Description
The Crashing Patient: Troubleshooting at the Bedside is a high-impact webinar designed to equip healthcare professionals with practical strategies for managing acute patient deterioration. This session will explore real-time clinical decision-making, rapid diagnostics, and bedside interventions essential during critical moments. Participants will learn to identify early warning signs, prioritize actions, and avoid common pitfalls in high-stress scenarios. Through case-based discussions, the webinar aims to enhance confidence and competence in handling crashing patients across various clinical settings.
Summary Listen
- The talk focuses on preventing cardiac arrest in the emergency department (ED) by emphasizing rapid assessment, stabilization, and troubleshooting. It begins by highlighting the high percentage of in-hospital cardiac arrests that occur in the ED due to factors like disease processes, delayed triage, overcrowding, and staffing shortages. It also notes that despite challenges, ED survival rates for cardiac arrest patients are relatively good, prompting the question of how to improve them.
- Preparation is crucial, involving a "zero-point survey" or "STEP UP" approach that emphasizes safety, team readiness, and environmental awareness. Teamwork is essential, with clearly defined roles and open communication using standard terminology. It stresses that a team leader is at the foot of the bed for better visualization and gather info. Differentiating alarms from background noise and knowing equipment locations are important for an efficient response.
- Assessment involves identifying the primary threat to the patient (airway, breathing, circulation, disability, exposure or ABCDE) and anticipating potential challenges like anatomical and physiological airway difficulties. For difficult airways, a structured approach (Vortex approach) with backup plans and adjuncts is necessary. Physiological challenges like hypoxia, hypotension, and acidosis ("CRASH" - Consumption, Right heart failure, Acidosis, Saturation, Hypotension) must be addressed before intubation.
- Circulation assessment involves differentiating shock types (hypovolemic, cardiogenic, septic, obstructive) using clinical examination, history, and adjuncts like ultrasound (RUSH protocol). Source control is also important in septic shock cases. It discusses how blood cast or ECG can confirm your findings. It is advised to treat the circulation aspect with fluid, pressure, and antibiotic.
- Seven case studies are presented to demonstrate the application of these principles. These examples emphasize the importance of recognizing key findings, utilizing adjuncts effectively, and acting decisively. It is important to keep resuscitating, because the longer the hypoxia and hypotension, the worse the neurological outcome.
- The talk emphasizes the importance of teamwork and communication, preparing, performing, and practicing your skills, using adjustment wisely, deep breathe, provide feedback, training together, getting inputs, removing ego and reassessing. Finally, being aware of the various pitfalls is essential. Remember to support each other, check, support inputs from teammates and be aware of situation.
Sample Certificate
About the Speakers
Dr. Ramakrishnan Dindigal
Assistant Professor, St. John\'s National Academy of Health Sciences, Bengaluru
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