Episode 62: Running a cardiac arrest

Bryan puts Brandon through the paces, discussing the nuts and bolts of managing a code.

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Takeaway lessons

  1. 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.
  2. Consider arterial lines early. IOs are usually fine for other access; central lines are rarely essential early.
  3. 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.
  4. Consider calcium if hyperkalemia is possible and magnesium if there’s torsades.
  5. Use bedside ultrasound to rule out reversible causes like cardiac tamponade and tension pneumothorax, but don’t interrupt compressions.
  6. 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.

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