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
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ID Staff
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Identify the 5 patients who are most likely to require chest compressions
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Have bedside RN or neighbors, RT and MDs (attending, fellows, residents) “Refresh”
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Identify preceptors or travelers that also need to be refreshed
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Refresh
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Staff should be able to:
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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)
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Turn on defibrillator to gray /ON section
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Utilize the Zoll with appropriately placed pads to get compression feedback
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Complete 10-20 consecutive compressions meeting all targets:
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Rate = 100-120/min
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Depth =
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Infants: ~1.5” or 4 cm (>=1/3 diameter of chest
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Children: ~2” inches or 5 cm (>=1/3 diameter of chest)
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Adults: 2”- max 2.5” or 5- max 6 cm
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Complete chest recoil between compressions
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Duration of Refresher session should be no more than 3 minutes/person
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Give “tidbits” with each Refresher:
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Don’t over-ventilate
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Push hard/ push fast
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Minimize interruptions
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Keep compressing while charging for a shock
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Switching “Count Down” – count down from 5 when CC provider is about to switch
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Other items/issues pertinent to patient or situation