guys I am in my third semester of paramedic school and we run a group of 3 per scenario .we are doing medical assessment where the pt codes eventually if your not on your game .does anyone have any cheat sheets or tips on how to do this ? cause our instructor tells us we are all over the place =( we have a 160k dummy that does everything from bleed ,cry,blinks his eyes the whole 9 yards ,its amazing ! we run it as one person is the lead and verbalizes everything ,the other is the drugs guy and the other is airway any help would be greatly appreciated
need info or tips on how to do megacode
- Thread starter emtssave
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What exactly are you having difficulty with? Megacodes in class are really pretty straightforward. See this, do that. They want to see that you know the algorithms. So learn those in and out and you'll be golden. The instructor will always find ways to stump you and make you think.
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STX has it right. The Megacode model is actually pretty straightforward and will always progress toward a code unless you do something to slow or stop the process. If you anticipate the ways your patient can "fall" into a code situation and do something about it, you'll have much better luck preventing the code in the first place. That being said, in a Megacode (and sometimes in real life too) a patient will probably still code despite whatever you do to prevent it from happening.
Not everyone needs an advanced airway, vascular access or be hooked up to the monitor. That being said, there are times you'll just know to have airway equipment ready, vascular access obtained, and monitoring instituted. When you see those triggers, you no longer do something under the term "precautionary" but rather have articulable reasons for that action.
Not everyone needs an advanced airway, vascular access or be hooked up to the monitor. That being said, there are times you'll just know to have airway equipment ready, vascular access obtained, and monitoring instituted. When you see those triggers, you no longer do something under the term "precautionary" but rather have articulable reasons for that action.
Ewok Jerky
PA-C
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Memorization and practice
NomadicMedic
I know a guy who knows a guy.
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MegaCode is nothing but "insert flap A into slot B" memorization.
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Everyone provided suggestions on how to learn the algorithms and whatnot. Just getting an answer (which may or may not be right) is not going to help.
akflightmedic
Forum Deputy Chief
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I taught for many years and I loved when I heard this and still see/hear it today....my comment to this is "remember, the patient never read the book" or "the patient did not know he was supposed to do that next".
FiremanMike
Just a dude
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I promise you that someday you'll look back on mega code and think "wait, why was I so stressed about that? ITS SO SIMPLE!!!"
Too slow and unstable - Pace
Too slow and stable - Nothing
Too fast and unstable - Zap
Too fast and stable - Vagal and nothing
Squiggly - CPR, Zap, 1 Epi, CPR, 300 amio
Flat - CPR, 1 Epi, CPR, 1 Epi,
Grab your ACLS book, look at the cheat sheet protocols in the back, and realize that most of them are very simple 2-4 step processes that are almost the same...rinse and repeat
Too slow and stable - Nothing
Too fast and unstable - Zap
Too fast and stable - Vagal and nothing
Squiggly - CPR, Zap, 1 Epi, CPR, 300 amio
Flat - CPR, 1 Epi, CPR, 1 Epi,
Grab your ACLS book, look at the cheat sheet protocols in the back, and realize that most of them are very simple 2-4 step processes that are almost the same...rinse and repeat
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Not too big on pharmacology, are you?...
Most of that was meant in jest, that said a lot of services around here don't treat "stable" patients with medications as long as they remain stable, at the point that they become unstable then...well...acls says electricity
I love pharmacology, I don't love ACLS, my services protocols, or the meds we carry...
NomadicMedic
I know a guy who knows a guy.
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You can base almost all of the stable/non stable stuff in megacodes on blood pressure. <90 = unstable.
my question is this when do you use the drugs for example .a witnessed arrest you shock quickly vs not witnessed you check a pulse no pulse you do cpr for two minutes 5 cycles 100 to 120 chest compressions new guidelines .when do you start using epi and when do you start using amio ? do you shock first once and than as you do chest compressions do you use epi so it circulates ? my biggest problem is when to use epi and ami .I am a rookie hard core so sorry for the noob questions
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A witnessed arrest gets shocked ASAP.
For an unwitnessed arrest, you follow the algorithms. Where does the algorithm tell you to administer epi or amio? As to specifically what time during each cycle, you start your pharmacological interventions while CPR is being performed. Ideally at the start of each cycle.
For an unwitnessed arrest, you follow the algorithms. Where does the algorithm tell you to administer epi or amio? As to specifically what time during each cycle, you start your pharmacological interventions while CPR is being performed. Ideally at the start of each cycle.
ford example witnessed arrest you shock asap followed by 2 minutes of cpr you check a pulse and monitor and still in vfib you shock again and resume cpr in those two minutes do you have someone administer epi ? if so once epi is in and you reassess a pulse and still no pulse do you shock again and than give amio while resuming cpr ?
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You need to be getting epi on board as soon as you get an IO in place, or whatever type of vascular access you are being taught. Then get sodium bi carb in right after that. KEEP dumping epi in every four minutes. (At least at my service, look at your algorithm).
Amio is for a vtach. You don't just give it because someone is in cardiac arrest. So check the monitor to see what rhythm they are in. Lidocaine is another alternative to ventricular arrhythmias, if you have it.
Can also consider calcium depending on the situation and what you think is causing the arrest. Same with narcan.
Again, you literally have the sheet of paper that tells you EXACTLY when to be doing all of this. Memorize it. Not much else you can do. There is not too many "tips" to give.
But please don't just be throwing around amiodarone due to the fact that someone is having CPR done to them. That's how you are coming off at least.
PS READ YOUR FREAKIN ALGORITHM
Amio is for a vtach. You don't just give it because someone is in cardiac arrest. So check the monitor to see what rhythm they are in. Lidocaine is another alternative to ventricular arrhythmias, if you have it.
Can also consider calcium depending on the situation and what you think is causing the arrest. Same with narcan.
Again, you literally have the sheet of paper that tells you EXACTLY when to be doing all of this. Memorize it. Not much else you can do. There is not too many "tips" to give.
But please don't just be throwing around amiodarone due to the fact that someone is having CPR done to them. That's how you are coming off at least.
PS READ YOUR FREAKIN ALGORITHM