Multidisciplinary Simulation
Appendix : Checklists of critical elements
ED Physicians
Time
Critical Elements
Completed?
Yes
No
Identify team leader and reporting structure
Demonstrate effective resuscitation of trauma victim
Perform effective maternal and fetal resuscitation
Recognize need to activate Trauma Team and Code OB
Demonstrate efficient management of a traumatic cardiac arrest
Communicate effectively with team members
Discuss patient condition with family
ED Nursing
Time
Critical Elements
Identify team leader and reporting structure
Perform assessment of patient using the TNCC trauma nursing process
sequence
Recognize need to activate Trauma Team and Code OB
Tilt backboard left lateral
Setup rapid transfuser and 2 large bore intravenous catheters, obtain O
negative blood and transfuse as needed
Place tocometer on patient and obtain fetal heart rate
Set up chest drainage unit and chest tube equipment and assist with
connections
Recognize signs of traumatic cardiac arrest and initiate ACLS resuscitation,
compressions, and assist with intubation
Set up OB cart
1
Completed?
Yes
No
1
Multidisciplinary Simulation
Set up infant warmer with connections to oxygen, outlet, and heat. Set up
Kangaroo Board**.
Give report to OB, NICU, and OR nurses upon transfer of care
Document assessment and interventions of resuscitation
Trauma
Time
Critical Elements
Completed?
Yes
No
Responds to trauma activation page
Locates patient
Obtains report on patient
Recognize the severity of patient scenario based on presentation & vital
signs
Performs thoracotomy with cross clamp and open cardiac massage
Contacts OR to prepare for surgery
Obstetrics-Gynecology/Labor & Delivery
Time
Critical Elements
Responds to Code OB page
Obtains report on patient
Recognize the severity of patient scenario based on presentation & vital
signs
Establish gestational age based on bi-parietal diameter (physicians)
Confirms fetal heart rate using ultrasound
Assesses for vaginal bleeding
Initiate fetal resuscitative measures (left lateral tilt)
Obtains OB cart (if not already done by ED)
2
Completed?
Yes
No
2
Multidisciplinary Simulation
Obtains infant warmer (if not already done by ED)
Recognize need to implement surgical techniques for emergency surgeries
(physicians)
Perform appropriate surgical techniques for emergency surgeries
(physicians)
Perform medical interventions for maternal hemorrhage
Prepares patient for surgery (nursing)
Sponge and needle count (nursing)
Calls 3B to admit baby (nursing)
Assists NICU if possible/as needed (nursing)
NICU Team
Time
Critical Elements
Completed?
Yes
No
Fellow, RN, and RCP gather kits and code beeper
NICU team arrives in ED and obtains report on patient
Troubleshoots infant warmer for connections (gas sources, electric) and
heat
Place neonate in plastic bag on warmer, attach pulse ox, place knit hat
Initiate effective ventilation with NeoPuff on warmer and facemask while
set up for intubation and emergent central venous line
Perform orderly sequence of resuscitation interventions
Select correct endotracheal tube size, correct distance for UVL placement,
correct drug dosing and frequency
Demonstrate competent use of bag/T-piece resuscitator, mask,
laryngoscope, stethoscope, transilluminator, and line tray
Legend: ED – emergency department; OB – obstetrics; NICU – neonatal intensive care; OR – operating
room; ACLS – Advanced Cardiac Life Support; RCP – respiratory care practitioner; TNCC – Trauma
Nursing Core Course; UVL – umbilical vein line
3
3
Multidisciplinary Simulation
**- manufactured by Kangaroo Board, Chicago, IL
4
4