scenario c (cogaids)chelsea icu nurse dannielle rt conditions pneumonia, shortness of air meds...
TRANSCRIPT
Scenario C (Cogaids)Megacode video 4
Timing: 7:22
1v5.1
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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