CASTeach 2 - Simulation 1: Asystole

Clinical setting and history (may be adapted to candidate background)

S: Resuscitation team called to a medical ward.
B: 67-year-old man recently transferred from CCU after a recent non-ST-elevation MI.
A: He is in cardiac arrest and we have started CPR.
R: Please take over his care.
D: You agree to come urgently.

Clinical course
Discussion points:
initial rhythm is Asystole
Need for continuous,
after 2 min returns to VF
high-quality CPR with
no reversible causes present (4 Hs and 4 Ts)
uninterrupted chest
ROSC after shock; no respiratory effort
compressions after
advanced airway
Interventions insertion. Use of end-tidal
Asy Checks patient - confirms cardiac arrest - starts CPR (30:2) CO2 values for signs of
Checks monitor/confirms rhythm fatigue
2 min CPR All reversible causes –
Adrenaline 1 mg IV emphasise the need to
Recognises and treats relevant reversible causes exclude relevant
(4 Hs and 4 Ts) reversible causes
VF Checks monitor/confirms rhythm
Checks patient (signs of life/pulse)
2nd shock
2 min CPR
SR Checks monitor/confirms rhythm
Checks patient (signs of life/pulse)
Begins ABCDE assessment

Handover and transfer

GIC-ALS Provider Course | CASTeach 2 | AUG 2021 | Version 1 1