Resuscitation Leadership: Beyond ACLS * MANY THANKS TO DR. NICK - - PowerPoint PPT Presentation

Resuscitation Leadership:

Beyond ACLS

* MANY THANKS TO DR. NICK JOHNSON FOR THE USE OF HIS SLIDES!

Get in the Right Mindset: Control

Self Patient

Get in the Right Mindset: Control

Cliff Reid, Making things Happen, 2013

Self Team Environment Patient

Preparation

ACLS is just the beginning

• Know the algorithms
• References are OK!
• Start out strong: checklist/script for the first 30-60

seconds

• Have a plan: common scenarios
• Practice, practice, practice

Prepare yourself even MORE

Know your resources

• Team
• Back up
• Equipment

Navigate the hospital

Team

Prepare your team

Pre-brief On-the-fly drills Mock codes “Practice as you play”

Controlling the Team & Environment: Leadership Best Practices

The Ultimate Code Team Leader

• Clear introductions
• Be loud, be calm, be nice
• Body language
• Delegate
• Crowd control
• Getting a hx
• Pulse checker

Back to our scripts…

Troublesome Codes: Be Prepared

Common Hang-ups: Have a Plan

The “not-a-code” code Awkward location The overly-enthusiastic fellow Vascular access issues Airway difficulties The über sub-specialty patient

Challenging Scenarios

Case #1

Case #2

Case #2

Surgical Airway Code

• The patient cannot be oxygenated or ventilated.
• The patient needs a definitive airway without delay and any of

the triggers outlined below are met.

• 3 attempts at endotracheal intubation and/or
• 10 minutes has elapsed
• The Anesthesiology attending physician or the Code Blue Team

Leader decides that a surgical airway is necessary and additional intubation attempts would be futile.

Case #2

Case #2

Case #2

For sub-specialty patients, ask for sub-specialty help Cardiac device patient in extremis:

• Vital signs may be unreliable
• Can closed-chest compressions performed?
• Is the device working?
• Is the patient hypovolemic?
• Is there bleeding or thrombosis?