saved a lot of patients from death. The guideline of using chest compression- CPR rather than mouth to mouth method is recommended by a lot doctors since it has shown more than 22% of people who were in a comma were saved by the use of hand only where they used chest compression- CPR method. The American Heart Association updates CPR guideline due to the technology, healthcare and science updates has made the association to know the changing human anatomy and other discoveries concerning diseases. According to the current American Heart Association official guideline for CPR, it encourages an individual who is helping unresponsive patient for the optimal patient outcomes to press hard and fast on the chest of the patient without considering whether the helper is an expert or not in the field of first aid. The guideline states clearly that through the use of chest compression for an individual who is in unresponsive state helps the patient in maintaining blood flow, additionally oxygen is also provided in large amount. Since coma is caused by low blood supply in the brain the use of chest compressions helps to boost and direct blood in the brain and in the heart of the individual patient. When a rescuer is helping the patient he or she should check whether the patient is responding and the breathing is normal. If otherwise, chest compression should be made to ensure blood supply to the other parts of the body like the heart and the brain. Incase of those rescuers who are professional or for the nurse or the doctor they check the pulse and if the pulse is absent for more than 10 seconds then the expert rescuer should press the patient hard and faster in more than 30 chest compressions. The more the chest compressions on the patient the more blood supply will be provided to the heart and brain of the patient making the patient to recover from the coma. Due to the delay caused before an ambulance has reached the site where the patient is, the process of giving chest compressions saves life and more importantly is to maintain proper blood circulation in the body of the patient thus making it possible for blood supply to the heart and brain. The new updated guideline of American Heart Association CPR recommends various techniques to be applied to the patient so that the patient will respond. According to Sampson and Marthas (1981) first a call to the healthcare should be done so that the management of the healthcare can prepare a transportation means that can be acquired quickly. Tilton (2007) indicates that the second step when dealing with unresponsive patient is to make the patient to respond , where if the patient is not responding then the rescuer should roll the patient on his or her back so that he or she can respond. The third step according to the American Heart Association (2014) is that it is important to give the patient chest compressions where the hand of the rescuer should be at the center of the patient pressing down the chest for both the adult and for the children. For those who have knowhow concerning the CPR, the opening of the airways should be made. The next step is to pinch the nose of the patient and the mouth of the patient should be covered additionally the patient should be given breath for 2 seconds by the rescuer so that blood can pass through. Lastly, the rescuer should keep on compressing the patient chest until a medical expert who will provide assistance will arrive so that he or she will save the life of the patient. According to St John Ambulance (2013) when dealing with unconscious patient, DRAB survey should be carried on while waiting for medical expert to come where dialing of 999 or 112 emergency telephone numbers for an ambulance. The DRAB survey involves Danger, Response, Airway and Breathing. In the first stage of the danger, it involves checking whether the unconscious patient and the rescuer are in danger and it is important for the rescuer to assess the situation. Response for the unconscious adult or the child should be checked. If they are not responding, the rescuer should shout for help and still shout for the patient for example can you here me? Incase of an infant who is in unconscious state, in the first stage one should check for a response and if not responding the infant should not be shaken rather one should flick the sole of an infant foot so that one can see if the infant will respond. For the airway if the unconscious patient is responding then one is absolutely sure that the individual is breathing but it is important for one to check if there is any bleeding and other injury which the patient could have obtained when he or she was in coma state. The rescuer should make sure that the patient is breathing well so it is important for the rescuer to open their airways. The airways can be opened by the use of hand by placing one hand on the forehead and using the two fingers to lift the chin so that the airway can be opened. On the other hand, breathing should be ensured where the rescuer should listen for more than 10 seconds whether the patient is breathing where monitoring of breathing should be done continuously. Additionally, the patient should be positioned well where the patient should not be allowed to roll forwards or backwards. For a patient who is in coma state and not breathing chest compression like in the case of American Heart Association must be done where 30 times chest compression in a rate of 100-120 per minutes. According to Janis (1958) the next step is to give 2 rescue breaths which ensure that the patient airway is open where the rescuer mouth should be intact with that of the patient where breath should be given