I know this came out in 2014 but I just wanted to say if anyone is watching now that Vasopressin has been out of the protocol for a couple of years now.
You should know what to give, how much to give, when to give it and your route of administration by this point. If you don't know then get an RT to help you. They're the best!
I remember having a code after eating lunch. I did compressions and I felt like I wanted to vomit in the first 30 seconds :( I had to switch really bad.
Why was the endotracheal tube not inserted in the first time they found the patient was at cardiac arrest? has the algorhythm been changed? i used to know the intubation attempt should be given at the very first time we found patient having cardiac arrest.
+Damon Jackson Vasopressin was removed to simplify the algorithm. This is unfortunate. Instead of expecting providers to improve their knowledge and skills. The update suggests providers can be remedial..
Well I think that characterisation is a little unfair. Vasopressin was initially incorporated to give ems providers time to do other interventions, because no other vasopressors were to be given for ten minutes. We now know through science that its effectiveness was not what was originally thought. If you look Narcan was added to the algorithm, and its effect in situations can be very pronounced.
+Damon Jackson Narcan, thiamine, and Epi were also standard code drugs. thiamine was removed because people were having anaphylactic reactions to it. narcan is making a comeback due to the increase of heroin and opiate overdoses
***** are you a healthcare provider? If so, I highly suggest that you surrender your license to the issuing agency as you are acting unprofessional and your attitude and decorum prove that you are unable to effectively provide care to patients and don't care about your job.
+Judith Tardo Excuse me, but are you deaf, dumb, delirious or disrespectful? I do alot more than ride ambulances and I do not appreciate you undermining my training nor do I appreciate swine like you tainting the reputation of the profession. most of us have spent more hours in a classroom than the average school student and have way more experience than a 9 year old like you would have. your incessant swearing does not make you educated in anyway and it actually makes you sound beyond dumb. I know how to resuscitate patients, I know the algorithms used in ACLS, I know how to interpret ECG tracings and know the pharmacokinetics, interactions and effects of each drug given. I also know a lot more than that but can't use those skills as my level of certification will not allow me to. some of the things you mentioned make you a danger to patients and you should not be practicing, your conduct is absolutely disgusting and unprofessional. you either clean up your conduct or leave the profession because I don't have the time to deal with your ignorance and sheer stupidity. on that note, I will stop responding to your tumultuous insults and be the bigger man here. I almost forgot, GO BACK TO FUCKING SCHOOL!
update from 2024, the hypothermia therapy(target temperature management, TTM) is aimed at 32-37.5 degree celsius. also, this is really quite a good video to illuminate how we should practice the mega code section.
@@Bfair123 1. no rush, be calm, that's the most important thing and actively apply each team member's position if you are the leader. 2. remember to check pulse/vital signs whenever there is a rhythmic change. 3. if the p't's alive (w/ pulse) be sure to note if the rhythm is regular/irregular, having a narrow or wide QRS complex and whether the patient is stable or unstable and choose the joule of charge accordingly. 4. when ROSC is achieved, aside from a secondary ABCDE evaluation, order a 12 lead ECG to assess if ST elevation is the case. That's the tips my poor brain notices at the moment, hope you pass your test tomorrow!
Somebody help my forgetful mind: What happened to the Pulse-Ox monitor the patient had on her finger when she arrived.? "Hypoxia"??? The PO not only measures oxygenation, but, also the quality of compressions during CPR. OK, i"m being picky. But, in this day and age, the PO is an indispensable monitor, which appears to be underappreciated in this video.
etco2 is what now monitors effective cpr as well as tube placement. etco2 < 10 shows need for improvement in cpr. fyi, in the scenario, the pt was initially at 92 pao2 and then went up to 95 pao2 on 2 lpm O2 prior to coding. As actor playing doc said, coronary thrombosis likely culprit as confirmed with STEMI in 12 lead. remember that pulse ox takes a bit to drop and accurately show hypoxia where as etco2 readings are much quicker. good video on acls cert.inst re " waveform capnography" which demonstrates this.
This was great if you want to know which to need to do but it doesn't so you procedures like a medic's case in a ministration in how you actually start the IO /iv . Or how you set up the monitor . To do what want it to do
If atropine the first line in Bradycardia had been administered from the beginning none of the other steps would have been needed. The patient went from Bradycardia to tachycardia, which leads to other after care for the patient.
@@chewchin7052bradycardia but no pulse,so they continued cpr instead of giving atropine.Also atropine can increase myocardial oxygen demand and aggravate ischemia?
there is such a thing as pulseless electrical activity where it can show a rhythm like bradycardia on the monitor but the patient has no pulse, they are in cardiac arrest. plus even if it was real bradycardia a pulse, with the low blood pressure of 70/40 most doctors would choose to push epinephrine at that point in favor of atropine. atropine is for bradycardia that is symptomatic with fatigue sob or other signs of poor perfusion, not for a person without a pulse. in the video’s scenario the patient has just arrived and no iv access was able to be established, how are you going to give an iv medication without an iv? just stab a patient with a syringe hoping it will land in a vein (most of these patients who are sick enough to cardiac arrest will be difficult sticks to begin with)? going for the io access was the only way to go, most providers wouldnt waste time trying to get an iv in and just ggo for an io because they know theyre not going to be able to get an iv in a patient like that. we are treating the patient, not the monitor. always check for a pulse never forget your bls.
Can amiodarone and vasopressin be given i.v bolus?they did not mention how they prepare meds of iv bolus amiodarone and vasopressin if without dilution or what dilution they mix with meds before i.vbolus to avoid confusion.
+rom z Continuous bagging only occurs with an advanced airway (like an endotracheal tube). Otherwise you follow 30 chest compressions with two breaths.
+UnicornxApocalypse But the team leader decides how much shock should be delivered (unlike in BLS where an AED) and they're giving IV drugs. Isn't this advanced already?
GOOD VIDEO. aint perfect but good somehow.. the second chest compressor should have been quicker in changing roles with the first compressor :) no unnecessary pauses in chest compressions..
I had to check this wasn't a joke. 'Code' on its own is a pretty silly name for a cardiac arrest/medical emergency. 'Megacode' is completely puerile. Do the AHA/ACLS actively encourage ridicule?