ACCEPTABLE: Announces that the rhythm is or could be Verbally states that it is atrial fibrillation or Afib. atrial fibrillation Verbally states that it is an irregular” rhythm. “irregularly Important to notice irregularity and sudden onset of event. UNACCEPTABLE: States that it is a supraventricular tachycardia without ever mentioning irregularity. States patient is without clarifying the nature of “tachycardic” tachycardia ACCEPTABLE: Announces that the rhythm is unstable or States out loud that the patient (or the hemodynamics) is unstable. that is States out loud that the blood pressure is low or the patient is hypotension hypotensive Treats the patient with pressors. Treats the patient with appropriate medications to slow the HR. (implication that it will improve the blood pressure) Administers ACCEPTABLE: vasoconstrictor of Actually gives phenylephrine in a reasonable dose (< 200 mcg per choice (phenylephrine administration) - < 200mcg) If they give an alternative e.g. 1 2 U Vasopressin. – – If they give the drug but do not verbalize the dose and the confederates do not query / ask them for a dose mark as present. – (Standardization error) Administers IV fluid ACCEPTABLE: bolus States / verbalizes that they are giving a fluid bolus, IV bolus, or “volume” Opens up fully the IV roller clamp. Raises IV pole or squeezes IV bag Touches the roller clamp, stop cock, IV tubing and verbalizes need for fluid/volume Administers drugs to ACCEPTABLE: slow the heart rate Administers a beta-blocker, adenosine or amiodarone. If they give the drug but do not verbalize the dose and the confederates do not query / ask them for a dose mark as present. – (Standardization error) ACCEPTABLE: Notifies surgeon/team about clinical situation
Announces that the rhythm is or could be atrial fibrillation ACCEPTABLE: Verbally states that it is atrial fibrillation or Afib. Verbally states that it is an “irregularly irregular” rhythm. Important to notice irregularity and sudden onset of event. UNACCEPTABLE: States that it is a supraventricular tachycardia without ever mentioning irregularity. States patient is “tachycardic” without clarifying the nature of tachycardia Announces that the rhythm is unstable or that is hypotension ACCEPTABLE: States out loud that the patient (or the hemodynamics) is unstable. States out loud that the blood pressure is low or the patient is hypotensive Treats the patient with pressors. Treats the patient with appropriate medications to slow the HR. (implication that it will improve the blood pressure) Administers vasoconstrictor of choice (phenylephrine - < 200mcg) ACCEPTABLE: Actually gives phenylephrine in a reasonable dose (< 200 mcg per administration) If they give an alternative – e.g. 1 – 2 U Vasopressin. If they give the drug but do not verbalize the dose and the confederates do not query / ask them for a dose – mark as present. (Standardization error) Administers IV fluid bolus ACCEPTABLE: States / verbalizes that they are giving a fluid bolus, IV bolus, or “volume” Opens up fully the IV roller clamp. Raises IV pole or squeezes IV bag Touches the roller clamp, stop cock, IV tubing and verbalizes need for fluid/volume Administers drugs to slow the heart rate ACCEPTABLE: Administers a beta-blocker, adenosine or amiodarone. If they give the drug but do not verbalize the dose and the confederates do not query / ask them for a dose – mark as present. (Standardization error) Notifies surgeon/team about clinical situation ACCEPTABLE:
ALN_2017_05_15_WEINGER_ALN-D-16-01184_SDC4.docx