Western Journal of Emergency Medicine: Integrating Emergency Care with Population Health

Learning Objectives: To train Emergency Medicine residents how to properly and safely handle complex scenarios that require resuscitation outside the normal Advanced Cardiovascular Life Support (ACLS) algorithm using peri-code algorithms using both high and low fidelity techniques.

All Emergency Medicine residents get basic training running a code during their ACLS certification in the United States. However, there are not many easily applicable and accessible courses that provide comprehensive detailed training on peri-arrest scenarios. Beyond ACLS is a 1-day training course that took place in our simulation center. Residents were first given a questionnaire regarding their confidence and knowledge on scenarios that may require them to deviate from the ACLS algorithm. Residents were subsequently split into groups of three, each consisting of an intern, junior and senior resident. The intern was responsible for airway, the junior was running the resuscitation and the senior was overseeing the whole process, ultimately inserting them into an attending position to guide their junior colleagues. After that, each team ran a total of 8 stations, each with different scenarios designed to challenge them in different cardiac situations. These stations also helped them develop strategies to think outside the box when circumstances or presentations are not normal. They also focused on team dynamics and teamwork in which learners practiced how to interact with other medical staff that may be present during resuscitations. The stations used both high and low fidelity techniques, as well as ultrasound training. After the conclusion of the session, the same questionnaire was given to the residents to account for differences in confidence and overall knowledge.