CARDIOLOGY

CARDIAC ARREST

Introduction

5 min

Introduce yourself and the group

Ground rules

Agree ground rules with students
Nothing to be shared outside of the session, respect others etc.
Feel free to leave the session at any time
Allow students to engage in 1:1 debrief with facilitator if helpful

Outline aim of the session as follows:

To provide a space for safe and constructive reflection about the cardiac arrest situation

Learning objectives:

To engage in reflection around witnessing a cardiac arrest
To understand roles of different team members in cardiac arrest situations
To encourage critical reflection of learners’ own feelings and attitudes towards cardiac arrest situations

Total time:

30 min

Number of students:

1-10

Grade of students:

3^rd to 5^th year medical students, could be adapted to nursing students or junior doctors/MDT members as appropriate

Created by:

Dr Charlotte Hayden

Uploaded:

17th September 2019

Last updated:

17th September 2019

Resources needed for this session:

None essential, flipchart paper/whiteboard and pens helpful

Resources linked to this session:

None

About this session

This session is designed to be delivered immediately or shortly following witnessing a cardiac arrest situation. Students should be encouraged to take few minutes, get food and/or drinks and change clothes (if appropriate) before starting the debrief.

NB Consider the location of this session, ideally find a room away from distractions where you will not be disturbed for the entire length of the session. Encourage students to leave bleeps with colleagues if applicable and practical.

Introduction: Immediate reactions

2 min

Ask the group how they are feeling. Each person should be encouraged to contribute. Keep this brief – 1-2 sentences each if possible.

Introduction: Series of Events

10 min

Encourage one student (who volunteers, alternatively a facilitator can do this) to briefly summarise the key events. This should include:

What was happening on arrival to the cardiac arrest situation?
Who was present at the arrest situation? What did they do?
What was the clinical outcome of the case? Who made the decision to stop resuscitation? Where is the patient being transferred to?
What will happen next?

Try to limit reflection at this point – allow all students to understand the events. Write discussion points or points for later reflection on a flipchart.

Ask other group members to contribute other thoughts or events that may have been missed.

Facilitated Reflection

at least 15 min

This activity will be almost completely guided by the student(s) initial response to the case. Use the prompts highlighted on the flipchart to start discussion.

Topics for discussion will be different depending on the individual scenario, but may include:

Technical aspects: giving CPR, drugs and indications, how to administer defibrillation
Team-working: how did the team interact, what was each person’s role, what was the student’s role and how did it feel?
Team-leadership: who was leading the team, what was their role, how did they act?
Patient and family perspective: how would the patient have felt, where were family members, how did they feel?
Clinical appropriateness: should CPR have been given, DNACPR discussions, what caused the cardiac arrest, was it reversible?

Encourage students to direct the conversation but facilitate them to consider how the events made them feel, how others may have interpreted them differently (i.e. how did the team leader feel, how did the patient’s family feel). Some helpful phrases and prompts for reflection:

I noticed that you said you felt … why was that?
What was going through your mind when … happened?
What aspects of this case went well?
What aspects of this case could have been improved? How would we have done this in practise?

Summarise key points.