This application uses a variety of randomly assigned patients that present with the ACLS core rhythms.

Published On: March 17, 2023Categories: Emergency Care VR

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This application uses a variety of randomly assigned patients that present with the ACLS core rhythms.

App Objectives

Non-Cardiac Arrest

1. Recognition of unstable, which informs management of the non-arrest patient:

  • Hypotension
  • Altered mental status
  • Signs of shock
  • Chest discomfort
  • Heart failure

2. Manage the following rhythms in a stable patient:

  • Sinus Tachycardia
  • Sinus Bradycardia
  • 2nd Degree AV Block – Type 1 (Wenckebach)

3. Manage the following rhythms in an unstable patient:

  • Atrial Fibrillation with RVR
  • Atrial Flutter
  • Sinus Bradycardia
  • Ventricular Tachycardia
  • AV Block

Cardiac Arrest

1. Situational awareness of the patient’s condition

  • Rhythm checks
  • Return of spontaneous circulation (ROSC)
  • Perfusion

2. High quality chest compressions

  • Immediate commencement of chest compressions if presence of a pulse is not certain
  • Rate not to fall below 100 bpm
  • EtCO2>10 (failure to achieve may be caused by inadequate rate as above of depth of compression <2 inches)
  • Swap compressors every 2 minutes or when signs of fatigue are identified (as indicated by a and c above)
  • CCF at least 80% and pauses not to exceed 10 seconds – not in V1

3. Avoid excessive ventilation

  • Ventilation not to exceed 10-12 breaths per minute

4. Obtain intraosseous access when peripheral accessis not readily attainable

5. General, Personal & Team Protection

  • Understanding PPE selection and proper donning/doffing for aerosolized pathogens
  • Developing situational awareness, as a PPE observer, for breaches during donning, intra-resuscitation, and doffing
  • Limiting the number of providers during aerosolizing procedures (i.e., intubation, pre-intubated CPR)
  • Developing reflex communication of pathogen status to any new providers entering the room

6. Airway and Ventilation:

  • Understanding and employing the oxygenation & ventilation strategies that pose lower risk for aerosolization.
  • Ensuring that a HEPA filter is attached to the BVM
  • Intubating as early as possible in cardiac arrest (with a cuffed tube)

7. Compressions:

  • Limiting the number of compressors by using a mechanical CPR device where appropriate
  • Possible learning objective for prone CPR in prone-vented patients with cardiac arrest

8. Management of the following rhythms:

  • Ventricular Fibrillation
  • Ventricular Tachycardia
  • Pulseless Ventricular Tachycardia
  • Asystole

9. Awareness of initiating post-arrest cooling protocol

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