Cardiac Arrest Scribe Template
Recognition of Cardiac Arrest & Initial Response:
- **Time of cardiac arrest:** 14:32:10
- **Time of emergency response activation:** 14:33:00
- **Initial response actions:**
- Activated emergency response system
- Assessed unresponsiveness
- Checked for a pulse
- Called for additional help
- Initiated CPR
CPR & Airway Management:
- **Time of CPR initiation:** 14:33:30
- **CPR details:**
- Chest compressions at a rate of 100-120/min
- Depth of 5-6 cm
- 3 cycles performed
- Utilized mechanical CPR device
- **Time of airway intervention:** 14:35:00
- **Airway management details:**
- Bag-mask ventilation initiated
- Intubation performed
- Confirmation via capnography
- **Oxygenation & ventilation details:**
- FiO2 set at 100%
- Respiratory rate of 12 breaths/min
- Tidal volume of 500 mL
Defibrillation & Rhythm Assessment:
- **Time of first rhythm check:** 14:36:00
- **Rhythm findings:** Ventricular Fibrillation (VF)
- **Time of defibrillation:** 14:36:30
- **Defibrillation details:**
- 1 shock delivered
- Energy level: 200J biphasic
- No immediate response
- **Subsequent rhythm checks:**
- 14:38:00: Pulseless Electrical Activity (PEA)
Medications Administered:
- **Time of medication administration:** 14:37:00
- **Medication details:**
- Epinephrine 1 mg IV
- No immediate response
- **Additional medications:**
- 14:39:00: Amiodarone 300 mg IV
Patient’s Response to Interventions:
- **Time of patient response:** 14:40:00
- **Patient’s response details:**
- Return of spontaneous circulation (ROSC)
- Improved rhythm
- Return of pulse
- **Additional responses:**
- Breathing effort noted
Procedures Performed:
- **Time of procedure:** 14:41:00
- **Procedure details:**
- Central line placement
- **Additional procedures:**
- 14:42:00: Intraosseous (IO) access
Communication & Leadership:
- **Time of communication:** 14:34:00
- **Communication details:**
- Orders given for medication administration
- Roles assigned to team members
- Major updates relayed to team
- **Additional communications:**
- Coordination with ICU for potential transfer
Outcome & Disposition:
- **Time of ROSC or termination:** 14:40:00
- **Outcome details:**
- ROSC achieved
- Post-resuscitation care initiated
- **Final disposition:**
- Transferred to ICU for ongoing monitoring
