In this post I link to the excellent A general approach to resuscitation* from First10 EM.
At Dr. Morgenstern’s recommendation in his post, I link also to The First Five Minutes of Resuscitation
I’ve embedded Dr. Strayer’s video from his post:
Ten minute screencast describing an expanded ABCs mnemonic.
The following are additional outstanding resources from Dr. Strayer’s post:
Mobile phone optimized cheat sheet at emupdates.com/resus.
And now here are excerpts from A general approach to resuscitation from First10 EM.
This basic approach is a slightly expanded version of the ABCs that can be used for board exams and those real life scenarios when the lights and sounds of the resus room have combined to wipe your mind blank. It serves as my mental checklist to help ensure I am thorough. My mnemonic is: (I am sorry if you are offended by profanity. If you are, please turn away now. Also, if you are, how is it possible for you to work in an emergency department? That being said, if you have a better mnemonic, please let me know.)
Safety
Hopefully recent Ebola scares will remind us that we must always ensure that it is safe to approach the patient before rushing in with our team. Could there be a toxicological exposure that requires the decontamination room first? What is the infective risk? Make sure everyone has appropriate PPE.
Help
Call for help early. It will probably never arrive in the first 10 minutes, but it never hurts to call early. [e.g. pediatrics or anesthesia]
Aside from physician help, ask yourself how many sets of hands you need. Most academic centres have too many people around, but in a small community hospital, certain situations might require calling extra nursing help down from the floor or getting paramedics to stick around.
Identify team and team leader
It is important to know who is in charge. The easiest way to do that is just to ask, “who is in charge?” When no one answers, you will quickly realize that you are in charge. At that point, identify yourself out loud as the team leader.
Tools
You never want to have to search for items at the moment that you need them. If there are tools you might need, get them ready as soon as possible (ideally before the patient even arrives). For example, if you are involved in a precipitous delivery in the ED, make sure a neonatal warmer is out [and turned on] and all equipment is available for the imminent neonatal resuscitation.
Goals of care
before jumping in with invasive procedures, do your best to quickly assess the patient’s wishes regarding end of life care. Is there a DNR or living will? Does the family know their wishes? Are there indicators of dismal outcome?
Review the details in the above chart at A General Approach To Resuscitation.
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