HIGHLIGHTED PORTIONS ARE HIGHLY TESTED!!!!!!!!
Week 1:
Team dynamics
Effective High-performance team dynamics
• Role of Team Leader – have a big picture mind set, patients' condition
o Organizes the group
o Monitors individual performance of team member
o Backs up team members
o Models excellent team behavior
o Trains and coaches
o Facilitates understanding
o Focuses on comprehensive patient care
o Temporarily designates another team member to take over as Team leader if an
advanced procedure is required (e.g., intubation)
• Role of Team member
o Clear about role assignments
o Prepared to fulfill their role responsibility
o Well-practiced in resuscitations skills
o Knowledgeable about the algorithms
o Committed to success
• CPR Coach – AHA goals are being met.
o Supports performance of high-quality BLS skills
o Provides feedback about the:
▪ Compressions rate, depth, and recoil
▪ Delivery of ventilation (rate and volume)
▪ Compression pauses
o Allows the team leader to focus on other aspects of clinical care
Elements of Effective Team Dynamics
• Roles
1. Clear Roles and Responsibilities
▪ Every member of the team should know his or her role and
responsibilities. Know other roles in case you need to take over for
another. Unclear roles lead to poor outcomes.
2. Knowing your Limitations
▪ Do not avoid taking assignments, respectfully ask for another
▪ Do not take assignments beyond your level of expertise
▪ Ask for help.
3. Constructive Interventions
, ▪Asks participants to intervene for the patient’s safety when they know
something is not right during a code.
▪ When speaking up to a question or to correct, be tactful and avoid a
confrontational tone of voice.
• What to Communicate
4. Knowledge sharing
▪ Avoid becoming fixated on a specific treatment or diagnosis.
• This is known as fixation error. Common phrases include:
o “Everything is ok.”
o “Only this is the correct way.”
o “Do anything but this.”
▪ All team members should communicate any changes in the patient’s
condition.
5. Summarizing and Re-evaluating
▪ Provides an opportunity to share the client status, interventions performed,
assessment findings, and re-evaluate if changes should be implemented to
improve the outcome.
• How to Communicate
6. Ensure Closed loop communication
▪ Best practice: Team member gets a message and restates the task back to
the team leader.
▪ The team leader listens for confirmation of the task performed from the
team member before assigning another task.
7. Clear messages
▪ Concise communication spoken with distinctive speech in a controlled
voice.
8. Mutual respect
▪ The team leader and members should respect, work and show support for
each other.
BLS Assessment
• Ensure the scene is safe
• Check responsiveness
• Shout for nearby help/activate the emergency response system and get the
AED/defibrillator
• Check breathing and pulse
o Scan the chest for respiratory movement and perform a pulse check for least 5
seconds, no more than 10 seconds
▪ An irregular respiratory pattern called agonal gasps may be present within
the first couple of minutes after sudden cardiac arrest.
▪ Gasping is not normal breathing and is a sign of cardiac arrest.
o If no pulse within 10 seconds, start CPR, beginning with chest compressions
, ▪ Compress the chest hard and fast at least 2-2.4 inches (5-6 cm) at a
rate of 100-120/min.
▪ Allow complete chest recoil after each compression. So that the heart
is filling with blood.
▪ Switch compressors about every 2 minutes or earlier if fatigued.
▪ Minimize interruptions in compressions to 10 seconds or less.
▪ Avoid excessive ventilation.
o If there is a pulse and absent breathing, start rescue breathing at 1 breath
every 6 seconds.
o Check pulse about every 2 minutes (5 cycles of CPR)
• Defibrillation
o If no pulse, check for a shockable rhythm with an AED/defibrillator as soon
as it arrives
o If using an AED, follow the prompt and provide shocks as indicated
o Follow each shock immediately with CPR, beginning with compressions
Primary Assessment: Airway Management
• Airway positioning maneuvers
o Head tilt- chin lift (if no suspicion of head/neck injury)
o Jaw thrust (if suspicion head/neck injury)
• Basic Airway Adjuncts
o Oropharyngeal Airway (OPA)
o Used in unconscious patients, with no gag reflex or cough
▪ Suction the mouth and pharynx of secretions, blood, or vomit
▪ Select the proper size of OPA
▪ Measure than flange from the corner of the mouth, the tip at the angle
of the mandible
▪ After insertion, monitor the patient and maintain airway patency
o Nasopharyngeal Airway (NPA)
o Used in conscious, semiconscious, or unconscious patients with or without gag
reflex
▪ Select the proper size
▪ Measure from the tip of the nose to the earlobe
▪ Lubricate the airway and insert
• Bag-Mask Ventilation (also known as Ambu bag or Bag valve mask (BVM))
o Consists of a ventilation bag attached to a face mask
o Must be connected to 100% oxygen source 10-15
o Provides positive pressure ventilation
o Deliver ventilation volume to produce visible chest rise in 1 second.
o Use E-C clamp technique to secure mask over face
o Tidel volumes 500-600 ml, half a squeeze of adult bag.
