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AS2.1-2 | Cardiopulmonary Resuscitation — Assignment
CLINICAL SCENARIO
You are the anaesthesiology registrar assigned to improve cardiac arrest response in a 30-bed general medicine ward. Your task is to design a structured, simulation-based CPR training and immediate post-arrest debriefing protocol for the ward nursing and resident team. This is a real clinical deliverable: hospitals with structured CPR training programmes and post-event debriefs demonstrate significantly higher rates of survival to discharge and improved CPR quality metrics. Your protocol must address adult BLS and ALS competencies, differentiate between shockable and non-shockable rhythms, assign team roles, and specify how to debrief immediately after a real arrest or simulation.
Instructions
- Begin with a brief clinical rationale (100–150 words): why structured CPR training and debriefing matter on a general medicine ward. Cite at least one specific CPR quality metric (e.g., EtCO2 target, compression fraction > 60%) that the programme will monitor.
- Write a BLS–ALS Quick-Reference Card (table or structured list) that ward staff can laminate and mount at the resuscitation trolley. It must include: (a) adult BLS parameters (rate, depth, ratio, compression fraction); (b) shockable vs non-shockable rhythms and their immediate management; (c) ALS drug doses — adrenaline and amiodarone (dose, timing, route); (d) post-ROSC immediate targets (SaO2, PaCO2, MAP, temperature).
- Describe a 30-minute simulation training session: objectives, scenario (patient collapse in a ward bay), roles assigned (team leader, compressor, airway, IV access, drug nurse, recorder), equipment required, and the three competency milestones each participant must demonstrate.
- Write a structured post-arrest debriefing template (hot debrief: within 1 hour of event). Include: what went well, what could be improved, and three specific factual checkpoints drawn from the arrest (one BLS parameter, one drug decision, one post-ROSC action).
- Conclude with one paragraph on the evidence base for simulation-based resuscitation training — state one specific improvement in outcome documented in the literature.
Length: 700–1000 words (excluding tables and structured lists, which may be formatted separately)
Grading Rubric — Cardiopulmonary Resuscitation Assignment Rubric
| Criterion | Points | Full-marks descriptor |
|---|---|---|
| Factual accuracy of BLS/ALS parameters and drug doses | 30 pts | All BLS parameters (rate 100–120/min, depth 5–6 cm, ratio 30:2), shockable/non-shockable distinction, adrenaline and amiodarone doses and timing, and post-ROSC targets are factually correct and complete with no errors. |
| Clinical applicability and completeness of the quick-reference card | 25 pts | The quick-reference card covers all four required elements (BLS parameters, rhythm management, drug doses with timing, post-ROSC targets) in a clear, scannable format suitable for lamination and bedside use. |
| Quality and realism of the simulation session design | 25 pts | Simulation session specifies objectives, a realistic ward scenario, all six roles with defined responsibilities, equipment list, and three measurable competency milestones. Could be run without modification by a senior resident. |
| Structured debriefing template and evidence-based conclusion | 20 pts | Debriefing template uses a structured format (what went well / what to improve), includes three factual checkpoints correctly derived from CPR evidence, and the concluding paragraph names a specific documented outcome improvement from simulation-based training. |
PEER REVIEW
Review your peer's submission against the following checkpoints: (1) Is the adrenaline dose and timing in the quick-reference card factually correct — 1 mg IV/IO after the 2nd shock and every 3–5 min? (2) Is the shockable rhythm distinction (VF/pulseless VT) clearly stated and correct? (3) Does the simulation session assign a team leader role with defined responsibilities? (4) Does the debriefing template include at least one factual rather than opinion-based checkpoint? (5) Is the post-ROSC temperature target specified? Provide one specific factual correction if any parameter is wrong, and one constructive suggestion for improving the clinical utility of the quick-reference card.