The roles and priorities in a cardiac arrest situation is dependent on
- the environment where arrest takes place
- the nature of the cardiac arrest, and
- the skill mix of the people in the immediate environment
TEAM LEADER ROLE
- ensure priorities of management are carried out effectively and efficiently
- co-ordinate defibrillation, intubation, cannulation and drug administration
- call for help if indicated (cardiothoracic surgeons, cardiologist for TOE)
- establish diagnosis (history, examination and ECG interpretation)
- check resuscitation status and prognosis
- order investigations
- reassess response to treatment
- communicated with admitting consultant
- ensure family is notified
- organise post-resuscitation care
- ensure documentation carried out appropriates
- Immediate Basic Life Support
- Rapid rhythm diagnosis with early defibrillation if shockable
- High quality, appropriately timed CPR (with minimal interruptions) – CAB (new AHA/ILCOR guidelines)
- Airway and Breathing – intubation and ventilation, titrated FiO2 to SpO2 90%
- Adrenaline 1mg Q3min IV
- Correction of cause of arrest
- Effective post-resuscitation care (therapeutic hypothermia, care of the dead patient and family)
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also the Innovation Lead for the Australian Centre for Health Innovation at Alfred Health, a Clinical Adjunct Associate Professor at Monash University, and the Chair of the Australian and New Zealand Intensive Care Society (ANZICS) Education Committee. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of LITFL.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of two amazing children.
On Twitter, he is @precordialthump.