• Advanced Airways
o Indications
Week 1:
Team dynamics
Effective High-performance team dynamics
• Role of Team Leader – have a big picture mind set, patients' condition
o Organizes the group
o Monitors individual performance of team member
o Backs up team members
o Models excellent team behavior
o Trains and coaches
o Facilitates understanding
o Focuses on comprehensive patient care
o Temporarily designates another team member to take over as Team leader if an
advanced procedure is required (e.g., intubation)
• Role of Team member
o Clear about role assignments
o Prepared to fulfill their role responsibility
o Well-practiced in resuscitations skills
o Knowledgeable about the algorithms
o Committed to success
• CPR Coach – AHA goals are being met.
o Supports performance of high-quality BLS skills
o Provides feedback about the:
▪ Compressions rate, depth, and recoil
▪ Delivery of ventilation (rate and volume)
▪ Compression pauses
o Allows the team leader to focus on other aspects of clinical care
Elements of Effective Team Dynamics
• Roles
1. Clear Roles and Responsibilities
▪ Every member of the team should know his or her role and
responsibilities. Know other roles in case you need to take over for
another. Unclear roles lead to poor outcomes.
2. Knowing your Limitations
▪ Do not avoid taking assignments, respectfully ask for another
▪ Do not take assignments beyond your level of expertise
▪ Ask for help.
3. Constructive Interventions
, ▪Asks participants to intervene for the patient’s safety when they know
something is not right during a code.
▪ When speaking up to a question or to correct, be tactful and avoid a
confrontational tone of voice.
• What to Communicate
4. Knowledge sharing
▪ Avoid becoming fixated on a specific treatment or diagnosis.
• This is known as fixation error. Common phrases include:
o “Everything is ok.”
o “Only this is the correct way.”
o “Do anything but this.”
▪ All team members should communicate any changes in the patient’s
condition.
5. Summarizing and Re-evaluating
▪ Provides an opportunity to share the client status, interventions performed,
assessment findings, and re-evaluate if changes should be implemented to
improve the outcome.
• How to Communicate
6. Ensure Closed loop communication
▪ Best practice: Team member gets a message and restates the task back to
the team leader.
▪ The team leader listens for confirmation of the task performed from the
team member before assigning another task.
7. Clear messages
▪ Concise communication spoken with distinctive speech in a controlled
voice.
8. Mutual respect
▪ The team leader and members should respect, work and show support for
each other.
BLS Assessment
• Ensure the scene is safe
• Check responsiveness
• Shout for nearby help/activate the emergency response system and get the
AED/defibrillator
• Check breathing and pulse
o Scan the chest for respiratory movement and perform a pulse check for least 5
seconds, no more than 10 seconds
▪ An irregular respiratory pattern called agonal gasps may be present within
the first couple of minutes after sudden cardiac arrest.
▪ Gasping is not normal breathing and is a sign of cardiac arrest.
o If no pulse within 10 seconds, start CPR, beginning with chest compressions
, ▪ Compress the chest hard and fast at least 2-2.4 inches (5-6 cm) at a
rate of 100-120/min.
▪ Allow complete chest recoil after each compression. So that the heart
is filling with blood.
▪ Switch compressors about every 2 minutes or earlier if fatigued.
▪ Minimize interruptions in compressions to 10 seconds or less.
▪ Avoid excessive ventilation.
o If there is a pulse and absent breathing, start rescue breathing at 1 breath
every 6 seconds.
o Check pulse about every 2 minutes (5 cycles of CPR)
• Defibrillation
o If no pulse, check for a shockable rhythm with an AED/defibrillator as soon
as it arrives
o If using an AED, follow the prompt and provide shocks as indicated
o Follow each shock immediately with CPR, beginning with compressions
Primary Assessment: Airway Management
• Airway positioning maneuvers
o Head tilt- chin lift (if no suspicion of head/neck injury)
o Jaw thrust (if suspicion head/neck injury)
• Basic Airway Adjuncts
o Oropharyngeal Airway (OPA)
o Used in unconscious patients, with no gag reflex or cough
▪ Suction the mouth and pharynx of secretions, blood, or vomit
▪ Select the proper size of OPA
▪ Measure than flange from the corner of the mouth, the tip at the angle
of the mandible
▪ After insertion, monitor the patient and maintain airway patency
o Nasopharyngeal Airway (NPA)
o Used in conscious, semiconscious, or unconscious patients with or without gag
reflex
▪ Select the proper size
▪ Measure from the tip of the nose to the earlobe
▪ Lubricate the airway and insert
• Bag-Mask Ventilation (also known as Ambu bag or Bag valve mask (BVM))
o Consists of a ventilation bag attached to a face mask
o Must be connected to 100% oxygen source 10-15
o Provides positive pressure ventilation
o Deliver ventilation volume to produce visible chest rise in 1 second.
o Use E-C clamp technique to secure mask over face
o Tidel volumes 500-600 ml, half a squeeze of adult bag.
• Advanced Airways
o Indications
