Pt. on vent in cardiac arrest - would she continue breathing?

Specialties CCU

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Pardon my ignorance but what would happen? It seems as if the respirations would continue, heartbeat or no...Is that right? Would appreciate any insight - thanks.

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Specializes in critical care, PACU.

in a code situation the patient is disconnected from the mechanical ventilator and the ETT is then attached to an ambubag so that the patient is manually oxygenated by usually the respiratory therapist.

I have not been in a wealth of codes (only about 10) but in all of them and from what I've read that is the case.

ambubags attached to oxygen give more control over oxygenation based on saturation and arent affected by predefined ventilator settings that might hinder resuscitation.

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Specializes in Critical Care.
Pardon my ignorance but what would happen? It seems as if the respirations would continue, heartbeat or no...Is that right? Would appreciate any insight - thanks.

In full cardiac arrest...no, the patient would not be breathing independently, at least not for long. The ventilator, however, would continue to deliver breaths until you turned it off. Even if it is in PSV/CPAP mode it would flip into apnea mode and deliver breaths. Without circulation the oxygen delivered would be useless.

You might also see some agonal breathing by the patient during the dying process but that too would be of no use without circulation.

When the pump goes the rest of the body goes in rapid sequence. Respiratory arrest can precede cardiac arrest and vice versa but if one occurs and is not reversed the other surely follows.

BTW, vented patients in cardiac arrest who are receiving ACLS are bagged manually and not left on the vent during attempts at resuscitation.

Sometimes, though, during withdrawal of care on a patient who is vented, the family will request that the patient remains on the ventilator. The vent will just keep going after asystole until it is turned off. A little disconcerting to family, sometimes.

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thanks for the replies. so, the vent would continue to deliver breaths whether or not pt. was breathing (of course the breaths wouldn't oxygenate pt. but they Would continue.) in short, if i look into a room with a vent dependent pt, just because the vent is functioning, this Does Not Mean they have a heartbeat... i was not sure what the vent would do in asystole...

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thanks for the replies. so, the vent would continue to deliver breaths whether or not pt. was breathing (of course the breaths wouldn't oxygenate pt. but they Would continue.) in short, if i look into a room with a vent dependent pt, just because the vent is functioning, this Does Not Mean they have a heartbeat... i was not sure what the vent would do in asystole...

The ventilator and the heart are two separate entities. The ventilator does not monitor the patient's rhythm. On top of that.....with as many times as the monitor dings asystole in a 12 hour shift.....the patient would be hypoxic quickly!

The ventilator works no matter what is going on with the patient provided that it's plugged in, has O2 and medical air, and is attached to a trach, ett, etc.

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thanks for the replies. so, the vent would continue to deliver breaths whether or not pt. was breathing (of course the breaths wouldn't oxygenate pt. but they Would continue.) in short, if i look into a room with a vent dependent pt, just because the vent is functioning, this Does Not Mean they have a heartbeat... i was not sure what the vent would do in asystole...

The ventilator is just a machine and it will continue to deliver breaths whether the patient is dead or alive. If the patient is no longer triggering breaths (as in resp arrest, death, deep sedation, paralysis), the ventilator delivers breaths at the set rate (or the set apnea ventilation rate). You always assess the patient first, not the monitor.:D

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Specializes in Anesthesia.

Good replies from all! Patients will find ways to up and die on you when you least expect it, so you have to keep a vigilant eye on them. If the patient is in PEA (pulseless electrical activity), the only way you would immediately know they are dead is if they have an Art line and their BP drops, or CVP or something, causing you to investigate the pt and hopefully check a pulse.

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Specializes in ED, ICU, Education.

Just out of curiosity, where did you go to nursing school?

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Specializes in MSN, FNP-BC.

The easiest way to look at it is to seperate the two. The vent is a machine. Yes some settings can be patient driven but it is a machine and you tell it what to do.

The patient is a seperate entity all his/her own. Independant from the ventialtor (this is different than dependant ON the vent).

So yes,if the patient stops working as in cardiac arrest, the machine just keeps on going because it is a machine seperate from the patient and is just doing it's job.

It's kind of the same thing you may experience with a pacemaker. When a patient dies, the pacemaker has to be turned off by a magnet because it is a machine that will just keep going and doing it's thing until you tell it to stop.

I hope that makes sense.

ETA: If a patient is on a vent they are probably not breathing on their own so no, the patient would not still be breathing in cardiac arrest but the machine would still be trying to pump them full of air giving them the appearance of "breathing".

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If doctor tell the patient has cardiac arrest after putting up for 3 days on ventilator and we have reversed the arrest by giving shock and still the patient has been put on ventilator with full support and high dosage of drugs. And if there is movement in the eye balls and eye lashes are up and down , what does it mean?

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The ventilator has nothing to do with the heart, and it is not regulated by the heart. When a ventilator is set up, it is programed to give a certain number of respirations per minute, to deliver a certain concentration of oxygen, to deliver breaths at a certain pressure, etc. Unless the ventilator malfunctions, or is turned off, it will continue to deliver breaths for that patient no matter what their heart does. Ventilators are used in cases when patients cannot breath on their own for whatever reason (they could be sedated and paralyzed, they could have a brain injury, the medical staff could be letting them, "rest," by decreasing their work of breathing, etc). When a patient goes into cardiac arrest, the ventilator is disconnected, and an ambu bag is connected to the endotracheal tube. The ambu bag is used to breathe for the patient, and it also delivers oxygen to the patient. If the code is successful and the patient regains vital signs, they will be placed on the ventilator again. If a patient goes into cardiac arrest and dies, and the ventilator isn't disconnected, it will continue to provide ventilation to them despite the fact that they have no pulse. So, yes, in theory you could leave someone on the vent during a code and it would continue to breathe for them, but you have more control over breaths per minute and oxygenation with an ambu bag during a code situation.

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Specializes in SICU.
If doctor tell the patient has cardiac arrest after putting up for 3 days on ventilator and we have reversed the arrest by giving shock and still the patient has been put on ventilator with full support and high dosage of drugs. And if there is movement in the eye balls and eye lashes are up and down , what does it mean?

As per the terms of service, no one here can give medical advice. Please talk to the Doctors in charge of this patients care. They are the ones to answer this question.

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