Resus Drills in Practice

Resus Drills in Practice

This week we have been testing out four of our recently released Resus Drills (as well as a nifty new 360° camera) to see how well each worked in practice and to learn from any feedback given by staff. This included everyone from our health care assistants, student nurses and physician associate students – all the way through to our FY2s, registrars and consultants.

Consider the following questions if you were faced with these scenarios:

  • How would you approach these cases with just 2 minutes warning?

  • What are the priorities?

  • Who else will you need?

  • What equipment would you want?

Scenario 1: Massive GI Bleed

“The red phone has just rung with a 3-minute warning of a 52-year-old male found on the bathroom floor by his daughter vomiting copious red blood. HR 132, BP 72/48, GCS 11, known alcoholic, named Derek.”

Click to  download  the PDF

Click to download the PDF

Learning points:

  1. Where is the Terlipressin kept in Resus?

  2. How to activate the Major Haemorrhage Protocol?

  3. How to set up the rapid transfuser?

Feedback about the Resus Drill:

“Gave me a different understanding on how massive upper GI bleeds are managed in ED as opposed to the endoscopy suite or ITU.” – Student Nurse

“We were able to identify equipment deficits in the department.” – EM Consultant

“It helped me understand process issues around the Major Haemorrhage protocol.”

Scenario 1 – Photo 1 (Resus Drills).jpg

Scenario 2: Lateral Canthotomy

“A 74-year-old man has fallen over in his garden – sustaining facial injuries. He is in the Emergency Room because he is on warfarin. His face is badly injured and his nose still oozing blood. Following EMAS [ambulance] handover, he says he can’t see out of his right eye very well in the last half an hour – and it is painful.”

Click to  download  the PDF

Click to download the PDF

Learning points:

  1. How to carry out the procedure

  2. Understanding the urgency of cases like this

  3. Identification of kit needed

Feedback about the Resus Drill:

“I hadn’t appreciated how time critical this presentation was.” – Trainee ENP

“Seeing what and how the procedure is preformed.” – Deputy Sister

Scenario 3: Facial Trauma

“The red phone has just rung with a 3-minute warning of a 49-year old bus driver, unrestrained, who collided with a bridge. He is GCS 13 and has heavy bleeding from hitting his face on the windscreen. No other apparent injuries. Observations are normal.”

Click to  download  the PDF

Click to download the PDF

Learning points:

  1. Where the facial trauma equipment stack was

  2. What are bite blocks and epistats, and where are they kept (see composite photo below from RCEM Learning)

Feedback about the Resus Drill:

“I really enjoyed learning about facial trauma as I have no experience of this.” – Student Nurse

“I now know this [equipment] stack exists for this type of injury.” – EM Registrar

An Epistat (bottom-left) and bite blocks (middle-right). Source:  RCEM Learning

An Epistat (bottom-left) and bite blocks (middle-right). Source: RCEM Learning

Further Reading on Facial Trauma…

Resus Drill 4: Premature Delivery

“An alarm goes out in Paediatric ED patient toilet opposite the main work-station. A 15-year-old female presented with abdominal pain gives birth unexpectedly. You are first on scene. A baby is on the floor attached by its cord.”

Click to  download  the PDF

Click to download the PDF

Learning points:

  1. You need both an Adult and a Paediatric team for this type of case

  2. Working with 2 teams and understanding what the priorities are

  3. How to call the Obstetric team

Feedback about the Resus Drill:

“Really helpful seeing how the two teams can work together!” – Paediatric Nurse

“Helped me to understand where the equipment I need is.” – Paediatric ANP

Look out for a future blog demonstrating our two other Resus Drills: Caesarean Section & Thoracotomy for Trauma!

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