Outbac1
Forum Asst. Chief
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Just kind of wondering how many services are implementing changes to go along with the new CPR/Arrest guidelines. How do they update you? Do you just get a letter or e-mail with your new changes. Or do the plan a day or two to present the new material to you. Here we go for a day or two depending on the material. It is mandatory and is paid at time and a half with a free lunch.
I had my fall in-service on Friday and the main topic was our new Cardiac Arrest and ACLS guidelines. Our Provincial Medical Director, Dr, A. Travers, was on the ILCOR board that made the recommendations to the AHA. As a result he was keen to have us start implementing the new guidelines as soon as possible after they came out.
As many of you have read the new guidelines I'll just highlight the changes we're making.
No stopping to "look, listen, feel".
Chest Compressions (CC) immediately at 100/min with 2" depth.
Initial oxygenation with NRB and OPA.
Rotate compressors every 2 min if at all possible.
IV when feasible w/o interrupting CC.
Restrict IV fluids unless otherwise indicated.
Epi 1mg 1:10000 IV q 4 min.
Lidocaine 1mg/kg - 0.5mg/kg q 10 min for refractory VF/VT (No decision yet
on a change to Amiodrone, could be a cost issue against perceived benefit.).
No more atropine for PEA/Asystole.
Focus on effective oxygenation, not method. ETI/EGD/BVM all acceptable.
Asynchronous ventilation post ETI/EGD.
ROSC passive cooling techniques, remove clothes, cool environment(air cond.), ice packs if available, cool NaCl. O2 sats 92-99%, vitals q 5min, serial ECGs, maintain syst b/p >90.
We also had some practice on some high risk/low volume skills such as: FBAO removal, cardioversion, pacing, meconium suctioning, cricothyrotomy, PIC lines, etc.
Other news.
We have prehospital thrombolytics coming in Jan 2011.
Our PCPs are finally getting IVs and D50 in Jan 2011. (About bloody time).
Other drugs are likely to follow.
Hot rumor new defib/monitors. Maybe LP15s or Phillips.
Adenosine may now be used on wide complex tachycardias.
And perhaps the best news. Protocols are going out to be replaced with guidelines. We are to use "Our best clinical judgement."
Not a bad day. I'm kinda excited about what the future will bring.
I had my fall in-service on Friday and the main topic was our new Cardiac Arrest and ACLS guidelines. Our Provincial Medical Director, Dr, A. Travers, was on the ILCOR board that made the recommendations to the AHA. As a result he was keen to have us start implementing the new guidelines as soon as possible after they came out.
As many of you have read the new guidelines I'll just highlight the changes we're making.
No stopping to "look, listen, feel".
Chest Compressions (CC) immediately at 100/min with 2" depth.
Initial oxygenation with NRB and OPA.
Rotate compressors every 2 min if at all possible.
IV when feasible w/o interrupting CC.
Restrict IV fluids unless otherwise indicated.
Epi 1mg 1:10000 IV q 4 min.
Lidocaine 1mg/kg - 0.5mg/kg q 10 min for refractory VF/VT (No decision yet
on a change to Amiodrone, could be a cost issue against perceived benefit.).
No more atropine for PEA/Asystole.
Focus on effective oxygenation, not method. ETI/EGD/BVM all acceptable.
Asynchronous ventilation post ETI/EGD.
ROSC passive cooling techniques, remove clothes, cool environment(air cond.), ice packs if available, cool NaCl. O2 sats 92-99%, vitals q 5min, serial ECGs, maintain syst b/p >90.
We also had some practice on some high risk/low volume skills such as: FBAO removal, cardioversion, pacing, meconium suctioning, cricothyrotomy, PIC lines, etc.
Other news.
We have prehospital thrombolytics coming in Jan 2011.
Our PCPs are finally getting IVs and D50 in Jan 2011. (About bloody time).
Other drugs are likely to follow.
Hot rumor new defib/monitors. Maybe LP15s or Phillips.
Adenosine may now be used on wide complex tachycardias.
And perhaps the best news. Protocols are going out to be replaced with guidelines. We are to use "Our best clinical judgement."
Not a bad day. I'm kinda excited about what the future will bring.