Stanford Medical Checklist Study · ☐CPR—RESUME IMMEDIATELY ↻DEFIB→CPR→MEDS CHECK In the...
Transcript of Stanford Medical Checklist Study · ☐CPR—RESUME IMMEDIATELY ↻DEFIB→CPR→MEDS CHECK In the...
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Stanford Medical Checklist StudyTraining (Cogaids) v4
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This screen may contain a digital, dynamic cognitive aid. You may use it to answer questions during a
scenario.
No interaction is required with this screen--the cognitive aid will automatically adapt to match the
current medical scenario.
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↑ETCO2, Tachycardia...SIGNS
DDXLight anesthesia Hypoventilation Over-heating
(external)
Thyroid storm Pheochromo-cytoma
Insufflation of CO2
Hypoxemia
SECONDARY
TREAT Anesthetic triggers—discontinue; ↑Gas—10 L/min; TIVA; Hyperventilate—FiO2 100%, O2...
☐Malignant Hyperthermia PEA VT/VF↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNS Light anesthesia, Hypo...DDX
T. Stark, 35 yrs, 102.1 kg
Services Help
YouTeam Lead
LarryPharmacist
ChelseaICU Nurse
DannielleRT
Conditions Cardiac Arrest, Shrapnel
Meds Lithium Dioxide
Other Palladium toxicity, alcoholism
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SECONDARY Patient—Monitor in ICU;Dantrolene—1 mg/kg
☐Cool patient☐Hyperkalemia? CaCl2 1g IV☐Labs
☐Hyperventilate—FiO2 100%, O2 high☐Dantrolene—2.5 mg/kg sterile☐Dantrolene—Rapidly administer until patient stable☐Na2CO3—1 to 2 mEq/kg
☑ Anesthetic triggers—discontinue
☐↑Fresh gas—10 L/min Do NOT change machine or circuit
☐TIVA
TREAT
☐Malignant Hyperthermia PEA VT/VF↑ETCO2, Tachycardia...SIGNS Light anesthesia, Hypo...DDX
T. Stark, 35 yrs, 102.1 kg
Services Help
YouTeam Lead
LarryPharmacist
ChelseaICU Nurse
DannielleRT
Conditions Cardiac Arrest, Shrapnel
Meds Lithium Dioxide
Other Palladium toxicity, alcoholism
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☑ Hyperventilate—FiO2 100%, O2 high☑ Dantrolene—2.5 mg/kg sterile☑ Dantrolene—Rapidly administer until patient stable☑ Na2CO3—1 to 2 mEq/kg
☑ Anesthetic triggers—discontinue☑ ↑Fresh gas—10 L/min☑ TIVA
☑ Cool patient
☐Hyperkalemia? CaCl2 1g IV Check blood gas for electrolyte abnormalities; CaCl2 1g, D50 1 Amp (25g Dextrose) + Reg. Insulin 10 units; (monitor glucose), or NaHCO3 1 Amp; No Ca channel blockers
☐Labs
TREAT
☐Malignant Hyperthermia PEA VT/VF↑ETCO2, Tachycardia...SIGNS Light anesthesia, Hypo...DDX
SECONDARY Patient—Monitor in ICU;Dantrolene—1 mg/kg
T. Stark, 35 yrs, 102.1 kg
Services Help
YouTeam Lead
LarryPharmacist
ChelseaICU Nurse
DannielleRT
Conditions Cardiac Arrest, Shrapnel
Meds Lithium Dioxide
Other Palladium toxicity, alcoholism
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In some conditions, this display will be blank.
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Now, this screen will display the software-based, dynamic cognitive aid.
Ready...?
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PEA VT/VFAll Aids search
Asystole
Myocardial Ischemia Anaphylaxis
VTach/VFib
Cardiac Arrest
BradycardiaPEA
Malignant Hyperthermia S. Card, 67 yrs, 64.0 kg
Services Help
YouTeam Lead
ChelseaNurse
Conditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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SECONDARY Consider possible root causes.
