Critical Care Core Course

Advanced Cardiac Life Support—Review&

Lifeline: Critical Care Transport

Critical Care Core Course--ACLS & Transport 2

ObjectivesACLS—Review

• Review AHA ACLS algorithms*

• Utilize basic cardiac rhythm recognition to choose appropriate algorithm

• State at least one interventions for each algorithm

Lifeline: Transport• Review the Transport

Process• List the critical steps

necessary to create a safe transport environment.

• Describe the Transport resources available at Johns Hopkins

12/23/2009

Critical Care Core Course--ACLS & Transport 3

ACLS—Review

12/23/2009

* This review is not meant to replace formal ACLS Class

Critical Care Core Course--ACLS & Transport 4

ACLS Review—Universal Algorithm

12/23/2009

Key Points• Airway• Breathing • Circulation

Each min means10 %↑Mortality

http://circ.ahajournals.org/content/vol112/24_suppl/images/large/4FF2.jpeg

Critical Care Core Course--ACLS & Transport 6

ACLS Review—Tachycardia Algorithm

12/23/2009

Key Points• Airway• Breathing • Circulation

Each min means10 %↑Mortality

http://circ.ahajournals.org/content/vol112/24_suppl/images/large/9FF2.jpeg

Critical Care Core Course--ACLS & Transport 9

ACLS Review— Bradycardia Algorithm

12/23/2009

Key Points• Airway• Breathing • Circulation

Each min means10 %↑Mortality

http://circ.ahajournals.org/content/vol112/24_suppl/images/large/8FF1.jpeg

Critical Care Core Course--ACLS & Transport 11

ACLS Review— Pulseless Algorithm

12/23/2009

Key Points• Airway• Breathing • Circulation

Each min means10 %↑Mortality

http://circ.ahajournals.org/content/vol112/24_suppl/images/large/8FF1.jpeg

Critical Care Core Course--ACLS & Transport 14

ACLS Review— Name This…

12/23/2009

http://www.m.auvilacom/images/BasicECG.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

ACLS Review— Name This…

12/23/2009 Critical Care Core Course--ACLS & Transport 15

Normal Sinus Rhythmhttp://www.m.auvilacom/images/BasicECG.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

Critical Care Core Course--ACLS & Transport 16

ACLS Review— Name This…

12/23/2009

http://www.rnceus.com/case/images/wencke.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

ACLS Review— Name This…

12/23/2009 Critical Care Core Course--ACLS & Transport 17

2nd Degree AV Block Type I

http://www.rnceus.com/case/images/wencke.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

Critical Care Core Course--ACLS & Transport 18

ACLS Review— Name This…

12/23/2009

http://www.m.auvilacom/images/BasicECG.gif

PR interval:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

ACLS Review— Name This…

12/23/2009 Critical Care Core Course--ACLS & Transport 19

Sinus Bradycardiahttp://www.m.auvilacom/images/BasicECG.gif

PR interval:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

Critical Care Core Course--ACLS & Transport 20

ACLS Review— Name This…

12/23/2009

http://whttp://www.scottishirishhealthcare.com/article_images/ventricular_tachycardia.jpgww.m.auvilacom/images/BasicECG.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

ACLS Review— Name This…

12/23/2009 Critical Care Core Course--ACLS & Transport 21

Ventricular Tachycardia

http://whttp://www.scottishirishhealthcare.com/article_images/ventricular_tachycardia.jpgww.m.auvilacom/images/BasicECG.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

Critical Care Core Course--ACLS & Transport 22

ACLS Review— Name This…

12/23/2009

http://www.rnceus.com/case/images/Torades.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

ACLS Review— Name This…

12/23/2009 Critical Care Core Course--ACLS & Transport 23

Torsades de Pointes

http://www.rnceus.com/case/images/Torades.gif

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

Critical Care Core Course--ACLS & Transport 24

ACLS Review— Torsades de Pointes

12/23/2009

http://www.themdsite.com/graphics/Physician_04.jpg

Critical Care Core Course--ACLS & Transport 25

ACLS Review— Name This…

12/23/2009

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

ACLS Review— Name This…

12/23/2009 Critical Care Core Course--ACLS & Transport 26

Narrow Complex Tachycardia

P:QRS:T:Ventricular Rate:Atrial Rate: Rhythm:

Critical Care Core Course--ACLS & Transport 27

ObjectivesACLS—Review

• Review AHA ACLS algorithms*

• Utilize basic cardiac rhythm recognition to choose appropriate algorithm

• State at least one interventions for each algorithm

Lifeline: Transport• Review the Transport

Process• List the critical steps

necessary to create a safe transport environment.

• Describe the Transport resources available at Johns Hopkins

12/23/2009

Critical Care Core Course--ACLS & Transport 28

Lifeline: The Transport Process• Provider orders a

test/procedure requiring a road trip.

• RN faxes a completed Transport Request to HOPCOM

• HOPCOM calls to confirm details and schedule transport

• Transport Team transports patient to test/procedure

• Patient returned & Care transferred to staff on unit of origin

12/23/2009

Critical Care Core Course--ACLS & Transport 29

Lifeline: Rules of the Road• What can we do to

safely transport this patient now with the resources at hand?

• How long will the patient be off of the unit?

• What is the plan?!?

12/23/2009

Critical Care Core Course--ACLS & Transport 30

Lifeline: Transport Resources• Lifeline Transport Team• Providers• Unit Staff• Respiratory Therapy• Testing/Procedure Area

Staff

12/23/2009