Preventing Sudden Cardiac Deaths - Evidence Based Article

Background:

Every year cardiac related deaths occur spontaneously and undiagnosed. Although they are not common these sudden cardiac deaths, SCD, actually occur more often in athletes. According to the article “Sudden Cardiac Death in Athletes” from the Journal of Internal Medicine, the fact that SCD occurs 2-3 times more often in athletes than non-athletes is not surprising considering the workload that excessive exertion adds to the heart. Adding excess workload on a heart with an undiagnosed heart defect or abnormality is exactly what causes these SCD’s in younger adults; however, coronary artery disease with exercise is what causes SCD in people over 35. These deaths could possibly be prevented if mandatory electrocardiogram, EKG, screenings along with the required yearly physical examination were mandatory, and that is what the article is trying to persuade the reader of.    

     The article talks about how this problem could possibly become worse in the near future due to the large amount of the population being “baby boomers” and the encouragement of national initiatives to be more physically active. This increased amount of older adults who are being encouraged to be more active and who will, according to the article, be less in shape is only going to increase these SCD related events. With proper screening of these athletes and regular exercisers, this could be prevented.  
Method:

The article suggests that EKG screening cannot detect everything and that people with supposedly “healthy hearts” may need genetic testing. But for now their main priority includes the annual resting EKG screening to determine if an abnormality is present.  The EKG can detect cardiomyopathy, valve disease, and electrophysiological disorders. They also suggest having a backup plan of having all necessary equipment available at sporting events such as a defibrillator and personnel trained in Advanced Cardiac Life support/ CPR. Along with the annual physical exam, the EKG will help prevent undiagnosed and unnecessary cardiac deaths.

The article bases their idea from Italy’s already mandated cardiac screening that has been in effect for 30 years. From 1970- 2000 Italy monitored all athletes from 13-14 years of age. The article stated that Italy reduced its SCD events from 4 to 0.4 per 100,000. The AHA and the European Society of cardiology backs the idea of cardiac screening in athletes. The article stated that FIFA (federation international Football Association) and UEFA (Union of European Football Assocation) both use the mandatory cardiac screening along with their mandated physical examinations. So why would the NFL, MLB, NBA and MLS not benefit from these screenings?

Conclusion:

In conclusion the article talks of screening athletes because they are at increased risk, but anyone who regularly exercises as well as non-athletes would all benefit from receiving a yearly cardiac exam as well. Nurses and anyone in the healthcare field could all understand how important a healthy heart is, and they can help promote this idea. All professions and businesses could include this screening in with their required annual physical examination and it could greatly benefit that person’s, as well as the majority of the population’s, life.

Schmied C. , Borjesson M. University Hospital Zurich, Zurich, Switzerland; and Karolinska University Hospital, Stockholm, Sweden. Sudden cardiac death in athletes. J Intern Med 2014; 275: 93–103.

Schmied, C., & Borjesson, M. (2014). Sudden cardiac death in athletes. Journal of Internal Medicine, 275(2), 93–103. doi:10.1111/joim.12184

http://onlinelibrary.wiley.com/doi/10.1111/joim.12184/full

201 Simulation Lab Reflective Journal

                                                 Simulation Lab Reflective Journal

1) In simulation lab our group completed several tasks. To start off the simulation we had had to order a patient ID band and add allergies to the patients chart after the patient stated having allergies to Demerol and Sulfa drugs. Admissions sent a wristband with the wrong date of birth and we had to reorder a band with the correct date of birth. We then drew a CBC, ESR, and BMP labs through venipuncture and labeled them and sent them down to the lab. We assessed the patients puncture wound while providing wound care, and then changed the dressing. Prior to doing wound care we administered Tylenol 625 mg oral route for slightly elevated fever of 100.9 Fahrenheit and pain of 4/10.

2) What I learned most about the tasks we completed in simulation lab was the correct way to label labs, cultures, and specimens to be sent off for lab work. When drawing labs you must make sure that each individual tube has a patient label with the following: First initial of first name, last name, title, time drawn, date drawn, site drawn from, and patients name. After labeling each test tube they should be put into a biohazard bag and the bag should have a patient label with the same information as the test tubes. Following these proper labeling techniques will ensure that the labs do not get discarded due to improper labeling. It will also avoid losing rapport with the patient when they think you have no idea how to do your job.

3) During my next simulation experience I will ensure that I know exactly how to perform the procedures listed in the doctors orders. Another area I will focus on for the next simulation is providing more teaching opportunities to the patient when they present themselves.

4) While watching the second group perform their simulation I learned that I should have some interventions prepared to initiate before I arrive to care for the patient. I also learned that I should look into areas that I can provide teaching on for this patient. The last thing that I learned from watching my peers is that a detailed assessment can be very crucial to the patient's outcome of healing.

5) A few things that I learned from the classroom that I incorporated into simulation were that number one you always need to assess the patient thoroughly. You never know what another nurse or doctor could have missed that may be detrimental to the patients health. The second thing I used from the classroom is when assessing a wound, the drainage can be an important sign of how the wound is healing. Our patient had a saturated sanguineous dressing from a puncture wound that had supposedly closed and was not bleeding. The last thing I used from the classroom was that you should always assess for allergies before each time you are administering a medication or performing a procedure. Our patient's chart stated no known allergies and the patient was allergic to Demerol and sulfa antibiotics. You never know when the patient may just suddenly remember an allergy they forgot to tell the admitting nurse.

-By Cody Fowler

Hi Cody happy blogging to you😊