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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.

Rolling Refresher Guidelines 

To be offered to staff daily and at different shifts

  • ID Staff

    1. Identify the 5 patients who are most likely to require chest compressions

    2. Have bedside RN or neighbors, RT and MDs (attending, fellows, residents) “Refresh”

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


  • 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” or 4 cm (>=1/3 diameter of chest

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

          • Adults: 2”- max 2.5” or 5- max 6 cm  

        • Complete chest recoil between compressions

      • Duration of Refresher session should be no more than 3 minutes/person

   Give “tidbits” with each Refresher:

  • 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

  • Other items/issues pertinent to patient or situation

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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