06.21.2023 - By Brandon Oto, PA-C, FCCM and Bryan Boling, DNP, ACNP, FCCM
Bryan puts Brandon through the paces, discussing the nuts and bolts of managing a code.
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Takeaway lessons
* 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.