Objectives
- Develop a proactive high performance rapid response team approach to respond to deteriorating patients.
- Apply psychological safety during rapid response situations.
- Evaluate rapid advanced assessment concepts with respect to the patient experiencing a life-threatening emergency.
- Identify determinants of cerebral and end organ perfusion.
- Analyze the essential determinants of cardiac output.
- Understand how reversible causes impact cardiac output and can exacerbate patient deterioration.
- Choose the best interventions for rapid stabilization of the generalized deteriorating patient.
- Apply best practice assessment and interventional approaches for a variety of emergent cardiac scenarios.
- Select the best practice rapid assessment and interventional approaches for critical respiratory patients.
- Identify current challenges relative to your specific practice environment and patient populations.
- Learn mental strategies necessary for success, self-care, and process improvement when treating critically ill patients.
- Incorporate pharmacological interventions into your current clinical practice with respect to the pre, peri, and post arrest management of the medically fragile patient.
- Determine documentation strategies for high risk, rapid response patient scenarios.
- Apply advanced laboratory medicine concepts with respect to the at risk patients you care for.
- Recognize subtle synergistic warning signs of the ‘perfect storm’ patient.
- Identify evidence-based practices to reduce sepsis risk.
- Outline evidence-based practices for treatment of the patient with sepsis.
- Apply up-to-date guidelines for assessment and intervention of the patient in shock (hypovolemic, distributive, obstructive, and cardiogenic).
Outline
High-Performance Resuscitation Teams During a Rapid Response
- Physical and psychological components
- Skills maintenance strategies
- Real-world application
- 2023 AHA Guidelines for CPR and Emergency Cardiovascular Care
Worst Case Scenarios & Proactive Planning
- Mental strategies for success
- Failure to rescue and how to avoid it
- Proactive risk assessments
- Lab test clues that a crisis is looming
- Clear, coherent communication of high-risk information
- Comprehensive management of the crashing patient: Before, during & after the code
Crucial Patient Assessments & Interventions
- Anticipate needs of high-risk populations (neuro, cardiac, respiratory, endocrine, oncologic)
- Incorporate rapid assessment techniques and ask the critical questions
- Identify subtle changes and time-sensitive issues of the rapid response patient
- Explore altered mental status causes
- Prioritize critical lifesaving Interventions
Pharmacological Guidelines for Emergent Patient Scenarios
- Current medication management guidelines for emergency situations
- Pharmacokinetic and pharmacodynamic considerations in the rapid response patient
- Pharmacologic pearls and pitfalls in medically fragile patients
Rapid Cardiac Assessment and Stabilization During Cardiac Emergencies
- Identify determinants of cardiac output and end organ perfusion
- Current interventions for reversible causes of cardiac emergencies
- Rapidly assess and treat concomitant reversible causes contributing to decreased cardiac output
- Rate control vs. rhythm control
- Detect first signs of life-threatening EKG changes
Optimize Response in Respiratory Distress and Cardio-Pulmonary Resuscitation
- Apply best practice methods to assess oxygenation and ventilation (Sao2, ETCO2, ABGs…)
- Critical thinking strategies for ABG analysis
- Identify oxygen delivery devices and their relative rates of delivering oxygen
- Must have components of high-quality CPR
- Resuscitation does not end with the return of spontaneous circulation (ROSC)
High-Performance Resuscitation Teams for Patients in Shock States
- Hypovolemic
- Distributive
- Obstructive
- Cardiogenic
- Pathology > differential diagnosis > treatment
High-Performance Resuscitation Teams in Sepsis
- Evidence-based practices to prevent sepsis
- Rapid assessment and stabilization of the septic patient
- Quick treatment strategies for septic distributive shock
Protect Yourself & Your License
- Potential pitfalls: Delegation, scope of practice, EMTALA, etc.
- Rapid risk assessment and analysis
- Limit liability with defensible documentation
- Ethical considerations