Here’s the video from March 2018’s consultant education, on the theme of traumatic arrest.
It includes a case discussion of a gunshot wound to the chest in a young women with cardiac arrest, a talk on the management of traumatic arrest and the utility of CPR, and finally a discussion on ED thoracotomy.
The quality’s not great and we lost the AV halfway through, so I’ve patched in a PowerPoint presentation of the second part.
There’s also a video from the Alfred procedures course on thoracotomy- please don’t distribute this further, as it’s released to candidates on the course only.
Hope you enjoy, please post any comments or questions and we’ll attempt to answer them.
EMRAP – the quiet chest in trauma
St Emlyn’s – CPR in TCA?
In 2015 the European Resuscitation Council changed their recommendations, slightly new algorithms, rates and the usual arguments about adrenaline and amiodarone. In my mind this detracts us from what is important. Scott Weingart is famous for saying we should be able to resuscitate better than a dermatologist who will attend the same ACLS course as yourself.
So how do we improve?
- Remove the cognitive load: We will be using our nursing staff to run the algorithms autonomously, timings, compressions, adrenaline and amiodarone dosing. Albeit ultimate responsibility lies with the doctor team leader you will have this option to use the nursing staff to run the algorithms.
- ACLS does not fix the problem. While the nurses are running the algorithms you need to find the cause of the arrest and fix it. See the power point presentation below for some thoughts and ideas and what the world of FOAM has to say on the issue.
- Support each other and the nursing staff during an arrest and also reflect on what can be done differently next time, even if this is during the weekly scenarios that will take place.
- Introduce yourselves to the nursing resus team at the beginning of your shift. If you are on airway, let them know your preferences.
- Dont run away from sick patients, this is what we train for and you will not improve if you do not challenge yourself.
Resources in the slides: