Bryan puts Brandon through the paces, discussing the nuts and bolts of managing a code.
- Managing a room is less about asserting authority and more about leading by example. Cardiac arrest is a great microcosm and litmus test for your team dynamics for all resuscitation.
- Consider arterial lines early. IOs are usually fine for other access; central lines are rarely essential early.
- ACLS is fairly rote and can be easily delegated. The most important role of the team lead, other than assuring quality, is considering reversible causes of arrest.
- Consider calcium if hyperkalemia is possible and magnesium if there’s torsades.
- Use bedside ultrasound to rule out reversible causes like cardiac tamponade and tension pneumothorax, but don’t interrupt compressions.
- Once you have a pulse, expect to need continuous pressors, readdress your ABCs, ensure adequate monitoring, consider TTM, and consider reversible causes such as coronary ischemia.