scenario c (cogaids)chelsea icu nurse dannielle rt conditions pneumonia, shortness of air meds...

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Scenario C (Cogaids)Megacode video 4

Timing: 7:22

1v5.1

2

3

4

5

6

7

8

9

10

11

PEA VT/VFAll Aids quick search

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

12

Asystole

Myocardial Ischemia Anaphylaxis

Cardiac Arrest

Bradycardia PEA

Malignant Hyperthermia

VFibVTach/

No PulseHAS PULSE

but Hypotensive

PEA VT/VFAll Aids quick search

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

13

Asystole

Myocardial Ischemia Anaphylaxis

Cardiac Arrest

Bradycardia PEA

Malignant Hyperthermia

VFibVTach/

No PulseHAS PULSE

but Hypotensive

PEA VT/VFAll Aids quick search

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

14

Asystole

Myocardial Ischemia Anaphylaxis

Cardiac Arrest

Bradycardia PEA

Malignant Hyperthermia

VFibVTach/

No PulseHAS PULSE

but Hypotensive

highlight vt/vfib here?

CHECK In the OR: Volatile—OFF, O2—100%...

TREAT FiO2—↑100%; Ventilation & Oxygenation—ok?; Anesthetics—↓ or off?; Atropine—0.5...

↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNSSIGNS

Code Cart

PEA Asys☐VTach & VFib

Rotate personnel compressors q2 min

ETCO2 > 10mmHg?

Arterial line diastolic > 20 mmHg?

≥100 comprsn/min≥2” deep

↓breaks in CPR; allow complete chest recoilVTach

VFib

Defibrillator

CONSIDER Antiarrhythmics; HypoMg or Torsades...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

15

TREAT☐Defibrillate —200 Joules (biphasic)

☐CPR—RESUME IMMEDIATELY☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

16

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☐Defibrillate —200 Joules (biphasic)

☐CPR—RESUME IMMEDIATELY☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

17

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

18

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

19

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

20

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

21

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

DannielleRT

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)☑ CPR—RESUME IMMEDIATELY

☐Epinephrine —1 mg IV push 3–5 min

↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

22

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)☑ CPR—RESUME IMMEDIATELY

☐Epinephrine —1 mg IV push 3–5 min

↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

23

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

↻ DEFIB → CPR → MEDS

↻CPR→DEFIB→MEDSTREATSIGNS VTach...

TREAT☑ Defibrillate—200 Joules (biphasic)☑ CPR—RESUME IMMEDIATELY☑ Epinephrine—1 mg IV push q 3–5 min

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

24

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

↻ DEFIB → CPR → MEDS

↻CPR→DEFIB→MEDSTREATSIGNS VTach...

TREAT☑ Defibrillate—200 Joules (biphasic)☑ CPR—RESUME IMMEDIATELY☑ Epinephrine—1 mg IV push q 3–5 min

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

25

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

↻ DEFIB → CPR → MEDS

↻CPR→DEFIB→MEDSTREATSIGNS VTach...

TREAT☑ Defibrillate—200 Joules (biphasic)☑ CPR—RESUME IMMEDIATELY☑ Epinephrine—1 mg IV push q 3–5 min

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

26

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

↻ DEFIB → CPR → MEDS

↻CPR→DEFIB→MEDSTREATSIGNS VTach...

TREAT☑ Defibrillate—200 Joules (biphasic)☑ CPR—RESUME IMMEDIATELY☑ Epinephrine—1 mg IV push q 3–5 min

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

27

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

28

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

29

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

30

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

31

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

32

Asystole , Pulse

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

33

CONSIDER☐Antiarrhythmics Amiodarone 300mg IV, Lidocaine 100mg IV

☐HypoMg or Torsades?→MgSO4 2g IV☐HyperK?→Ca, insulin & glucose, NaHCO3

SIGNS VTach...

PEA Asys☐VTach & VFib↻DEFIB→CPR→MEDSTREAT

CHECK ↻IV—access? ↻Ventilation—OK? In the OR: Volatile...

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

34

Asystole , Pulse

35

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s36

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s37

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

Volatile—OFF; O2—100%; Ventilation—10 breaths...IMMEDIATE

☐Epinephrine—1mg IV push q 3-5 mins

TREAT

Brady VT/VF☐AsystoleCPRFlat Line, No PulseSIGNS Resume CPR

Hypovolemia, Hypoxia, Tension pneumothorax, Thrombosis Coronary, Thrombosis Pulmonary...H&T’s

38

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Volatile—OFF; O2—100%; Ventilation—10 breaths...IMMEDIATE

☐Epinephrine—1mg IV push q 3-5 mins

TREAT

Brady VT/VF☐AsystoleCPRFlat Line, No PulseSIGNS Resume CPR

Hypovolemia, Hypoxia, Tension pneumothorax, Thrombosis Coronary, Thrombosis Pulmonary...H&T’s

39

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Volatile—OFF; O2—100%; Ventilation—10 breaths...IMMEDIATE

☐Epinephrine—1mg IV push q 3-5 mins

TREAT

Brady VT/VF☐AsystoleCPRFlat Line, No PulseSIGNS Resume CPR

Hypovolemia, Hypoxia, Tension pneumothorax, Thrombosis Coronary, Thrombosis Pulmonary...H&T’s

40

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Volatile—OFF; O2—100%; Ventilation—10 breaths...IMMEDIATE

☐Epinephrine—1mg IV push q 3-5 mins

TREAT

Brady VT/VF☐AsystoleCPRFlat Line, No PulseSIGNS Resume CPR

Hypovolemia, Hypoxia, Tension pneumothorax, Thrombosis Coronary, Thrombosis Pulmonary...H&T’s

41

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Volatile—OFF; O2—100%; Ventilation—10 breaths...IMMEDIATE

☐Epinephrine—1mg IV push q 3-5 mins

TREAT

Brady VT/VF☐AsystoleCPRFlat Line, No PulseSIGNS Resume CPR

Hypovolemia, Hypoxia, Tension pneumothorax, Thrombosis Coronary, Thrombosis Pulmonary...H&T’s

42

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Volatile—OFF; O2—100%; Ventilation—10 breaths...IMMEDIATE

☐Epinephrine—1mg IV push q 3-5 mins

TREAT

Brady VT/VF☐AsystoleCPRFlat Line, No PulseSIGNS Resume CPR

Hypovolemia, Hypoxia, Tension pneumothorax, Thrombosis Coronary, Thrombosis Pulmonary...H&T’s

43

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s44

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s45

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s46

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

CONSIDER VTach

CPR

Brady VT/VF☐AsystoleFlat Line, No PulseSIGNS

Code Cart

IMMEDIATE Volatile—OFF; O2—100%; Ventilation—10 breaths/min?; Consider: Local anesthetic...

TREAT Epinephrine—1mg IV, Vasopressin 40 units IV...

Hypovolemia, Hypoxia, Tension pneumothorax...H&T’s47

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

Rotate personnel compressors q2 min

ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?

≥100 cmprsns/min, ≥2” deep, 8–10 breaths/min

↓ breaks in CPR, Allow complete chest recoil

CONSIDER VTach

48

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☐Defibrillate —200 Joules (biphasic)

☐CPR—RESUME IMMEDIATELY☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

TREAT☐Defibrillate —200 Joules (biphasic)

☐CPR—RESUME IMMEDIATELY☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

49

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☐Defibrillate —200 Joules (biphasic)

☐CPR—RESUME IMMEDIATELY☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

50

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

51

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

52

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

53

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

54

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

55

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

56

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

57

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

58

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

59

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

TREAT☑ Defibrillate—200 Joules (biphasic)

☐CPR —RESUME IMMEDIATELY

☐Epinephrine—1 mg IV push q 3–5 min↻DEFIB→CPR→MEDS

PEA Asys☐VTach & VFibVTachSIGNS VFib, CPR: ≥100...

CHECK In the OR: Volatile—OFF, O2—100%; Ventilation—OK?. Always Check: IV...

CONSIDER Antiarrhythmics—Consider; HypoMg or Torsades?; HyperK?

60

K. Note, 78 yrs, 61.1 kg

Services Help

YouTeam Lead

LarryPharmacist

ChelseaICU Nurse

Conditions Pneumonia, shortness of air

Meds Atenolel 50mg

Other History of cardiac problems

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