Improving Adherence to a Pediatric Advanced Life Support Supraventricular Tachycardia Algorithm in Community Emergency Departments Following in Situ Simulation

2019 ◽  
Vol 50 (9) ◽  
pp. 404-410 ◽  
Author(s):  
Riad Lutfi ◽  
Erin E. Montgomery ◽  
Zachary J. Berrens ◽  
Mouhammad Yabrodi ◽  
Mathew L. Yuknis ◽  
...  
Keyword(s):  
Supraventricular Tachycardia ◽  
Emergency Departments ◽  
Life Support ◽  
Advanced Life Support ◽  
In Situ Simulation

ICU nurse advanced life support re-accreditation: the feasibility of a multidisciplinary team-based in-situ simulation approach

2017 ◽  
Vol 30 (2) ◽  
pp. 111
Author(s):  
Nerilee Baker ◽  
Susan Whittam ◽  
Sean Scott ◽  
Nilesh Mahale ◽  
Peter McCanny ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Life Support ◽  
Advanced Life Support ◽  
Simulation Approach ◽  
In Situ Simulation

scholarly journals Impact of In Situ Education on Management of Cardiac Arrest after Cardiac Surgery

2021 ◽  
Vol 23 (2) ◽  
pp. 54-61
Author(s):  
Bhargavi Gali ◽  
◽  
Grace Arteaga ◽  
Glen Au ◽  
Vitaly Herasevich
Keyword(s):  
Cardiac Arrest ◽  
Cardiac Surgery ◽  
Life Support ◽  
Advanced Life Support ◽  
Cardiac Massage ◽  
Chest Compressions ◽  
In Situ Simulation ◽  
Before And After ◽  
Initial Medication

Background: Advanced life support interventions have been modified for patients who have recently undergone sternotomy for cardiac surgery and have new suture lines. We aimed to determine whether the use of in-situ simulation increased adherence to the cardiac surgery unit-advanced life support algorithm (CSU-ALS) for patients with cardiac arrest after cardiac surgery (CAACS). Methods: This was a retrospective chart review of cardiac arrest management of patients who sustained CAACS before and after implementation of in-situ simulation scenarios utilizing CSU-ACLS in place of traditional advanced cardiac life support. We utilized classroom education of CSU-ACLS followed by in-situ high-fidelity simulated scenarios of patients with CAACS.. Interprofessional learners (n = 210) participated in 18 in-situ simulations of CAACS. Two groups of patients with CAACS were retrospectively compared before and after in situ training (preimplementation, n=22 vs postimplementation, n=38). Outcomes included adherence to CSU-ALS for resuscitation, delay in initiation of chest compressions, use of defibrillation and pacing before external cardiac massage, and time to initial medication. Results: Chest compressions were used less often in the postimplementation vs the preimplementation period (11/22 [29%] vs 13/38 [59%], P = 0.02). Time to initial medication administration, use of defibrillation and pacing, return to the operating room, and survival were similar between periods. Conclusion: In this pilot, adherence to a key component of the CSU-ALS algorithm—delaying initiation of chest compressions—improved

scholarly journals Adherence to Pediatric Cardiac Arrest Guidelines Across a Spectrum of Fifty Emergency Departments: A Prospective, In Situ, Simulation‐based Study

2018 ◽  
Vol 25 (12) ◽  
pp. 1396-1408 ◽  
Author(s):  
Marc Auerbach ◽  
Linda Brown ◽  
Travis Whitfill ◽  
Janette Baird ◽  
Kamal Abulebda ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Emergency Departments ◽  
In Situ Simulation ◽  
Simulation Based

scholarly journals MP20: Evaluation of the disruptors during advanced life support in emergency departments

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S49-S49
Author(s):  
J. Truchot ◽  
D. Michelet ◽  
D. Drummond ◽  
P. Plaisance
Keyword(s):  
Emergency Departments ◽  
Exploratory Study ◽  
Online Survey ◽  
Life Support ◽  
Medical Curriculum ◽  
Real Life ◽  
Advanced Life Support ◽  
Cross Sectional ◽  
Phone Calls ◽  
Ed Overcrowding

Introduction: Simulation is used as a teaching technique in the medical curriculum, and especially for advanced life support (ALS). However, simulated ALS can differ greatly from real life ALS. The aim of this exploratory study was to identify the different disruptors associated with real life ALS. Methods: We conducted a cross-sectional, anonymous, online survey that included 32 items. It was distributed by email to emergency physicians from five emergency departments in Paris. The aim of this online survey was to identify the elements perceived as disruptors during ALS. Other aspects of the survey explored the perceived differences between simulated ALS and real life ALS. Descriptive statistics of percentage, mean and standard deviation were used to analyse the data. Results: Among 100 surveyed physicians, 43 (43%) answers were analysed. 53% were women with a mean age of 32 ± 3 years old. The identified disruptors from real life ALS were task interruptions mainly from non-medical staff (n = 16; 37%), patient's siblings (n = 5; 12%), other specialists (n = 5; 12%) and the phone calls (n = 2; 5%). The situation of ED overcrowding (n = 12; 28%) was also mentioned as a potential disruptor. Overall, physicians reported that some technical and non-technical tasks were harder to perform in real life compared to simulated sessions. Conclusion: This exploratory study allowed the identification of disruptors encountered in real life cases of ALS, and may be used for future simulation-based teaching to enhance realism during sessions

