Rapid Response

What should you consider before transferring a patient between floors?

• are they stable?

• can they tolerate positioning?

• who is needed for transportation?

• which meds need to continue while transferring?

Code stroke priorities

• recognize signs quickly

• last known well time

• CT scanner!

Code sepsis priorities

• recognize signs quickly

• get cultures + administer abx

• BP support

How do you support a patient’s blood pressure during sepsis?

hydration + inotropes (digoxin + dobutamine)

What are some clinical statistics of deterioration?

• HR >140 or <40

• BP >180 or <90

• O2 sat <90%

• urine output <50mL over 4hrs

What are some visual signs of deterioration?

• altered mental status/decreased LOC

• chest pain

• airway obstruction

• seizure

• uncontrolled pain

How do you use a defibrillator during CPR?

• power on

• place defib pads

• charge to correct joules (start at 200, then 300, then 360)

• continue chest compressions while charging

• CLEAR! and shock

• resume CPR for 2 minutes before checking for a pulse

How much epi is used in a code?

1mg every 3-5 mins

How much amiodarone is used in a code?

300mg, then 150mg (for v-tach or v-fib)

How much atropine is used for symptomatic bradycardia?

0.5-1mg

How much sodium bicarb is given for metabolic acidosis?

50 meq

What should you do post-ROSC?

• meds/fluids for low BP

• place pt. on ventilator (if intubted)

• check vitals ever 5-15mins for next hr

• investigate causes (lab work, diagnostics)

• update family