Stanford Medical Checklist Study Training (Cogaids) v4
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1 Stanford Medical Checklist Study Training (Cogaids) v4 1
2 Blank 2
3 This screen may contain a digital, dynamic cognitive aid. may use it to answer questions during a scenario. No interaction is required with this screen--the cognitive aid will automatically adapt to match the current medical scenario. 3
4 Malignant Hyperthermia PEA VT/VF DDX ETCO2, Tachycardia... Tachycardia, Tachypnea, Acidosis, Light Masseter anesthesia, spasm... Hypo... DDX Light anesthesia Hypoventilation Over-heating Larry Pharmacist ICU Nurse Dannielle RT (external) Pheochromo- Thyroid storm Hypoxemia cytoma Insufflation of CO2 T. Stark, 35 yrs, kg Anesthetic triggers discontinue; Gas 10 Cardiac Arrest, L/min; TIVA; Hyperventilate FiO2 100%, O2... Shrapnel SECONDARY Lithium Dioxide Palladium toxicity, alcoholism 4
5 Malignant Hyperthermia PEA VT/VF ETCO2, Tachycardia... DDX Light anesthesia, Hypo... Anesthetic triggers discontinue Larry Pharmacist ICU Nurse Dannielle RT Fresh gas 10 L/min Do NOT change machine or circuit TIVA Hyperventilate FiO2 100%, O2 high Dantrolene 2.5 mg/kg sterile Dantrolene Rapidly administer until patient stable T. Stark, 35 yrs, kg Na2CO3 1 to 2 meq/kg Cool patient Hyperkalemia? CaCl2 1g IV Labs Cardiac Arrest, Shrapnel Lithium Dioxide Patient Monitor in ICU; Palladium toxicity, SECONDARY Dantrolene 1 mg/kg alcoholism 5
6 Malignant Hyperthermia PEA VT/VF ETCO2, Tachycardia... DDX Light anesthesia, Hypo... Anesthetic triggers discontinue Fresh gas 10 L/min Larry Pharmacist ICU Nurse Dannielle RT TIVA Hyperventilate FiO2 100%, O2 high Dantrolene 2.5 mg/kg sterile Dantrolene Rapidly administer until patient stable Na2CO3 1 to 2 meq/kg Cool patient T. Stark, 35 yrs, kg Hyperkalemia? CaCl2 1g IV Check blood gas for electrolyte abnormalities; CaCl2 1g, D50 1 Amp (25g Dextrose) + Reg. Insulin 10 units; (monitor glucose), or NaHCO3 1 Amp; No Ca channel blockers Labs Cardiac Arrest, Shrapnel Lithium Dioxide Patient Monitor in ICU; Palladium toxicity, SECONDARY Dantrolene 1 mg/kg alcoholism 6
7 In some conditions, this display will be blank. 7
8 Now, this screen will display the software-based, dynamic cognitive aid. Ready...? 8
9 All Aids PEA VT/VF search Asystole VTach/VFib Nurse PEA Bradycardia Myocardial Ischemia Anaphylaxis Cardiac Arrest Malignant Hyperthermia 9
10 Possible Crisis? PEA VT/VF ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm... Not breathing? No pulse? Nurse Call for? Begin compressions immediately. Consider possible root causes. SECONDARY 10
11 Possible Crisis? PEA VT/VF ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm... Not breathing? No pulse? Nurse Call for? Begin compressions immediately. Consider possible root causes. SECONDARY 11
12 Possible Crisis? PEA VT/VF ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm... Not breathing? No pulse? Nurse Call for? Begin compressions immediately. Consider possible root causes. SECONDARY 12
13 Possible Crisis? PEA VT/VF ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm... Not breathing? No pulse? Nurse Call for? Begin compressions immediately. Consider possible root causes. SECONDARY 13
14 Possible Crisis? PEA VT/VF ETCO2, Tachycardia, Tachypnea, Acidosis, Masseter spasm... Not breathing? No pulse? Nurse Call for? Begin compressions immediately. Consider possible root causes. SECONDARY 13
15 No pulse Brady VT/VF Flat Line, No Pulse CPR Kyle Doctor ICU Nurse Dannielle RT Start chest compressions (mid sternum) Allow for complete chest recoil Check rhythm ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg? Code Blue 14
16 No pulse Brady VT/VF Flat Line, No Pulse CPR Start chest compressions (mid sternum) Kyle Doctor ICU Nurse Dannielle RT Allow for complete chest recoil Check rhythm ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg? Code Blue 15
17 No pulse Brady VT/VF Flat Line, No Pulse CPR Start chest compressions (mid sternum) Kyle Doctor ICU Nurse Dannielle RT Allow for complete chest recoil Check rhythm ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg? Code Blue 16
18 No pulse Brady VT/VF Flat Line, No Pulse CPR Start chest compressions (mid sternum) Kyle Doctor ICU Nurse Dannielle RT Allow for complete chest recoil Check rhythm ETCO2 > 10mmHg? Arterial line diastolic > 20mmHg? 17
19 VTach - Wide PEA Asys VTach Defibrillate # Joules Kyle Doctor ICU Nurse Dannielle RT CPR RESUME IMMEDIATELY DEFIB CPR MEDS CHECK In the OR: Volatile, O2 Ventilation OK?. Always Check: IV... CONSIDER DDX 18
20 VTach - Wide PEA Asys VTach Defibrillate # Joules Kyle Doctor ICU Nurse Dannielle RT CPR RESUME IMMEDIATELY DEFIB CPR MEDS CHECK In the OR: Volatile, O2 Ventilation OK?. Always Check: IV... CONSIDER DDX 19
21 VTach - Wide PEA Asys VTach Defibrillate # Joules Kyle Doctor ICU Nurse Dannielle RT CPR RESUME IMMEDIATELY DEFIB CPR MEDS CHECK In the OR: Volatile, O2 Ventilation OK?. Always Check: IV... CONSIDER DDX 19
22 VTach & VFib PEA Asys VTach Defibrillate (biphasic machine) Kyle Doctor ICU Nurse Dannielle RT CPR RESUME DEFIB CPR MEDS CHECK In the OR: Volatile, O2 Ventilation OK?. Always Check: IV... CONSIDER DDX 20
23 VTach & VFib PEA Asys VTach Defibrillate (biphasic machine) Kyle Doctor ICU Nurse Dannielle RT CPR RESUME DEFIB CPR MEDS CHECK In the OR: Volatile, O2 Ventilation OK?. Always Check: IV... CONSIDER DDX Coumadin 21
24 22
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