Friday, April 20

Resuscitation, Can you perform a task and still run the code?

The short answer is YES.

The long answer is also YES.

A quote running around the interwebs today I first saw in my feed from Sam Ghali @EM_RESUS on Twitter.

I get the gist of the message, that we need a team approach to Resus and every team needs a leader who can stand back and run things without getting tunnel vision on any one task.

I also don't believe the statement to be accurate that "If you're running a resuscitation while performing a procedure you're likely doing neither very well."  Multitasking has been proven to reduce the attention given to each task, so don't try to burn me there, but there are tasks at a resus our rural friends are well familiar with.
Back in the day (it was a Thursday) we ran codes with 3 people.  2 EMTs and 1 Paramedic.  Sometimes one of the EMTs was an intermediate and we could throw them on the access task.

Now that I'm in the urban setting we have plenty of people to run a code effectively.  Eventually.

There have been a number of times I have been running the recus while performing a task.  Usually access.  It's muscle memory and can be accomplished rather quickly and easily while still monitoring CPR quality, BVM usage and the rhythm on the monitor.  I'll grab the sharp and run a BGL, open the airway kit and place it next to the head as they set up the BVM, there are a number of tasks and skills that can be done effectively by the team leader.  If I don't get involved and we delay access, are we helping?  Not really.

There is a big push for us to focus on the Pit Crew method, or High Performance Method, or whatever it will be called next week and I understand why.  It helps.

Sam's statement was meant to provoke thought and challenge the old ways, not to establish new policy in our systems and I understand that, but we also need to be realistic about the ability of EMS providers to complete one task while monitoring others.  I'm not going to BVM and try to get access at the same time, but I may need to BVM and run the code at the same time until more help arrives.  And that's OK.

Challenge the norms, find the weaknesses, address them, learn from near misses and apply sound judgement.

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