When you know the roles and responsibilities of each team member, you can anticipate what's coming next, which will increase the ability of the team to communicate, improve the efficiency and performance of the resuscitation, and the chances for the patient to have a positive outcome. Are you sure that is what you want given?, C. Ill draw up 0.5 mg of atropine. When communicating with high-performance team members, the team leader should use closed-loop communication. ensuring complete chest recoil, minimizing. Which is the best response from the team member? increases while improving the chances of a. [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: VF/Pulseless VT Case > Managing VF/Pulseless VT: The Adult Cardiac Arrest Algorithm > VF/pVT (Left Side); page 93]. Which drug and dose should you administer first to this patient? A fascinating and challenging read about the dilemma of the older workers who are economically inactive. 0000004212 00000 n The next person is called the AED/Monitor Start fibrinolytic therapy as soon as possible, C. Order an echocardiogram before fibrinolytic administration, Start fibrinolytic therapy in appropriate patients (those without contraindications) within 1 hour of hospital arrival and 3 hours from symptom onset. Early defibrillation is critical for patients with sudden cardiac arrest. Chest compressions may not be effective Which best describes this rhythm? 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. [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: VF/Pulseless VT Case > Application of the Adult Cardiac Arrest Algorithm: VF/pVT Pathway > Foundational Facts: Resume CPR While Manual Defibrillator Is Charging; page 96], B. excessive ventilation. By receiving a clear response and eye contact, the team leader confirms that the team member heard and understood the message. B. Noncontrast CT scan of the head A critical decision point in the assessment of the patient with acute stroke is the performance and interpretation of a noncontrast CT scan to differentiate ischemic from hemorrhagic stroke. 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? Three minutes into a cardiac arrest resuscitation attempt, one member of your team inserts an endotracheal tube while another performs chest compressions. 0000014177 00000 n The patient meets the criteria for termination of efforts, C. The team is ventilating the patient too often (hyperventilation), D. Chest compressions may not be effective, D. Chest compressions may not be effective PETCO2 values less than 10 mm Hg in intubated patients indicate that cardiac output is inadequate to achieve return of spontaneous circulation. Closed-loop communication. 0000023390 00000 n When applied, the cardiac monitor initially showed ventricular tachycardia, which then quickly changed to ventricular fibrillation. in resuscitation skills, and that they are What is the maximum time that. 12mg Adenosine is indicated for most forms of stable narrow-complex supraventricular tachycardia. The lead II ECG reveals this rhythm. A patient in respiratory distress and with a blood pressure of 70/50 mmHg presents with the lead II ECG rhythm shown here. Ventricular fibrillation and pulseless ventricular tachycardia require CPR until a defibrillator is available. Which is the appropriate treatment? 0000039541 00000 n The roles of team members must be carried Another member of your team resumes chest compressions, and an IV is in place. A dose of 1 mg IV/IO should be given and repeated every 3 to 5 minutes. When IV/IO access is available, give epinephrine 1 mg IV/IO during CPR after the second shock and repeat epinephrine 1 mg IV/IO every 3 to 5 minutes. The patient is experiencing shortness of breath, a blood pressure of 68/50 mm Hg, and a heart rate of 190/min. A 3-month-old infant with bronchiolitis is intubated for management of respiratory failure. due. A team member thinks he heard an order for 500 mg of amiodarone IV. member during a resuscitation attempt, all, of you should understand not just your particular [ACLS Provider Manual, Part 5: The ACLS Cases > Acute Coronary Syndromes Case > EMS Assessment, Care, and Hospital Preparation > Administer Oxygen and Drugs; page 65], C. 100 to 120/min When performing chest compressions, you should compress at a rate of 100 to 120/min. When you stop chest compressions, blood flow to the brain and heart stops. A 5-year-old child presents with lethargy, increased work of breathing, and pale color. A. [ACLS Provider Manual, Part 5: The ACLS Cases > Respiratory Arrest Case > Basic Airway Adjuncts: Oropharyngeal Airway > Technique of OPA Insertion; page 51], C. Determine if a carotid pulse is present, D. Resume CPR, starting with chest compressions Follow each shock immediately with CPR, beginning with chest compressions. Code team leaders who embrace their position tend to have more effective leadership, better team coordination, and overall superior performance. and speak briefly about what each role is, We talked a bit about the team leader in a If the patient became