Megacode Testing Checklist 1/2Bradycardia VF/Pulseless VT Asystole ROSCStudent Name: ______________________________________________________________ Test Date: _______________________Critical Performance Steps if done correctlyTeam LeaderEnsures high-quality CPR at all timesAssigns team member rolesEnsures that team members perform wellBradycardia ManagementStarts oxygen if needed, places monitor, starts IVPlaces monitor leads in proper positionRecognizes symptomatic bradycardia Administers correct dose of atropinePrepares for second-line treatment VF/Pulseless VT ManagementRecognizes VFClears before ANALYZE and SHOCKImmediately resumes CPR after shocksAppropriate airway managementAppropriate cycles of drugrhythm check/shockCPR Administers appropriate drug(s) and dosesAsystole ManagementRecognizes asystoleVerbalizes potential reversible causes of asystole/PEA (Hs and Ts) Administers appropriate drug(s) and dosesImmediately resumes CPR after rhythm checksPostCardiac Arrest CareIdentifies ROSCEnsures BP and 12-lead ECG are performed, O2 saturation is monitored, verbalizes need for endotracheal intubation and waveform capnography, and orders laboratory tests Considers therapeutic hypothermia STOP TESTTest Results Circle P or NR to Indicate Pass or Needs Remediation: P NRInstructor signature affirms that skills tests were done according to AHA Guidelines. Save this sheet with course record.Instructor Signature: ________________________________________________Print Instructor Name: _____________________________________________Date: ________________90-1011_ACLS_Part5_Appendix_B.indd 133 12/22/10 4:16 PM 2011 American Heart AssociationMegacode Testing Checklist 3Tachycardia VF/Pulseless VT PEA ROSCStudent Name: ______________________________________________________________ Test Date: _______________________Critical Performance Steps if done correctlyTeam LeaderEnsures high-quality CPR at all timesAssigns team member rolesEnsures that team members perform wellTachycardia ManagementStarts oxygen if needed, places monitor, starts IVPlaces monitor leads in proper positionRecognizes unstable tachycardiaRecognizes symptoms due to tachycardiaPerforms immediate synchronized cardioversionVF/Pulseless VT ManagementRecognizes VFClears before ANALYZE and SHOCKImmediately resumes CPR after shocksAppropriate airway managementAppropriate cycles of drugrhythm check/shockCPR Administers appropriate drug(s) and dosesPEA ManagementRecognizes PEAVerbalizes potential reversible causes of PEA/asystole (Hs and Ts)Administers appropriate drug(s) and dosesImmediately resumes CPR after rhythm and pulse checksPostCardiac Arrest CareIdentifies ROSCEnsures BP and 12-lead ECG are performed, O2 saturation is monitored, verbalizes need for endotracheal intubation and waveform capnography, and orders laboratory tests Considers therapeutic hypothermia STOP TESTTest Results Circle P or NR to Indicate Pass or Needs Remediation: P NRInstructor signature affirms that skills tests were done according to AHA Guidelines. Save this sheet with course record.Instructor Signature: ________________________________________________Print Instructor Name: _____________________________________________Date: ________________90-1011_ACLS_Part5_Appendix_B.indd 134 12/22/10 6:40 PM 2011 American Heart Association135Megacode Testing Checklist 4Tachycardia VF/Pulseless VT PEA ROSCStudent Name: ______________________________________________________________ Test Date: _______________________Critical Performance Steps if done correctlyTeam LeaderEnsures high-quality CPR at all timesAssigns team member rolesEnsures that team members perform wellTachycardia ManagementStarts oxygen if needed, places monitor, starts IVPlaces monitor leads in proper positionRecognizes tachycardia (specific diagnosis)Recognizes no symptoms due to tachycardiaAttempts vagal maneuversGives appropriate initial drug therapyVF/Pulseless VT ManagementRecognizes VFClears before ANALYZE and SHOCKImmediately resumes CPR after shocksAppropriate airway managementAppropriate cycles of drugrhythm check/shockCPR Administers appropriate drug(s) and dosesPEA ManagementRecognizes PEAVerbalizes potential