Code STEMI
Code STROKE
Code Hemorrhage
Name that Rhythm, Name that Treatment
Rapid Response/MSET basics
100

Where is the closest Inova Cath Lab located?

Inova Fairfax Hospital

100

What is the door to CT goal? What is the door to drug time?

CT goal <=10 minutes

Drug <=30 minutes

100

What comes in the first cooler? Subsequent coolers?

First cooler:

4 PRBC's and 4 FFP/liquid plasma

Second cooler:

4PRBC's, 4 FFP/liquid plasma, 1 platelets

Third Cooler

4 PRBC's and 4 FFP/liquid plasma

100

What is this rhythm and how would you treat it?


high quality CPR, Epinephrine every 3-5 minutes, rinse and repeat
100

We round on all MEWS scores of this and above.

4

200

How do you pull the STEMI kit in the Omnicell?

Type in Kits and pull under STEMI- medications will be dispensed 1 by 1.

200

Blood pressures must be under what in order to administer Tenecteplase?

Must be < 185/110

200

How do you access the MTP narrator on an inpatient unit? Through the ED? On L&D?

Inpatient units- click on code documentation and then click on MTP start OR click on rarely used and select Emergent Blood

ED- Click on MTP from the ED narrator

L&D: not approved at this, revert to old method of paper and use traditional blood transfusion record

200

What is this rhythm called and how do you treat it?


Ventricular tachycardia and cardiovert

200

Where do you go to pull Zoll data on compression quality following an MSET?

Zoll online under case review

300

What medications are part of the STEMI kit?

Aspirin, Nitroglycerin SL, Heparin 5,000 unit vial, Zofran ODT

300

What are core components that STAR should document with a Stroke Alert?

Last well known time

Blood Glucose

BP/vital signs

NIHSS

Dysphagia

Stroke Note

300

There are 4 places where Belmont Infusers can be found. Where are these?

ICU- outside room 2

ED- in Room 3

Labor and Delivery- outside OR 1

OR- next to the crash cart 

300

What is the name of this rhythm?


Ventricular Fibrillation

300

You just got off the elevator on the third floor and you see Jennifer Whalen collapse unresponsive to the floor. What is the process for when a team member or visitor suffers a medical emergency that requires urgent evaluation and intervention?

Immediately transport the team member or visitor to the ED- no point of care interventions should be performed except CPR. The priority is definitive stabilization and treatment- do not delay transport for any reason!

Team Member RRT/MSET should be called overhead as Visitor MSET or Visitor RRT.

400

What is the number to IFMC cath lab or where could you find this information?

STEMI packet has numbers listed:

Cardiac Access line: (703) 776-5905

Cath lab direct: (703) 776-2894

Cath Lab RN report: (703) 776-7029

400

A new stroke is confirmed on a patient in room 436. Dr. Ajayi has ordered a Nicardipine drip. What are your next actions? How frequently can you titrate this medication? How frequently should you check blood pressures?

Patient needs to be upgraded to Level 2 and moved to either 4 South or ICU. For level 2, you can only titrate Nicardipine every 15 minutes and at minimum, BP's should be done every 15 minutes. 

400

What fluids CANNOT be given through the Belmont?

Platelets, Cryo, Calcium, Lactated Ringers, Hartmann's solution

400

What is this rhythm and how do you treat it?



Sinus Brady- can be normal variant, if symptomatic, atropine is 1st line treatment. If not responsive to atropine, initiate transcutaneous pacing.

500

What is the most appropriate course of action if MMT gives you a transfer time of 45 minutes?

Cancel MMT transport and call 911 to have patient taken by ACLS ambulance unit- anything greater than 15 minutes should go by EMS

500

How would you document an NIHSS on a patient that is either unconscious or unable to follow commands?

Ask Mikki

500

All Belmont's in the hospital are in use and there is a 5th hemorrhage event. What is the best way to rapidly infused blood?

Pressure bags or IV pump with 999ml/hr

500

What is this rhythm and how would you treat it?



SVT- initiate vagal maneuvers, prepare for adenosine administration (6mg, 12mg) followed by rapid flush. If unresponsive to medication, synchronized cardioversion
500

Name all the reversible causes of codes (H's and T's), how you would rule them out and how you would treat them.

Hypovolemia

Hyper/Hypothermia

Hydrogen Ion

Hypoxia

Hyper/hypokalemia

Hypoglycemia

Tamponade

Toxins

Thrombus

Tension Pneumothorax