The Resus Room
Name the three allocated nursing roles in the resus room. (do you know what their responsibilities are?)
Circulation Nurse: Monitoring, IV access, medication preparation and administration, defibrillation, assists with arterial line/CVC insertion.
Airway Nurse: Prepares non invasive and invasive intubation equipment, airway adjuncts, suction, and bag-valve-mask devices. Monitors the patient's airway patency and oxygen levels.
Resus Team Leader (RTL) : Overseas and prompts nursing team. Resource allocation/delegation. Usually scribes all clinical interventions, procedures, and vital signs in real time. Records exact times for drug administration, rhythm checks, and defibrillator shocks. Ongoing care-planning.
Why is it important we ask patients when they last ate?
Adds to the clinical picture. Knowing the last meal time helps medical teams decide if a procedure can happen right away or if they must wait for the stomach to empty. Reading Blood Tests Accurately. Giving Medications Safely.
What is hypoventilation? What can cause this?
Respiratory depression (hypoventilation) is when you breathe too slowly or too shallowly, leading to carbon dioxide building up in your blood (hypercapnia). Overdose of certain kinds of medications, like opioids, and certain brain, lung and muscle conditions can cause respiratory depression. It can lead to respiratory failure or cardiac arrest.
What are the 8 rights of medication administration?
Patient → Medication → Dose → Route → Time → Documentation → Reason → Response
What is pyelonephritis?
a medical term for a sudden and severe kidney infection, usually caused by bacteria that travel up from the bladder
What is an example of an effective communication style used in the resus room?
"closed loop communication" a method of communication that promotes acknowledgment of the receipt of information and clarification with the sender that the information received is the same as the original, intended information.
"hands off handover" if no immediate needs briefly step back from physical contact or active procedures on the patient. This pause stops task distraction.
If a patient reports chest pain what is the time frame for having an ECG signed by a consultant?
10 minutes
Name 6 of the CRT Criteria.
AIRWAY THREAT?
BREATHING:
Respiratory rate ≤ 7 or > 30
SpO₂ ≤ 88%
O₂ flow rate > 8 L/min
CIRCULATION:
Pulse < 40 bpm
Pulse ≥ 140 bpm
Sbp (manual) < 90 mmHg or ≥ 200 mmHg
DISABILITY:
GCS ≤ 12 or dropped by 2 points from baseline
CONSCIOUSNESS:
Sedation Score 3 – difficult to rouse (Severe respiratory depression)
Unexpected or uncontrolled seizure
OTHER:
3 or more observations in the red zone
Unattended MDT review (> 30 minutes)
Significant bleeding
ANY CONCERN OF TREATING STAFF
A patient is prescribed a medication but you don't recognise the drug. What should you do?
Look it up! AIDH, eMIMS clarify with nurse/prescriber/pharmacy.
What is DKA? What causes it?
Diabetic ketoacidosis (DKA) is a life-threatening medical emergency that happens when the body lacks enough insulin to use blood sugar for energy, forcing it to break down fat instead.
To combat hypotension Vasopressors or Inotropes may be given. Name an additional consideration a resus nurses would advocate for when these are started.
Arterial Line (Artline): These drugs require constant blood pressure tracking. An arterial line gives a real-time, exact measurement of the blood pressure beat-by-beat.This helps nurses safely adjust the medication dose.
Central Venous Catheter (CVC): Vasopressors are strong medications.They can leak out of small veins and damage the skin, a peripheral extravasation injury. A central line places the medication into a large vein near the heart for safe delivery.
What is a pain assessment? when is it indicated?
Anytime a patient reports pain.
P – Provocation/Palliation: What makes the pain worse, and what makes it better?
Q – Quality: What does the pain feel like (for example, sharp, dull, burning, or aching)?
R – Region/Radiation: Where is the pain located on the body, and does it spread or travel anywhere else?
S – Severity: How bad is the pain, usually rated on a scale from 0 to 10?
T – Timing: When did the pain start, how long does it last, and is it constant or intermittent?
What is your concern when a patient has a low GCS?
A low GCS indicates a decreased level of consciousness (LOC) and raises concerns about the patient's ability to maintain and protect their airway, placing them at risk of airway obstruction and aspiration.