reversible causes of PEA/asystole (Hs and Ts)Administers appropriate drug(s) and dosesImmediately resumes CPR after rhythm and pulse checksPostCardiac Arrest CareIdentifies ROSCEnsures BP and 12-lead ECG are performed, O2 saturation is monitored, verbalizes need for endotracheal intubation and waveform capnography, and orders laboratory testsConsiders therapeutic hypothermiaSTOP TESTTest Results Circle P or NR to Indicate Pass or Needs Remediation: P NRInstructor signature affirms that skills tests were done according to AHA Guidelines. Save this sheet with course record.Instructor Signature: ________________________________________________Print Instructor Name: _____________________________________________Date: ________________90-1011_ACLS_Part5_Appendix_B.indd 135 12/22/10 4:16 PM 2011 American Heart Association136Megacode Testing Checklist 5Tachycardia VF/Pulseless VT PEA ROSCStudent Name: ______________________________________________________________ Test Date: _______________________Critical Performance Steps if done correctlyTeam LeaderEnsures high-quality CPR at all timesAssigns team member rolesEnsures that team members perform wellTachycardia ManagementStarts oxygen if needed, places monitor, starts IVPlaces monitor leads in proper positionRecognizes unstable tachycardiaRecognizes symptoms due to tachycardiaPerforms immediate synchronized cardioversionVF/Pulseless VT ManagementRecognizes VFClears before ANALYZE and SHOCKImmediately resumes CPR after shocksAppropriate airway managementAppropriate cycles of drugrhythm check/shockCPR Administers appropriate drug(s) and dosesPEA ManagementRecognizes PEAVerbalizes potential reversible causes of PEA/asystole (Hs and Ts)Administers appropriate drug(s) and dosesImmediately resumes CPR after rhythm and pulse checksPostCardiac Arrest CareIdentifies ROSCEnsures BP and 12-lead ECG are performed, O2 saturation is monitored, verbalizes need for endotracheal intubation and waveform capnography, and orders laboratory testsConsiders therapeutic hypothermia STOP TESTTest Results Circle P or NR to Indicate Pass or Needs Remediation: P NRInstructor signature affirms that skills tests were done according to AHA Guidelines. Save this sheet with course record.Instructor Signature: ________________________________________________Print Instructor Name: _____________________________________________Date: ________________90-1011_ACLS_Part5_Appendix_B.indd 136 12/22/10 4:16 PM 2011 American Heart Association137Megacode Testing Checklist 6Tachycardia VF/Pulseless VT PEA ROSCStudent Name: ______________________________________________________________ Test Date: _______________________Critical Performance Steps if done correctlyTeam LeaderEnsures high-quality CPR at all timesAssigns team member rolesEnsures that team members perform wellTachycardia ManagementStarts oxygen if needed, places monitor, starts IVPlaces monitor leads in proper positionRecognizes tachycardia (specific diagnosis)Recognizes no symptoms due to tachycardiaAttempts vagal maneuversGives appropriate initial drug therapyVF/Pulseless VT ManagementRecognizes VFClears before ANALYZE and SHOCKImmediately resumes CPR after shocksAppropriate airway managementAppropriate cycles of drugrhythm check/shockCPR Administers appropriate drug(s) and dosesPEA ManagementRecognizes PEAVerbalizes potential reversible causes of PEA/asystole (Hs and Ts)Administers appropriate drug(s) and dosesImmediately resumes CPR after rhythm and pulse checksPostCardiac Arrest CareIdentifies ROSCEnsures BP and 12-lead ECG are performed, O2 saturation is monitored, verbalizes need for endotracheal intubation and waveform capnography, and orders laboratory testsConsiders therapeutic hypothermia STOP TESTTest Results Circle P or NR to Indicate Pass or Needs Remediation: P NRInstructor signature affirms that skills tests were done according to AHA Guidelines. Save this sheet with course record.Instructor Signature: ________________________________________________Print Instructor Name: _____________________________________________Date: ________________90-1011_ACLS_Part5_Appendix_B.indd 137 12/22/10 4:16 PM 2011 American Heart Association