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Rolling Refreshers

For patients identified as "high risk", a designated clinician will brief their bedside provider for anticipated challenges, equipment calibration and optimal positioning, supply/medication availability, and "refreshing" of resuscitation psychomotor skills with Rolling Refresher cart.

Quick Rolling Refresher How-To

Offer “tidbits” at each Refresher session:

  • Don’t over-ventilate

  • Push hard/ push fast

  • Minimize interruptions

  • Keep compressing while charging for a shock

  • Switching “Count Down” – count down from 5 when CC provider is about to switch

  • Any ergonomic issues - is a stepstool at the bedside?

  • Other items/issues pertinent to patient or situation

  • Any system or clinical issues 

Target Key Staff

  • Identify the 5 patients who are most likely to require chest compressions.
  • Have bedside RN or neighbors, RT and MDs (attending, fellows, residents) “Refresh”.

  • Identify preceptors or travelers that also need to be refreshed.

  • Offer to staff daily and at different shifts.

 

Refresh

  •  Staff should be able to:

    • Demonstrate proper placement of dual sensor defib electrodes/pads in anterior/posterior position on the manikin (pedi, child or adult, depending on size of their patient) 

    • Turn on defibrillator to gray /ON section  

    • Utilize the ZOLL with appropriately placed pads to get compression feedback 

    • Complete 10-20 consecutive compressions meeting all targets:

      • Rate = 100-120/min

      • Depth =  

        • Infants: ~1.5” (4 cm) or > 1/3 chest diameter 

        • Children: ~2” (5 cm) or > 1/3 chest diameter 

        • Adults: 2”- 2.5” max. (5-6 cm max.)

      • Complete chest recoil between compressions

    • Duration of each Refresher session should be no more than 5 minutes/person.

To build your own Rolling Refresher Cart, please refer to the Rolling Refresher Cart Purchasing Guide below for information and specifications.

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