Cite this post as:
Mike Lauria. Emergency Reflex Action Drills. EMCrit Blog. Published on April 24, 2018. Accessed on December 2nd 2021. Available at [https://emcrit.org/emcrit/emergency-reflex-action-drills/ ].
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Unless otherwise noted at the top of the post, the speaker(s) and related parties have no relevant financial disclosures.
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Jason Benaim
Great Post, love the concept. I’ll definitely be teaching this to our learners and referring people to your post! I have a suggestion for the ERAD for the patient with hypoxia on the ventilator that’s more action oriented than using DOPES. The problem with the DOPES mneumonic is you first have to remember what each letter stands for, then you have to think about what you’re going to do about it. I prefer teaching our residents to think of DOTS: Disconnect the vent Oxygen by BVM (with PEEP) Tracheal suctioning Sonography- lung ultrasound to confirm lung sliding and rule out… Read more »
Thanks for this interesting read. We adopted immediate action drills in our clinical operations after seeing our pilots practice theirs in the simulator. Loss of rotor RPM for example has immediate responses that are required before you have time to pull out and read a checklist. Some clinical scenarios are like this too – you need to practice it till it is reflex. The “HOTT Drill” that we use in traumatic arrest and the precipitously deteriorating trauma patient is an example of this. You can see the details here: https://careflightcollective.com/2015/11/02/collective-podcast-ep-2-on-traumatic-cardiac-arrest-and-this-and-that/ and here: https://careflightcollective.files.wordpress.com/2015/11/hottt-drill.pdf. The post is 3 years old now… Read more »
Hey Alan,
That’s awesome. Do you have ERADs for other situations or apply it to things other than traumatic arrest?
This is awesome. I haven’t seen that approach before with “DOTS”. I’ll add that to the tool box. Thanks, Brandon
This is awesome. I haven’t seen that approach before with “DOTS”. I’ll add that to the tool box. Thanks, Brandon
It would almost be great to start a public Google Document and have people contribute their own ERADs….
For profound hypotension, is the Epi 0.5ml administered from the 10 ml prefilled?
Yes. That’s correct. 0.5 ml of the 10 ml prefilled amp (100 mcg/cc)
Thank you for continuing to write and speak on enhancing cognitive performance in emergencies. The concept of ERADs is super helpful in considering how to personally respond and help educate other clinicians and learners in managing critical emergency maneuvers. I’ve been considering this one for managing rapid infusers: APM. Access, Prime, Manage. Access: assure adequate IV/central access. Prime: focus 100% mental effort on accurately priming and setting up the system [e.g. Level 1 or Belmont]. This is often the crux move… remember, slow is smooth, smooth is fast. You’re pulling out the big guns with a rapid infuser. Set it… Read more »
Nice. I like that Jon…ACESS-PRIME-MANAGE.
I’ll keep that one in mind for sure!
I enjoy reading your articles. find them informative and thankful for your sources list. A compendium of your posts and your sources should be required reading with the skills taught during any type of medical training This training has to continue after graduation. As a former airline pilot that now works in medicine, I have a word of caution with ERADS. The aviation industry learned that relying on memory for numerous emergencies tended to not produce good outcomes. Pilots now have just a hand full of oh crap memory items before pulling out the checklists. I caution medicine to remember… Read more »
Hey Jeff, thanks for reading and thanks for the feedback. I agree that these things only work with meaningful, deliberate practice.
Hey Mike- great post- I know this was over a year ago- I saw the new post and circled back to this one. One ERAD I have is for VL- specifically hyperangulated VL- I thought of this after I witnessed a resident keep the blade in the mouth when the screen went blank, trying in vain to “diagnose” the issue. The simplest version is if the screen goes out- if it is completely blank then the blade needs to come out of the mouth immediately and be replaced with another blade- whether it is a new disposable blade or switching… Read more »