Team Focused CPR - acidremap.com
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Adult Cardiac Protocol Section Team Focused CPR Clinical Operating Guidelines AC-11 This protocol has been altered from the original NCCEP Protocol by the Durham County EMS Medical Director 4/2020 AT ANY TIME Return of Spontaneous Circulation Go to Post Resuscitation Protocol AC 9 Criteria for Death / No Resuscitation Review DNR / MOST Form Decomposition Rigor mortis Dependent lividity Blunt force trauma Injury incompatible with life Extended downtime with asystole Do not begin resuscitation Follow Deceased Subjects Policy First Arriving BLS / ALS Responder Initiate Compressions Only CPR Initiate Defibrillation Automated Procedure if available Call for additional resources Second Arriving BLS / ALS Responder Assume Compressions or Initiate Defibrillation Automated / Manual Procedure Assume Ventilations DO NOT Interrupt Compressions Ventilate at 6 to 8 breaths per minute Begin Continuous CPR Compressions Push Hard ( 2 inches) Push Fast (100 - 120 / min) Change Compressors every 2 minutes (sooner if fatigued ) (Limit changes / pulse checks 10 seconds) Place iGel or ETT ASAP Ventilate at 1 breath every 6 seconds Place viral filter when available Monitor ETCO2 S Third Arriving Responder BLS or ALS BLS ALS Establish Team Leader (Hierarchy) EMS ALS Personnel Fire Department or Squad Officer EMT First Arriving Responder Initiate Defibrillation Manual Procedure Continuous Cardiac Monitoring Establish IV / IO Administer Appropriate Medications Establish Airway with BIAD if not in place Initiate Defibrillation Automated Procedure Establish IV / IO Administer Appropriate Medications Establish Airway with BIAD if not in place P A Continue Cardiac Arrest Protocol AC 3 Establish Team Leader (Hierarchy) Fire Department or Squad Officer EMT First Arriving Responder Rotate with Compressor To prevent Fatigue and effect high quality compressions Take direction from Team Leader Fourth / Subsequent Arriving Responders Take direction from Team Leader S Continue Cardiac Arrest Protocol AC 3 Incident Commander o Fire/FR Officer until EMS Officer arrives o Team Leader until ALS arrival o Manages Scene/Bystanders o Responsible for briefing family prior to ALS arrival Code Commander o ALS Personnel o Responsible for pt. care o Ensure high-quality compressions o Ensure frequent compressor changes
Transcript of Team Focused CPR - acidremap.com
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Team Focused CPR
Clinical Operating Guidelines AC-11This protocol has been altered from the original NCCEP Protocol by the Durham County EMS Medical Director4/2020
AT ANY TIME
Return ofSpontaneous
Circulation
Go to Post Resuscitation
Protocol AC 9
Criteria for Death / No ResuscitationReview DNR / MOST Form
DecompositionRigor mortis
Dependent lividityBlunt force trauma
Injury incompatible with life
Extended downtime with asystole
Do not begin resuscitation
FollowDeceased Subjects
Policy
First Arriving BLS / ALS ResponderInitiate Compressions Only CPR
Initiate Defibrillation Automated Procedureif available
Call for additional resources
Second Arriving BLS / ALS ResponderAssume Compressions or
Initiate Defibrillation Automated / Manual ProcedureAssume Ventilations
DO NOT Interrupt CompressionsVentilate at 6 to 8 breaths per minute
Begin Continuous CPR Compressions Push Hard ( 2 inches) Push Fast (100 - 120 / min)
Change Compressors every 2 minutes(sooner if fatigued)
(Limit changes / pulse checks 10 seconds)Place iGel or ETT ASAP
Ventilate at 1 breath every 6 secondsPlace viral filter when available
Monitor ETCO2
S
Third Arriving ResponderBLS or ALS
BLS ALS
Establish Team Leader(Hierarchy)
EMS ALS PersonnelFire Department or Squad Officer
EMTFirst Arriving Responder
Initiate Defibrillation Manual ProcedureContinuous Cardiac Monitoring
Establish IV / IOAdminister Appropriate Medications
Establish Airway with BIAD if not in place
Initiate Defibrillation Automated ProcedureEstablish IV / IO
Administer Appropriate Medications Establish Airway with BIAD if not in place
P
A
Continue Cardiac Arrest Protocol AC 3
Establish Team Leader(Hierarchy)
Fire Department or Squad OfficerEMT
First Arriving ResponderRotate with Compressor
To prevent Fatigue and effect high quality compressions
Take direction from Team Leader
Fourth / Subsequent Arriving RespondersTake direction from Team Leader
S
Continue Cardiac Arrest Protocol AC 3
Incident Commandero Fire/FR Officer until EMS Officer arrives
o Team Leader until ALS arrival
o Manages Scene/Bystanders
o Responsible for briefing family prior to ALS arrival
Code Commandero ALS Personnel
o Responsible for pt. care
o Ensure high-quality compressions
o Ensure frequent compressor changes
Ad
ult C
ard
iac
Pro
toc
ol S
ec
tion
Team Focused CPR
Clinical Operating Guidelines AC-11This protocol has been altered from the original NCCEP Protocol by the Durham County EMS Medical Director4/2020
Pearls
FIRST ARRIVING UNIT PLACE AN iGEL AS SOON AS POSSIBLE. PAUSE CPR TO PLACE iGEL. IF THE iGEL DOES NOT SEAL WELL, THE MOST EXPERIENCED PROVIDER SHOULD PERFORM ENDOTRACHEAL INTUBATION
VIA VIDEO LARYGOSCOPY. IF THE PATIENT REQUIRES INTUBATION, PAUSE CPR FOR THE ATTEMPT. BVM should be attempted only if iGel and ETI fail. Ensure a good mask seal by using two rescuers (one for mask seal, one
for ventilation) as well as an appropriate sized airway adjunct. Team Focused Approach / Pit-Crew Approach recommended; assign responders to predetermined tasks. Efforts should be directed at high quality and continuous compressions with limited interruptions and early defibrillation
when indicated. DO NOT HYPERVENTILATE: If no advanced airway (BIAD, ETT) compression to ventilation ratio is 30:2. If advanced airway
in place, ventilate 10 breaths per minute with continuous, uninterrupted compressions. Success is based on proper planning and execution. Procedures require space and patient access. Make room to work.
Code Commandero ALS Personnel
o Responsible for pt. care
o Ensure high-quality compressions
o Ensure frequent compressor changes
Incident Commandero Fire/FR Officer until EMS Officer arrives
o Team Leader until ALS arrival
o Manages Scene/Bystanders
o Responsible for briefing family prior to ALS arrival