An In Situ Simulation-Based Training Approach to Active Shooter Response in the Emergency Department

2018 ◽  
Vol 13 (02) ◽  
pp. 345-352 ◽  
Author(s):  
Mark S. Mannenbach ◽  
Carol J. Fahje ◽  
Kharmene L. Sunga ◽  
Matthew D. Sztajnkrycer
Keyword(s):  
Emergency Department ◽  
Emergency Departments ◽  
Low Frequency ◽  
Training Model ◽  
The United States ◽  
Lessons Learned ◽  
Added Value ◽  
Active Shooter ◽  
In Situ Simulation

ABSTRACTWith an increased number of active shooter events in the United States, emergency departments are challenged to ensure preparedness for these low frequency but high stakes events. Engagement of all emergency department personnel can be very challenging due to a variety of barriers. This article describes the use of an in situ simulation training model as a component of active shooter education in one emergency department. The educational tool was intentionally developed to be multidisciplinary in planning and involvement, to avoid interference with patient care and to be completed in the true footprint of the work space of the participants. Feedback from the participants was overwhelmingly positive both in terms of added value and avoidance of creating secondary emotional or psychological stress. The specific barriers and methods to overcome implementation are outlined. Although the approach was used in only one department, the approach and lessons learned can be applied to other emergency departments in their planning and preparation. (Disaster Med Public Health Preparedness. 2019;13:345–352)

scholarly journals A Collaborative In Situ Simulation-based Pediatric Readiness Improvement Program for Community Emergency Departments

2017 ◽  
Vol 25 (2) ◽  
pp. 177-185 ◽  
Author(s):  
Kamal Abulebda ◽  
Riad Lutfi ◽  
Travis Whitfill ◽  
Samer Abu-Sultaneh ◽  
Kellie J. Leeper ◽  
...  
Keyword(s):  
Emergency Departments ◽  
Improvement Program ◽  
In Situ Simulation ◽  
Simulation Based

scholarly journals Case Report: Exercise-Induced Supraventricular Tachycardia in a 16-Year-Old Boy with Tricuspid Regurgitation

2020 ◽  
Vol 5 (1) ◽  
pp. 1-7
Author(s):  
Putu Satya Pratiwi ◽  
Romy Windiyanto
Keyword(s):  
Differential Diagnosis ◽  
Supraventricular Tachycardia ◽  
Pediatric Patients ◽  
Sinus Tachycardia ◽  
Life Support ◽  
Advanced Life Support ◽  
Strenuous Exercise ◽  
Compensatory Response ◽  
Exercise Induced ◽  
Narrow Complex Tachycardia

Supraventricular tachycardia (SVT) is a tachydysrhythmia that is often found in pediatric patients which requires treatment. In contrast to sinus tachycardia, SVT is not a normal compensatory response to physiologi-cal stress. This article discusses the case of supraventricular tachycardia in a 16-year-old boy, which appear during strenuous exercise. In this case a guide was also provided in identifying SVT, excluding the differential diagnosis for narrow complex tachycardia, followed by guidelines for the management of pediatric tachycardia based on the Pediatric Advanced Life Support algorithm.

scholarly journals Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

2021 ◽  
Vol 11 (3) ◽  
pp. 170
Author(s):  
Francisco Martín-Rodríguez ◽  
José L. Martín-Conty ◽  
Ancor Sanz-García ◽  
Virginia Carbajosa Rodríguez ◽  
Guillermo Ortega Rabbione ◽  
...  
Keyword(s):  
Early Warning ◽  
Emergency Departments ◽  
Life Support ◽  
Area Under The Curve ◽  
Advanced Life Support ◽  
Early Mortality ◽  
Early Warning Score ◽  
Mortality Data ◽  
Early Warning Scores ◽  
National Early Warning Score

Early warning scores (EWSs) help prevent and recognize and thereby act as the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different EWSs (National Early Warning Score 2 (NEWS2), quick sequential organ failure assessment score (qSOFA), Modified Rapid Emergency Medicine Score (MREMS) and Rapid Acute Physiology Score (RAPS)) to predict mortality within the first 48 h in patients suspected to have Coronavirus disease 2019 (COVID-19). We conducted a retrospective observational study in patients over 18 years of age who were treated by the advanced life support units and transferred to the emergency departments between March and July of 2020. Each patient was followed for two days registering their final diagnosis and mortality data. A total of 663 patients were included in our study. Early mortality within the first 48 h affected 53 patients (8.3%). The scale with the best capacity to predict early mortality was the National Early Warning Score 2 (NEWS2), with an area under the curve of 0.825 (95% CI: 0.75–0.89). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients presented an area under the curve (AUC) of 0.804 (95% CI: 0.71–0.89), and the negative ones with an AUC of 0.863 (95% CI: 0.76–0.95). Among the EWSs, NEWS2 presented the best predictive power, even when it was separately applied to patients who tested positive and negative for SARS-CoV-2.

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