apneic and pulseless but the rhythm remained the same, which would take the highest priority? [ACLS Provider Manual, Part 4: The Systematic Approach > The BLS Assessment > Critical Concepts: Quality Compressions; page 37]. Determine if a carotid pulse is present, D. Resume CPR, starting with chest compressions, Follow each shock immediately with CPR, beginning with chest compressions. Which action should the team member take? In the application of the Tachycardia Algorithm to an unstable patient, identify and treat the underlying cause. Pro Tip #2: It's important to understand how important high-quality CPR is to the overall resuscitation effort. Which dose would you administer next? High-quality CPR, A team is attempting to resuscitate a child who was brought to the emergency department by. During a resuscitation attempt, the team leader asks you to administer an initial dose of Epinephrine at 0.1 mg/kg to be given IO. Measure from the thyroid cartilage to the bottom of the earlobe, C. Estimate by using the formula Weight (kg)/8 + 2, D. Estimate by using the size of the patients finger, A. Both are treated with high-energy unsynchronized shocks. CPR is initiated. Check the ECG for evidence of a rhythm, B. [ACLS Provider Manual, Part 5: The ACLS Cases > Bradycardia Case > Rhythms for Bradycardia; page 121]. 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. . assignable. [ACLS Provider Manual, Part 5: The ACLS Cases > Tachycardia: Stable and Unstable > Cardioversion > Recommendations; page 137], This ECG rhythm strip shows a monomorphic ventricular tachycardia. In addition to defibrillation, which intervention should be performed immediately? Compressor every 5 cycles or approximately, every 2 minutes or at which time where the A 45-year-old man had coronary artery stents placed 2 days ago. The CT scan was normal, with no signs of hemorrhage. [ACLS Provider Manual, Part 5: The ACLS Cases > Acute Coronary Syndromes Case > EMS Assessment, Care, and Hospital Preparation > Administer Oxygen and Drugs; page 65]. It is important to quickly and efficiently organize team members to effectively participate in PALS. [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]. The child is in, CPR is in progress on a 10-month-old infant who was unresponsive and not breathing, with no. Chest compressions Ventricular fibrillation and pulseless ventricular tachycardia require CPR until a defibrillator is available. The leader's The first rhythm, A 3-year-old child is in cardiac arrest, and a resuscitation attempt is in progress. That means compressions need to be deep enough, Another member of your team resumes chest compressions, and an IV is in place. 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. The Role of Team Leader. advanced assessment like 12 lead EKGs, Laboratory. everything that should be done in the right The Timer/Recorder team member records the What should the team member do? recommendations and resuscitation guidelines. [ACLS Provider Manual, Part 5: The ACLS Cases > Bradycardia Case > Rhythms for Bradycardia; page 121]. 0000017784 00000 n [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. Administration of epinephrine 1 mg IV push, Ventricular fibrillation and pulseless ventricular tachycardia require CPR until a defibrillator is available. Which of the following signs is a likely indicator of cardiac arrest in an unresponsive patient? They record the frequency and duration of After your initial assessment of this patient, which intervention should be performed next? Improving patient outcomes by identifying and treating early clinical deterioration. 39 Q [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]. to open the airway, but also maintain the, They work diligently to give proper bag-mask [ACLS Provider Manual, Part 3: Effective High-Performance Team Dynamics > Elements of Effective High-Performance Team Dynamics > How to Communicate; page 31]. 0000058273 00000 n 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. A team member is unable to perform an assigned task because it is beyond the team members scope of practice. Which facility is the most appropriate EMS destination for a patient with sudden cardiac arrest who achieved return of spontaneous circulation in the field? During a resuscitation attempt, the team leader orders an initial dose of epinephrine at 0.1 mg/kg to be given IO. Which of the following is a characteristic of respiratory failure? The leader should state early on that they are assuming the role of team leader. [ACLS Provider Manual, Part 5: The ACLS Cases > Acute Stroke Case > CT Scan: Hemorrhage or No Hemorrhage > Introduction; page 84]. Which initial action do you take? Her lung sounds are equal, with moderate rales present bilaterally. The patient does not have any contraindications to fibrinolytic therapy. [ACLS Provider Manual, Part 5: The ACLS Cases > Cardiac Arrest: VF/Pulseless VT Case > Managing VF/Pulseless VT: The Adult Cardiac Arrest Algorithm > VF/pVT (Left Side); page 93]. 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