TREAT Begin compressions immediately.
↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNS
SIGNS
Call for Help?
PEA VT/VF☐Possible Crisis?
Not breathing? No pulse?
Services Help
YouTeam Lead
ChelseaNurse
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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SECONDARY Consider possible root causes.
TREAT Begin compressions immediately.
↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNS
SIGNS
Call for Help?
PEA VT/VF☐Possible Crisis?
Not breathing? No pulse?
Services Help
YouTeam Lead
ChelseaNurse
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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SECONDARY Consider possible root causes.
TREAT Begin compressions immediately.
↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNS
SIGNS
Call for Help?
PEA VT/VF☐Possible Crisis?
Not breathing? No pulse?
Services Help
YouTeam Lead
ChelseaNurse
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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SECONDARY Consider possible root causes.
TREAT Begin compressions immediately.
↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNS
SIGNS
Call for Help?
PEA VT/VF☐Possible Crisis?
Not breathing? No pulse?
Services Help
YouTeam Lead
ChelseaNurse
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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SECONDARY Consider possible root causes.
TREAT Begin compressions immediately.
↑ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm...SIGNS
SIGNS
Call for Help?
PEA VT/VF☐Possible Crisis?
Not breathing? No pulse?
Services Help
YouTeam Lead
ChelseaNurse
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
13
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CPR
Brady VT/VF☐No pulseFlat Line, No PulseSIGNS
Check rhythm
ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?
Allow for complete chest recoil
Code Blue
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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Start chest compressions (mid sternum)
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CPR
Brady VT/VF☐No pulseFlat Line, No PulseSIGNS
Check rhythm
ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?
Start chest compressions (mid sternum)
Allow for complete chest recoil
Code Blue
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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CPR
Brady VT/VF☐No pulseFlat Line, No PulseSIGNS
Check rhythm
ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?
Allow for complete chest recoil
Code Blue
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
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Start chest compressions (mid sternum)
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CPR
Brady VT/VF☐No pulseFlat Line, No PulseSIGNS
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
Check rhythm
ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg?
Allow for complete chest recoil
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Start chest compressions (mid sternum)
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CONSIDER DDX
TREAT☐Defibrillate — # Joules
☐CPR—RESUME IMMEDIATELY
↻DEFIB→CPR→MEDS
CHECK In the OR: Volatile, O2Ventilation—OK?. Always Check: IV...
PEA Asys☐VTach - WideVTachSIGNS
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
18
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CONSIDER DDX
TREAT☐Defibrillate — # Joules
☐CPR—RESUME IMMEDIATELY
↻DEFIB→CPR→MEDS
CHECK In the OR: Volatile, O2Ventilation—OK?. Always Check: IV...
PEA Asys☐VTach - WideVTachSIGNS
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
19
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CONSIDER DDX
TREAT☐Defibrillate — # Joules
☐CPR—RESUME IMMEDIATELY
↻DEFIB→CPR→MEDS
CHECK In the OR: Volatile, O2Ventilation—OK?. Always Check: IV...
PEA Asys☐VTach - WideVTachSIGNS
Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
19
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TREAT☑ Defibrillate (biphasic machine)
☐CPR —RESUME
↻DEFIB→CPR→MEDS
PEA Asys☐VTach & VFibVTachSIGNS
Services Help Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Cumadin
Other Prior cardiac arrest
CONSIDER DDX
CHECK In the OR: Volatile, O2Ventilation—OK?. Always Check: IV...
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TREAT☑ Defibrillate (biphasic machine)
☐CPR —RESUME
↻DEFIB→CPR→MEDS
PEA Asys☐VTach & VFibVTachSIGNS
Services Help Services Help
YouTeam Lead
KyleDoctor
ChelseaICU Nurse
DannielleRT
S. Card, 67 yrs, 64.0 kgConditions High blood pressure
Meds Coumadin
Other Prior cardiac arrest
CONSIDER DDX
CHECK In the OR: Volatile, O2Ventilation—OK?. Always Check: IV...
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