Case Studies

Question 1

Chain of Survival

Answer 1

• Prevention & Preparedness
• Activation of the ERS
• High-quality CPR
• Adv resuscitation intervention
• Post-Cardiac Arrest Care
• Recovery

Question 2

In Hospital Cardiac Arrest (IHCA)
Chain of Survival

Answer 2

• Early recognition & prevention
• Activation of emergency response (RRT)
• High-quality CPR
• Defibrillation
• Post cardiac arrest care
  -Recovery

Question 3

Outside Hospital Cardiac Arrest (OHCA)
Chain of Survival

Question 4

Criteria to activate the Rapid Response Team (RRT)

Answer 4

Criteria to activate the Rapid Response Team
Threatened Airway
RR (KNOW BASELINE)
< 6/ mins
> 30 /mins
HR (KNOW BASELINE)
< 40/min
> 140/ min
Systolic BP(KNOW BASELINE)
< 90 mmHg
Symptomatic HTN
Unexpected decrease LOC
Unexplained agitation
Seizure
Significant fall in URINE OUTPUT
Subjective concern of pt

Question 5

RESPIRATORY DISTRESS

Answer 5

RESPIRATORY DISTRESS
Tachypnea
Inc Respiratory Effort
Abn A/W sounds
Tachycardia
Pale, Cool skin
Changes in LOC
Use of abd muscles to breathe

Question 6

RESPIRATORY FAILURE

Answer 6

MARKED Tachypnea
Bradypnea, Apnea
No Respiratory Effort
Tachycardia EARLY
Bradycardia LATE
Cyanosis
Stupor
Coma LATE

Question 7

HIGH PERFORMANCE TEAMS

Answer 7

TIMING
QUALITY
COORDINATION
ADMINISTRATION

Question 8

HIGH PERFORMANCE TEAMS

TIMING

Answer 8

1ST COMPRESSION TO 1ST SHOCK
CHEST COMPRESSION FRACTION > 80%
MINIMIZE PRESHOCK PAUSE
EARLY RESPONSE TIME

Question 9

HIGH PERFORMANCE TEAMS

QUALITY

Answer 9

RATE, DEPTH, CHEST RECOIL
MINIMIZING INTERRUPTIONS
SWITCHING COMPRESSORS
AVOIDING EXCESS VENTILATION
USE OF FEEDBACK DEVICE

Question 10

HIGH PERFORMANCE TEAMS

COORDINATION

Answer 10

TEAM MEMBERS WORKING TOGETHER
PROFICIENCY

Question 11

HIGH PERFORMANCE TEAMS

ADMINISTRATION

Answer 11

LEADERSHIP
MEASUREMENT
CQI (CONTINUOUS QUALITY IMPROVEMENT)
NUMBER OF CODE TEAM MEMBERS

Question 12

ROLE OF TEAM LEADER

Answer 12

Organize group
Monitor Indiv performance of team members
Backs up team members
Models behavior
Trains & coaches
Facilitates understanding
FOCUS: Comprehensive Pt Care
Temp Designiation to another member: ADV procedure required

Question 13

ROLE OF TEAM MEMBER

Answer 13

Profcient in performing skills/ scope (of practice)
Clear role assignments
Prepared to fulfill role/ responsibilites
Competent Resuscitation skills
Knowledge (@ algorithm)
COMMITMENT to success

Question 14

ROLE OF CPR COORDINATOR

Answer 14

COORDINATE the start
COACH improvement in quality of COMPRESSIONS
STATE midrange targets
COACH to the midrange targets
MINIMIZE length of pauses between COMPRESSIONS

Question 15

Why is it important to have a CPR coach?

Question 16

ELEMENTS OF EFFECTIVE DYNAMICS

Answer 16

ELEMENTS OF EFFECTIVE DYNAMICS
CLEAR roles & responsibilites
KNOW your limitations
CONSTRUCTIVE Interventions
KNOWLEDGE Sharing
SUMMARIZE & Reevaluate
EFFECTIVE Communication

Question 17

IMPORTANCE OF MAINTAINING EFFECTIVE COMMUNICATION

Answer 17

IMPORTANCE OF MAINTAINING EFFECTIVE COMMUNICATION
CLOSED-LOOP COMMUINICATION
CLEAR MESSAGE
MUTUAL RESPECT

Question 18

How to achieve effective communication

Question 19

SYSTEMIC APPROACH (SCENARIO)

Answer 19

SYSTEMIC APPROACH (SCENARIO):
INITIAL ASSESSMENT
BLS ASSESSMENT
PRIMARY ASSESSMENT
SECONDARY ASSESSMENT

Question 20

Initial Assessment

Answer 20

Initial Assessment

VISUALIZATION
VERIFY SCENE SAFETY
DETERMINE CONSCIOUS vs UNCONSCIOUS PATIENT

Question 21

BLS ASSESSMENT

Answer 21

BLS ASSESSMENT

√ RESPONSIVENESS
SHOUT/ SEEK NEARBY HELP
√ BREATHING & PULSE
DEFRBRILLATION

Question 22

PRIMARY ASSESSMENT

Answer 22

PRIMARY ASSESSMENT

AIRWAY
BREATHING
CIRCULATION
DISABILITY
EXPOSURE

Question 23

SECONDARY ASSESSMENT

Answer 23

SECONDARY ASSESSMENT

COMPRESS 2 inches (5 cm)
COMPRESS RATE 100-120/min
COMPLETE Chest Recoil after each compression
COMPRESS Hard & Fast
INTERRUPTION <10 sec
AVOID EXCESSIVE VENTILATION (30:2)
SWITCH COMPRESSOR EVERY 2 mins (OR earlier if fatigued)