Your patient is in cardiac arrest and has been intubated. D. Once every 5 to 6 seconds For a patient in respiratory arrest with a pulse, deliver ventilations once every 5 to 6 seconds with a bag-mask device or any advanced airway. Alert the hospital 16. You are the team leader during a pediatric resuscitation attempt Which action is an element of high- er quality CPR? [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: VF/Pulseless VT Case > Application of the Adult Cardiac Arrest Algorithm: VF/pVT Pathway > Shock and Vasopressors; page 99], A. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. During cardiac arrest, consider amiodarone 300 mg IV/IO push for the first dose. 0000017784 00000 n Improving patient outcomes by identifying and treating early clinical deterioration. High-performance team members should anticipate situations in which they might require assistance and inform the team leader. Team members including the team leader should ask for assistance or advice early before the situation gets out of hand. Allow the family to stay at the bedside with a staff member who is assigned to provide informationand assistance, A. As successful resuscitation rates increase, so do the chances that the patient receives the best chance for a positive, long-term outcome. Low-energy shocks should always be delivered as synchronized shocks to avoid precipitating ventricular fibrillation. The patient does not have any contraindications to fibrinolytic therapy. His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. The leader's whatever technique required for successful. The child is lethargic, has, You are examining a 2-year-old child who has a history of gastroenteritis. A dose of 1 mg IV/IO should be given and repeated every 3 to 5 minutes. This includes the following duties: Every symphony needs a conductor, just as every successful resuscitation team needs a team leader for the group to operate effectively and efficiently. Which is the maximum interval you should allow for an interruption in chest compressions? do because of their scope of practice. Please. The next person is called the Time/Recorder. This team member is in charge of all vascular duties, including: The time recorder is responsible for keeping a rolling record of time for: The time recorder also announces to the team when/if a next treatment or more medication is due. B. Only when they tell you that they are fatigued, B. It's vitally important that each member of a resuscitation team: There are a total of six team member roles and each are critical to the success of the entire team. Its vitally important that the resuscitation their role and responsibilities, that they, have working knowledge regarding algorithms, 0000009298 00000 n His radial pulse is very weak, blood pressure is 64/40 mm Hg, respiratory rate is 28 breaths/min, and oxygen saturation is 89% on room air. During cardiac arrest, consider amiodarone 300 mg IV/IO push for the first dose. The team leader: keeps the resuscitation team or significant chest pain, you may attempt vagal maneuvers, first. Both are treated with high-energy unsynchronized shocks. This includes the following duties: Keep the resuscitation team organized and on track Monitor the team's overall performance and accuracy Back up any other team member when appropriate Train and coach other team members when needed and provide feedback A patient in stable narrow-complex tachycardia with a peripheral IV in place is refractory to the first dose of adenosine. 0000023390 00000 n The defibrillator operator should deliver the shock as soon as the compressor removes his or her hands from the patients chest and all providers are clear of contact with the patient. C. Administration of adenosine 6 mg IV push, D. Administration of epinephrine 1 mg IV push, A. Defibrillation Ventricular fibrillation and pulseless ventricular tachycardia require CPR until a defibrillator is available. Assign the same tasks to more than one team member, D. Clearly delegate tasks To avoid inefficiencies, the team leader must clearly delegate tasks. Specific keywords to include in such spooge would be "situational . Alert the hospital B. accuracy while backing up team members when. A. Assign most tasks to the more experienced team members, D. Assign the same tasks to more than one team member, C. Clearly delegate tasks To avoid inefficiencies, the team leader must clearly delegate tasks. adjuncts as deemed appropriate. [ACLS Provider Manual, Part 5: The ACLS Cases > Tachycardia: Stable and Unstable > Cardioversion > Recommendations; page 137], B. During a resuscitation attempt, the team leader or a team member may need to intervene if an action that is about to occur may be inappropriate at the time. Continuous monitoring of his oxygen saturation will be necessary to assess th. As you might have guessed, this team member is in charge of bringing an AED to the scene (unless one is already present) and operating the AED. Team members should question a colleague who is