until the chest rises of the patient. For unconscious and not breathing child from age 1 to puberty rescue breath should be given first in more than 5 times and finally chest compression should be done in more than 30 times at a rate of 100 -120 compressions. Conclusion of the literature review In conclusion, coma is a state that can lead to death for the adults, children and infants and thus care should be taken whenever one is prone to this kind of state. Detailed information concerning the body feelings should be given to a medical expert so that further investigation should be done. What is the cause of unresponsive state of individual? As discussed early the cause is mainly lack of blood to flow well in the heart and in the brain where it can lead to unresponsive state or coma and others experiencing fainting. If the blood flow of the patient is maintained together with oxygen in the body of an individual, then it will mean that blood flow will be boosted where it will be pumped to the heart and to the brain of the patient thereby marking the individual to remain healthy. Failure of the blood and oxygen to be sufficient in the brain and the heart results to this state of coma and in many circumstances if first aid is not given as required it will lead to death. What needs to be investigated in the present and in the future is the blood sugar level of individuals even if one has never experienced coma so that one can be aware of the blood sugar level which should be maintained at maximum and minimum levels to avoid blood sugar that is too low. Medical check ups should be conducted to the individual so that incase of low blood sugar medical care should be taken to avoid the situation of coma in the present and in the future. It is important for individuals who have an experience of unresponsive state and those who have never experienced coma to get enough fluid particularly in the warm weather so that an increase in the blood of individual will be increased as much as possible. According to Elzer (2000), enough supply of blood in the heart and in the brain will make an individual to remain healthy thus conducting daily routines without problem additionally the state of unresponsive will never be experienced when there is enough blood supply. Standing in one place for too long without moving especially for those who are known to have that problem of fainting is not recommended. It is recommended that those who are prone to fainting should not be standing in one place for too long rather they should be moving or exercising so that the chance of fainting can be controlled. Whenever an individual feel like he or she will faint, it is recommended to sit or lie with his or her head bent to the knees so that it can be eliminated and thus any person who is beside should hold him or her so that they can move to a place that is comfortable where any other first aid can be given. People with diabetes should be eating a well balanced diet that has been recommended by a medical expert so that their blood sugar does not go below the recommended level. Additionally, medical check ups should be conducted in the present and in the future so that the unresponsive state can be prevented. Recommendation practices for the future improvements The performance improvement of the patient cannot be improved when the rescuer is trying to give the patient some drink or food rather it will make the situation to be worse. It is recommended never to give unconscious individual any food or drink. In the relation to that, the patient should not be left alone since others can start to roll downwards which may result to injuries in other parts of the body. A pillow should not be placed under the head of the individual rather the patient should be lied flat in the ground to allow blood to flow in the brain and in other parts of the body while the rescuer is pressing the chest compressions hard and fast so that the patient can become responsive while the ambulance has arrived in the scene. According to Carter (2012) it is not recommended for the rescuer not to slap the unconscious patient on the face or splash water on the face or in the whole body of the patient which many people think it is the solution to make the patient responsive. This will not make the patient to respond rather it may lead to other complications. What has been discussed above should be repeated until the patient responds waiting for the ambulance or medical experts to alive and carry medical check ups so that the patient can be revived from another experience of the coma. References AHA CPR Guidelines –Latest Jan 12, 2014, First Aid Training For Parents and Carers by Yalonda Williams of Encore CPR. Biros, M. dealing with unconscious person. Rosens Emergency Medicine: Concepts and Clinical Practice. Philadelphia, Pa: Mosby Elsevier; 2009. Carter, J. (2012). Lippincott’s Textbook for Nursing Assistants: A Humanistic Approach To Care Giving. Philadelphia: Wolters Kluwer. Cooke, J. Depressed consciousness and coma.  Rosens Emergency Medicine: Concepts and Clinical Practice. Philadelphia, Pa: Mosby Elsevier; 2009. Dealing with Someone Who Is Unconscious, August 2013 by St John Ambulance Elzer, M. (2000). Psychoanalytic psychotherapy: a handbook. Of nursing journal. Kothari .R. (2006). Emergency Medicine: Concepts and Clinical Practice. Pa: Mosby Elsevier. Psychological stress; psychoanalytic and behavioral studies of surgical patients, by Janis, I. 1958 Sampson, E and Marthas, M. (1981). Group Process for the Health Professions. New York: Wiley Tilton, B. (2007). Backcountry First Aid and Extended Care. Guilford, Conn: globe Pequot press. Read More