Next our very own @ABichmann will be talking about debriefing in resuscitation!
First we hear about how stress and anxiety manifest themselves and about how COVID has heightened many of these feelings!
There are many different factors in stress and the impact that it may have. Some stresses are single events. Some may recur and if they recur enough then you may not have time to recover and these may turn into chronic stresses
In an ideal world, we have some mild stresses which we are able to adapt to. This is how we develop new skills and we then have reasonable time to recover and consolidate these skills before facing new stresses. This is seen in the graph on the left!
Now Anna is leading us through a case where someone arrested as they were being admitted for an elective surgery. On the ITU team there were concerns about how to rearrange the unit, who to send from the team and how to get to an unusual place for an arrest!
During a casual post-arrest conversation, a colleague revealed that they felt they were not functioning at their best as they were on their 5th consecutive long shift.
In another case, Anna asked one of her colleagues to check the patients pulse and received the response 'no'. Initially slightly taken aback, she later discovered that it was because the staff member was nervous and felt they would not be able to do it effectively.
How were there lessons learnt? Debriefing. It can be a hot or cold debrief, but it will provide information on the event and help to answer some of the questions that team members may have about their colleagues actions and decisions!
• • •
Missing some Tweet in this thread? You can try to
force a refresh
Welcome to this weeks #ResusciTuesdays. We will be learning about REBOA in medical cardiac arrest. REBOA stands for ‘Resuscitative Endovascular Balloon Occlusion of the Aorta’. Its aim is to occlude the aorta and therefore improve blood flow to the brain and coronary vessels.
REBOA is sometimes talked about alongside other interventions in cardiac arrest such as ECMO and SAAP (Selective Aortic Arch Perfusion - learn more here: intensivecarenetwork.com/selective-aort…). In this we will just be talking about simple balloon occlusion.
In Trauma, REBOA is used by some services to prevent exsanguinating haemorrhage. There is still a lot of ongoing debate about its use in Trauma, but it has been incorporated into clinical practice in places and there are ongoing trials such as @UKREBOATrial
Our next talk is Patrick Druwe talking about the REAppropriate trial!
To put these results into context we first will talk about the outcomes after OHCA
In Japan there is a high rate of resuscitation attempts in patients who may not have a resuscitation attempt elsewhere! There is therefore a high rate of non-shockable OHCA and these have poorer outcomes!
The Young ERC webinar has commenced! We will be talking all about Stress and Resuscitation. You can watch along live on our Facebook facebook.com/YoungERC.resus and we will be tweeting about the key takeaway points as we go!
Our first talk is from Kate Vasey who will be talking about the importance of self care!
When we are faced with stress we make an assessment about what we CAN do and what the task will involve. We then make an assessment about whether we can undertake that task and depending on how easily we think we can do it, our body will produce a stress response!
First up @abbamamma discussing the size of the problem with dispatchers/HCPs not being exposed to high loads of cardiac arrest calls and seizure activity a confusing factor #RESUS20
Seizures are hard for lay responders and HCPs to recognise. You can check a pulse as an indication of cardiac arrest but this is hard to teach lay rescuers. Plus arrhythmia may cause a seizure. How do we tackle this?? #RESUS20#CPR
Can AI help our dispatchers when trying to multi task: taking the call, talking to lay rescuer, dispatching EMS #RESUS20 is protocol with specific training or level of medical training a better system?
From the NCAA data we know there are around 250 paediatric cardiac arrests in UK hospitals each year! A study over a 7 year period found the majority of arrests had non shockable rhythms (95.7%)
Despite these being associated with worse outcomes in adults, a survival to hospital discharge of 54.2% was seen.
ReSPECT has been a big development in UK resuscitation as it aims to create a greater conversation around advanced care planning!
The UK national cardiac arrest audit has input from 176 uk hospitals. This year has seen a slight decrease in incident of IHCA and in survival, but this year has been affected by COVID and may therefore not be comparable!