Causes of decreased LOC include hypoglycaemia, stroke, seizures, drug or alcohol intoxication, head injury, sepsis, hypoxia, hypercapnia, electrolyte disturbances, and shock.
Is an antihistamine first line treatment for anaphylaxis?
Adrenaline (epinephrine) is the only first-line and life-saving treatment for anaphylaxis. It must be injected into the muscle immediately. You should never delay giving adrenaline to administer antihistamines or other medications. Antihistamines are considered third-line or secondary interventions.
What is an ectopic pregnancy?
The general term for any pregnancy outside the womb, most often in a fallopian tube, and it cannot survive or develop normally. As the tissue grows, it can cause the fallopian tube to stretch and eventually burst (rupture) if left untreated. A rupture leads to massive internal bleeding, which causes sharp pain, dizziness, fainting, and life-threatening shock if not treated immediately.
What are the two types of NIV and what is the main difference between them?
The two main types of positive-pressure non-invasive ventilation (NIV) are Continuous Positive Airway Pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP), and the main difference is how air pressure is delivered during breathing.
When is an AWS done? Why do nurses assess this?
Alcohol acts as a central nervous system (CNS) depressant. When it is suddenly removed, the brain overcompensates, leading to extreme autonomic hyperactivity. Nurses track symptoms closely to prevent progression to severe stages like Grand Mal Seizures and Delirium Tremens - A severe state characterized by profound confusion, severe tremors, vivid hallucinations, and extreme cardiovascular instability that can be fatal if left untreated
Peaked T-waves on an ECG may indicate what?
hyperkalemia (high blood potassium levels), but they can also be an early sign of myocardial ischemia (heart attack) or a normal variant
What is the "green whistle"?
A small, hand-held, self-administered inhaler containing methoxyflurane (Penthrox), a fast-acting prescription pain medicine. Used for relief of moderate or severe pain as a result of trauma. It may also be used for short episodes of pain as a result of procedures.
Explain the brief pathophysiology of myocardial infarction.
A myocardial infarction (MI) occurs when blood flow through a coronary artery is significantly reduced or completely blocked, causing myocardial ischemia and subsequent cell death.
The typical process is: Atherosclerotic plaque → plaque rupture → platelet activation & thrombus formation → coronary artery occlusion → ↓ myocardial blood flow → ischaemia → myocardial cell death (necrosis)
What does the acronym COACHED stand for? When is this used in the resus room?
C – Continue compressions: Keep performing chest compressions while the machine gets ready, minimising any pause in CPR.
O – Oxygen away: Move free-flowing oxygen (like a bag-valve-mask) away from the patient's chest to lower any small risk of fire.
A – All others clear: Ensure team members and bystanders are clear of the patient and the bed.
C – Charging: Charge the defibrillator (typically set to 200 Joules for adults on biphasic devices) while compressions continue.
H – Hands off: Tell the compressor to stop and remove their hands just before delivering the shock.
E – Evaluate rhythm: Quickly check the monitor to see if the heart rhythm requires a shock.
D – Defibrillate or Disarm: Deliver the shock if the rhythm is shockable (such as ventricular fibrillation), or disarm (dump the charge) if it is not.
Your patient meets “CODE SEPSIS” criteria. What does this mean, and what intervention might you initiate?
The patient meets parameters that put them at high risk of sepsis and requires urgent assessment and treatment. Initiate the sepsis pathway, including obtaining, IV access, lactate (VBG), blood tests, fluid resuscitation if indicated, and timely antibiotics as prescribed, while continuing A–E assessment and escalation.
Septic "screening": Respiratory swab, CXR, UA, wound swabs, blood cultures, ?CT.
What are the four signs of an "unstable" tachyarrhythmia?
Chest Pain (?ischemic)
Hypotension
Heart Failure (oedema)
Altered mental state
What is a special consideration that applies when giving amiodarone and GTN infusion?
When administering an amiodarone infusion and a glyceryl trinitrate (GTN) infusion, a critical consideration is that both medications adsorb to polyvinyl chloride (PVC) plastics, meaning they require PVC-free administration sets, syringes, and infusion bags.
What is shock? Can you name a type?
A state of inadequate tissue perfusion resulting in insufficient oxygen delivery to the body's organs and tissues.
Hypovolemic Shock
Distributive Shock
Obstructive Shock
Cardiogenic Shock