Rhythm Review
Miscellaneous
Equipment/Devices
Protocol
100
The initial intervention for this rhythm is to deliver 3 consecutive defibrillation shocks
ventricular tachycardia
100
What drug is not standardly utilized in RACS?
Epinephrine
100
This can be found in the "walmart" and contains the majority of the supplies needed to perform a RACS event
The HEART CART !!!!
100
This major time-saving set of tasks can be completed prior to the surgeon's arrival to bedside
1) sterile prep and draping of the surgical field or
2) sterile prep and draping of the bedside table with necessary supplies
200
The initial intervention for this rhythm is to exclude underlying VF by turning off any pacing device
PEA
200
What call should be made to the lab upon initiation of a RACS event?
Code Heart to blood bank: Code heart notifies the lab to prepare blood products in preparation for mass transfusion and allows the lab to bring us a cooler of blood if we do not have an associate available to retrieve the products.
200
This device should be obtained and placed outside the room in which the RACS process is being utilized in case of multiple blood transfusions
The BELMONT rapid infuser
200
Once the surgeon or midlevel provider has a cleaned and draped surface, the next task to be completed will require one of these pieces of equipment
1) staple remover or 2) suture removal kit or 3) scalpel depending on suture line closure device utilized
300
What is the appropriate intervention for PEA if no underlying Vfib is present?
CPR should be continued until resternotomy
300
Interventions can be delayed to confirm rhythm identification thus confirming appropriate course of action for this long
no more than 1 minute
300
These can be found in the bottom drawer of the heart cart. They will be utilized in combination with the defibrillator at surgeon discretion thus need to be prepped early and in a sterile manner in preparation for rapid utilization once the chest is open
Internal defibrillation paddles
300
A RACS event requires this number of participants, each with their own set of tasks for which they are the primary responsible party.
6 minimum
400
The initial intervention for this rhythm is to utilize pacing wires or consider external pacing if wires are not in place.
Bonus : there are two rhythms
400
If vtach or vfib is persistent despite amiodarone administration, how often can a defibrillation be delivered until resternotomy is achieved?
Every 2 minutes until resternotomy is achieved.
400
In case of emergency or malfunction, extra RACS supplies are accessible by the charge nurses in this location
Extra supplies such as defib paddles and sterile equipment can be found in CVOR
400
These are the primary roles of the participants in a RACS events
1) Surgeon/Provider
2) Medications/Code Cart(defibrillator)
3) Airway/ Respiratory
4) Compressor/First Assist
5) Team Lead
6) Documenter
500
What drug and dose can be administered if this rhythm persists despite defibrillation? 
Amiodarone 300mg IV
500
If the patient is on a ventilator at the initiation of RACS, these setting changes should be made.
FiO2 should be increased to 100%
Peep turned off
You can also change to a BVM with 100% O2 if surgeon or respiratory provider prefers
500
What do you do with the IABP in a RACS scenario?
Place it on pressure trigger, this coordinates the IABP with CPR and inflation during diastole
500
The rib spreader can be found here and should be placed in this particular location in preparation for a RACS event
Sternotomy tray, bottom drawer of the cart and should be placed on the draped bedside table in preparation for surgeons' arrival