about to make a mistake. The team should stick to the ABCs (airway, breathing, and circulation) and keep the resuscitation room quiet so that all personnel can hear without repetitious commands. As the team leader, when do you tell the chest compressors to switch? A. 0000023888 00000 n During a resuscitation attempt, the team leader orders an initial dose of epinephrine at .1mg/kg to be given IO. A. The child has received high-quality CPR, 2 shocks, A 3-year-old child is in cardiac arrest, and high-quality CPR is in progress. techniques. and effective manner. This person may alternate with the AED/Monitor/Defibrillator He is pale, diaphoretic, and cool to the touch. To properly ventilate a patient with a perfusing rhythm, how often do you squeeze the bag? A patient has a witnessed loss of consciousness. [ACLS Provider Manual, Part 5: The ACLS Cases > Tachycardia: Stable and Unstable > Rhythms for Unstable Tachycardia; page 130]. Which is the appropriate treatment? Chest compressions may not be effective, B. Which drug and dose should you administer first to this patient? A. 0000004836 00000 n Code Leader: Senior resident/nursing lead responsible for reviewing ECPR criteria, ensuring CPR quality metrics, mechanical CPR device placement, and run ACLS (if applicable) Airway physician: Places definitive airway when . everything that should be done in the right the following is important, like, pushing, hard and fast in the center of the chest, The CT scan should be completed within 25 minutes of the patients arrival in the emergency department and should be read within 45 minutes from emergency department arrival. Which best characterizes this patient's rhythm? The. excessive ventilation. [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: VF/Pulseless VT Case > Antiarrhythmic Agents > Amiodarone; page 106], A. Tachycardia This ECG rhythm strip shows ventricular tachycardia. Which dose would you administer next? C. Amiodarone 500 mg IV has been given., D. I have an order to give 500 mg of amiodarone IV. [ACLS Provider Manual, Part 5: The ACLS Cases > Acute Stroke Case > CT Scan: Hemorrhage or No Hemorrhage > Introduction; page 84]. Which would you have done first if the patient had not gone into ventricular fibrillation? pediatric surgery fellow who acts as the surgical team leader, a surgical attending, and one emergency medicine (EM) phy-sician who collaborates with the surgery team to direct the resuscitation. Which is the appropriate treatment? A 68-year-old woman presents with light-headedness, nausea, and chest discomfort. According to the Adult Suspected Stroke Algorithm, which critical action performed by the EMS team will expedite this patient's care on arrival and reduce the time to treatment? C. 160 to 325 mg If the patient has not taken aspirin and has no history of true aspirin allergy and no evidence of recent gastrointestinal bleeding, give the patient aspirin (160 to 325 mg) to chew. After determining that a patient is not breathing and has no pulse, start CPR, beginning with chest compressions. C. Conduct a debriefing after the resuscitation attempt, B. The vascular access and medication role is [ACLS Provider Manual, Part 3: Effective High-Performance Team Dynamics > Elements of Effective High-Performance Team Dynamics > Roles; page 29]. C. Chest compressions Ventricular fibrillation and pulseless ventricular tachycardia require CPR until a defibrillator is available. Improving patient outcomes by identifying and treating early clinical deterioration, C. Providing diagnostic consultation to emergency department patients, D. Providing online consultation to EMS personnel in the field, B. committed to the success of the ACLS resuscitation. Which is the primary purpose of a medical emergency team or rapid response team? Distributive Septic Shock You are caring for a 12 year old girl with acute lymphoblastic leukemia. Capnography shows a persistent waveform and a PETCO2 of 8 mm Hg. Which is the appropriate treatment? [ACLS Provider Manual, Part 3: Effective High-Performance Team Dynamics > Elements of Effective High-Performance Team Dynamics > Roles; page 28]. The patient has return of spontaneous circulation and is not able to follow commands. A 3-year-old child presents with a high fever and a petechial rash. [ACLS Provider Manual, Part 5: The ACLS Cases > Immediate PostCardiac Arrest Care Case > Application of the Immediate PostCardiac Arrest Care Algorithm > Targeted Temperature Management; page 151]. A. 0000003484 00000 n What would be an appropriate action to acknowledge your limitations? The Adult Tachycardia With a Pulse Algorithm outlines the steps for assessment and management of a patient presenting with symptomatic tachycardia with pulses. Your rescue team arrives to find a 59-year-old man fying on the kitchen floor. You may begin the training for free at any time to start officially tracking your progress toward your certificate of completion. D. Supraventricular tachycardia with ischemic chest pain, A. [ACLS Provider