Final answer:
When heart rate does not improve during CPR, ensure proper compression depth and rate, and consider patient and external factors affecting cardiac function, such as electrolyte imbalances, medication effects, and body temperature extremes.
Step-by-step explanation:
Questions to Ask When HR Not Improving During CPR
When performing CPR and noticing no improvement in the patient's heart rate (HR) despite correct compressions and ventilation, several factors should be considered. Confirm that compressions are at least 5 cm deep and at a rate of 100 compressions per minute, as recommended in current CPR guidelines. The hands should be properly positioned on the sternum between the lines at T4 and T9 to effectively compress the heart. If these standards are met and there is still no improvement, it may be necessary to reassess patient factors such as a potential pneumothorax, medication overdoses, or electrolyte imbalances, which could affect HR recovery. Additionally, one should consider external factors such as hypothermia or hyperthermia, which can influence the heart's function. Any significant deviation in body temperature can affect HR and the strength of heart contractions, and in severe cases, lead to a cessation of heart function.
Cardiac output (CO) is dependent on both HR and stroke volume (SV). When HR is drastically elevated or diminished, it could adversely influence CO, leading to insufficient blood circulation. In emergency situations like CPR, understanding these physiologic responses can be crucial for managing the patient's condition and deciding on further interventions.