respiratory arrest

[krissy29RN]

Does anyone know how long it will take for cardiac arrest to occur after respiratory arrest without CPR?

[nurse2033, MSN, RN]

It depends on too many factors. It could vary tremendouly depending on conditions and health of the patient.

[GHGoonette, BSN, RN]

Respiratory arrest may be drug induced, related to certain disease processes eg tetorifice or due to airway obstruction. Prompt intervention ie establishing airway and ventilation should maintain the PaO2 at adequate levels so as to prevent tissue and organ damage caused by prolonged cyanosis. To give you actual time frames off the top of my head-I think 5 minutes is the length of time before brain death occurs, but this may vary according to circumstances.

There are documented instances of people drowning in freezing water, and being submerged for unbelievable lengths of time, only to be successfully revived later.

[Penelope_Pitstop, BSN, RN]

There is no one answer to this.

Just know that it WILL occur, and sooner rather than later.

[GilaRRT]

You do not perform CPR on a patient with isolated respiratory rest.

[nminodob]

You do not perform CPR on a patient with isolated respiratory rest.

maybe I am overthinking this, but if a person isn't breathing effectively you would want to give them rescue breathing after clearing their airway, and wouldn't this fall under the category of CPR? If not, why do we have to learn about rescue breathing when getting our CPR cert? CPR isn't limited to compressions and defibrillation...

[XB9S, BSN, MSN, EdD, RN, APN]

You do not perform CPR on a patient with isolated respiratory rest.

Depending on your location, the new BLS guidelines state if you patient is not breathing normally then start compressions

http://www.resus.org.uk/pages/bls.pdf

In Hospital Resuscitation

4C. If the patient is not breathing but has a pulse (respiratory arrest):

 Ventilate the patient’s lungs (as described above) and check for a pulse

every 10 breaths (about every minute).

Only those competent in assessing breathing and a pulse will be able to make the

diagnosis of respiratory arrest. If there are any doubts about the presence of a pulse,

start chest compression and continue until more experienced help arrives.

5. If the patient has a monitored and witnessed cardiac arrest:

The emphasis is on ensuring adequate circulation, if there is any doubt about the presence of circulation then compressions are indicated

[XB9S, BSN, MSN, EdD, RN, APN]

maybe I am overthinking this, but if a person isn't breathing effectively you would want to give them rescue breathing after clearing their airway, and wouldn't this fall under the category of CPR? If not, why do we have to learn about rescue breathing when getting our CPR cert? CPR isn't limited to compressions and defibrillation...

Take a look at my post above and the new guidelines. In my mind, any form of resuscitation falls into the category of CPR, and I have recently been in the postion of assisting a collapsed person who had fitted and was extremely cyanotic on my arrival (this was in a shopping centre)

He was not breathing normally, but there was some abnormal respiratory effort, myself and a paramedic took the decision to start compressions in line with the new guidance. He began making a more convincing respiratory effort after 2 cycles of 30 compressions. I am convinced that this was the right call to make

[OttawaRPN]

Take a look at my post above and the new guidelines. In my mind, any form of resuscitation falls into the category of CPR, and I have recently been in the postion of assisting a collapsed person who had fitted and was extremely cyanotic on my arrival (this was in a shopping centre)

He was not breathing normally, but there was some abnormal respiratory effort, myself and a paramedic took the decision to start compressions in line with the new guidance. He began making a more convincing respiratory effort after 2 cycles of 30 compressions. I am convinced that this was the right call to make

Right. Agonal respirations do not provide adequate oxygenation to the body and should be considered the same as no breathing at all. Maybe they're gasping their last breath, which resembles the last furtive spasms like a fish out of water, it's the reflex action of the chest and neck muscles trying to grab a few more valuable 02 molecules. This breathing is not adequate for tissue perfusion.

If you're looking at a person and they can't wake up or you're not sure they're breathing, chances are they're not breathing. If they're taking shallow breaths and you can't see the chest rise and fall, that bit of breathing is not enough to circulate 02 appropriately. When in doubt, compress. Remember the first rule of CPR: doing something is better than doing nothing.

[GilaRRT]

Regardless, if I appreciate a pulse, no compressions. Not breathing normally is too much of a grey area for me. I understand there may be special situations; however, "isolated" respiratory arrest is not cardiac arrest. As health care professionals, we should be able to make that distinction in most cases.

Regarding the question of respiratory arrest to cardiac arrest transition, I cannot say. Assuming I have a healthy patient who is well denitrogenised, I could make them apneic for nearly 10 minutes or so before their saturations even fall below 90%. Take a sick person, and we've all seen these people develop bradycardia and even arrest in less than a minute. Trying to average such a wide spread out would be impossible IMHO. Add in a couple of standard deviations, and we have a very large rang of time that will vary significantly from patient to patient.

[nminodob]

"Assuming I have a healthy patient who is well denitrogenised, I could make them apneic for nearly 10 minutes or so before their saturations even fall below 90%."

Sorry, but I have to challenge this statement - how have you verified this "fact"? I would hate to be the experimental subject!

[BrnEyedGirl, BSN, MSN, RN, APRN]

"Assuming I have a healthy patient who is well denitrogenised, I could make them apneic for nearly 10 minutes or so before their saturations even fall below 90%."

Sorry, but I have to challenge this statement - how have you verified this "fact"? I would hate to be the experimental subject!

This is actually why the new guidlines are not suggesting breaths at all anymore,.chest compressions only. Depending on the pt, you may have up to 30 min of reserve O2. Check out the AHA website for new guidlines.