Time Management during arrest

[Sizz]

Hey guys,

Simple question, how do you or what do you feel is your best method of managing the time during an "in field" arrest. My biggest concern is the time gaps for your epi and so forth on rotation between CPR and the shocks in between working the rest of the code.

Yea the CPR cycles are typically 2 minutes / 5 cycles with at *least a minimum of 100 compression + / min which I could run 2 cycles then be good to push a med, etc

I know also I've turned on the *CPR button on the LP15 which is to me totally distracting and yes I do wear a watch which I could work on getting better at remembering to look at it often during the code as I know most of it's rough estimates.

Basically managing the time of each given drug as well as documentation of approx when each was given( Yes I'll know the order of which I gave them and about how longs passed in between as well as how much etc but for exact times / documentation afterwords).

Does the Zoll offer anything different than LP or I might just need to familiarize myself with the LP15 better.

How do you typically manage it in the field w/out the recorder in a hospital setting?

Lastly any quick way of fully disabling the LP15 alarms that tell me to check the pt and so forth as this is also a huge distraction, I seem to be only temporarily silencing them.....I'm obviously checking and aware of what my pt is doing.

Thank you

 

[WTEngel]

I count cycles. 5 cycles is approximately 2 minutes if your pacing is appropriate.

Epi is given every other cycle, making the approximate spacing 4 minutes or so, perfectly between the 3-5 minute window.

It is my opinion that cycles is a better method because it is a very objective, determined amount of circulation for the patient, vs 2 minutes where you just kind of stop where ever you are at.

If the patient is intubated, I will have the compressor count to 200 compressions, announcing every interval of 50. That should give you about 2 minutes of continuous compressions.

AHA states that 5 cycles, 2 minutes, or 200 compression (in the intubated patient) are all acceptable methods for determining time for drug administration.

In regards to marking the time of drug administration, that is what your glove, patient cot sheet, or note sheet are for. Just take a moment to write the drug down and note the time of administration, on one of the above listed items. The cot sheet works particularly well, as it can help you give a good handoff report at the hospital.

 

[Medic Tim]

Where I work we use the Phillips Mrx. with cpr puck. it measured depth , rate, etc and gives live feedback. it counts out your 2 minutes for you and there is a "marker" button you can push for ept, lido, whatever drug etc. so for vf/vt you alternate epi and lido and pea/asystole epi every other. we do 5 cycles on scene. if asystole for all 5 and we are more than 20 from the hospital we can call it with OLMC contact.

I have used the lp 12 before and it was a matter of watching the clock on the monitor and recording times on your glove or some white tape on your thigh.

in Maine codes are worked on scene. after 20 min of ALS you can call it

 

[epipusher]

During our arrests(my partner and I that is)we designate one person to use and enter all information into the Siren ePCR computer. It has and assessment/treatment button with the designated person time stamping all the specific "buttons" as we go. It has buttons for airway treatment, medication admin.,start/stop cpr, dfib, iv access, pulse check, etc. This gives us the appropriate times between each treatment. Works very well for us, especially since we work all medical arrests for 30min, or until ROSC.