resuscitation: the first five minutes

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DC3, A through J

Danger

is it safe to approach the patient?

D C3 A B C D E F G H I J

personal protective equipment

decontaminate

chemical restraint

Call for help

is the patient in the right place?

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are the right people here or notified?is the necessary equipment at bedside?

Calm

make the room quiet

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unnecessary personnel to perimeteridentify team leader

Cardiac arrest

pulse check if unresponsive

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compressions if no certain pulseanalyze rhythm, defibrillate if indicated

A irway

does the patient need an airway intervention?

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voice, secretions, stridor, posturing head & neck position, jaw thrustsuction, foreign bodyoral/nasal airway, LMAprepare to intubate

Breathing

oxygenate: NC, face mask, NIV

D C3 A B C D E F G H I J

ventilate: bag mask, LMASpO2, RR, resp effort, auscultate lungsthoracostomyalbuterol, epinephrine, nitroglycerineportable chest xray

Circulation

vascular access

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monitorHR, BP, pulses, JVP, skin & perfusionIVF, blood12-lead ECGCa for hyperK

Disability

level of consciousness / mentation

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STAT head CT

pupilsmovement at 4 extremitiescapillary blood glucose / D50

Exposure

initiate active cooling or warming

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trauma rash alert bracelet medication patches ID, medical history, medications

remove all clothing & check pocketsvisualize every inch of skin

rectal temp

Family & friends

collateral history (ask EMS)

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set expectationsadvanced directives

family-witnessed resuscitation

Ganal esia

IV/IM morphine 0.1 mg/kg IV fentanyl 1 mcg/kg IN fentanyl 2 mcg/kg IV ketamine 0.15 mg/kg

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HCG

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2 drops whole blood on bedside pregnancy test cassette

displace uterus to left

perimortem C section

Infection

D C3 A B C D E F G H I J

isolatebroad spectrum antibioticssource control

Jel (ultrasound)

D C3 A B C D E F G H I J

pericardial effusion, ejection fraction RV strain, regional wall motion IVC collapsibility intraperitoneal fluid, aorta, IUP PTX, pulmonary edema, pleural effusion intracranial pressure DVT venous & arterial access

Cspine

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* for oral boards

Danger Call for helpCalmCardiac arrest Airway BreathingCirculationDisabilityExposure Family/friends Gesia HCG Infection Jel (ultrasound)

anal

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