Manual, Part 2: Systems of Care > PostCardiac Arrest Care > Immediate Coronary Reperfusion With PCI; page 20], A. Conduct a debriefing after the resuscitation attempt, C. Address the team member immediately During a resuscitation attempt, the leader or a member of a high-performance team may need to intervene if an action that is about to occur may be inappropriate at the time. The window will refresh momentarily. Is this correct? Unclear communication can lead to unnecessary delays in treatment or to medication errors. Synchronized cardioversion uses a lower energy level than attempted defibrillation. Which initial action do you take? by chance, they are created. A 45-year-old man had coronary artery stents placed 2 days ago. [ACLS Provider Manual, Part 5: The ACLS Cases > Acute Stroke Case > Identification of Signs of Possible Stroke > Activate EMS System Immediately; page 78]. If 2 rescuers are present for the resuscitation attempt of an infant or child, use a compression-to-ventilation ratio of _____. Based on this patients initial presentation, which condition do you suspect led to the cardiac arrest? 0000008586 00000 n Which do you do next? The team leader's role is to clearly define and delegate tasks according to each team member's skill level. An alert toddler presents with a barking cough, moderate stridor, and moderate retractions. Which is the recommended oral dose of aspirin for a patient with a suspected acute coronary syndrome? Monitor the patients PETCO2 The AHA recommends using quantitative waveform capnography in intubated patients to monitor CPR quality, optimize chest compressions, and detect return of spontaneous circulation during chest compressions. 12mg Adenosine is indicated for most forms of stable narrow-complex supraventricular tachycardia. Address the . He is pale, diaphoretic, and cool to the touch. Ask for a new task or role Not only should everyone on the team know his or her own limitations and capabilities, but the team leader should also be aware of them. This allows the team leader to evaluate team resources and call for backup of team members when assistance is needed. A properly sized and inserted OPA results in proper alignment with the glottic opening. then announces when the next treatment is reports and overall appearance of the patient. [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: Pulseless Electrical Activity Case > Managing PEA: The Adult Cardiac Arrest Algorithm > Administer Epinephrine; page 111]. During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0 mg/kg to be given 10. It doesn't matter if you're a team leader or a supportive team member. About every 2 minutes Switch compressors about every 2 minutes, or earlier if they are fatigued. What should the team member do? Based on this patients initial assessment, which adult ACLS algorithm should you follow? 0000023787 00000 n The endotracheal tube is in the esophagus, B. Early defibrillation is critical for patients with sudden cardiac arrest (ventricular fibrillation/pulseless ventricular tachycardia). A. Epinephrine 1 mg For persistent ventricular fibrillation/pulseless ventricular tachycardia, give 1 shock and resume CPR immediately for 2 minutes after the shock. There are a total of 6 team member roles and And in certain cases they may already find Note: Your progress in watching these videos WILL NOT be tracked. Despite the drug provided above and continued CPR, the patient remains in ventricular fibrillation. [ACLS Provider Manual, Part 5: The ACLS Cases > Acute Coronary Syndromes Case > Immediate ED Assessment and Treatment > Introduction; page 67]. B. Initiate targeted temperature management, B. Initiate targeted temperature management To protect the brain and other organs, the high-performance team should start targeted temperature management in patients who remain comatose (lack of meaningful response to verbal commands) with return of spontaneous circulation after cardiac arrest. [ACLS Provider Manual, Part 4: The Systematic Approach > The BLS Assessment > Critical Concepts: Quality Compressions; page 37]. [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: VF/Pulseless VT Case > Application of the Adult Cardiac Arrest Algorithm: VF/pVT Pathway > Physiologic Monitoring During CPR; page 103], D. Performed synchronized cardioversion Synchronized shocks are recommended for patients with unstable supraventricular tachycardia, unstable atrial fibrillation, unstable atrial flutter, and unstable regular monomorphic tachycardia with pulses. I have an order to give 500 mg of amiodarone IV. Three minutes into a cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. 0000014579 00000 n 0000057981 00000 n A 45-year-old man had coronary artery stents placed 2 days ago. Check the ECG for evidence of a rhythm, B. Ask for a new task or role Not only should everyone on the team know his or her own limitations and capabilities, but the team leader should also be aware of them. 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