Acls Sim Pad

Practical ACLS Megacode Testing and Training Scenario Set for SimPad
Consolidated Instructor Manual
Frances Wickham Lee, DBA

Scenario Authors:
Frances Wickham Lee, DBA
John Walker, BHS
John Schaefer, MD
Matthew McEvoy, MD
Sheila Scarbrough, RN
Rev. 1/13/2013
Table of Contents

Curricular Information
Faculty Information-General Instructions (Training)
Faculty Information-Specific Instructions (Training)
Faculty Information-Specific Instructions (Testing)
12
Setup and Equipment
18
Case Information
19
Debriefing Information
25
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Curricular Information
ACLS Training is a set of fifteen scenarios based on the 2010 American Heart
Association ACLS guidelines and written for use with the existing ACLS
curriculum.
The ACLS Training set includes the following:
1. Asystole In-Hospital 1
2. Asystole In-Hospital 2
3. Bradycardia In-Hospital 1
4. Bradycardia In-Hospital 2
5. PEA In-Hospital 1
6. PEA In-Hospital 2
7. PEA In-Hospital 3 (Bradycardia)
8. Stable Tachycardia In-Hospital 1
9. Stable Tachycardia In-Hospital 2
10. Unstable Tachycardia In-Hospital 1
11. Unstable Tachycardia In-Hospital 2
12. Ventricular Fibrillation/Pulseless Ventricular Tachycardia In-Hospital 1
13. Ventricular Fibrillation/Pulseless Ventricular Tachycardia In-Hospital 2
14. Post Cardiac Arrest Care In-Hospital 1
15. Post Cardiac Arrest Care In-Hospital 2
ACLS Testing is a set of six scenarios based on the 2010 American Heart
Association ACLS guidelines and written for use with the existing ACLS
curriculum.
The ACLS Testing set includes the following:
1.
2.
3.
4.
5.
6.
Megacode A (Bradycardia to VF/Pulseless VT to Asystole)

Megacode B (Stable Tachycardia to VF/Pulseless VT to PEA)
Megacode C (Stable Tachycardia to VF/Pulseless VT to PEA)
Megacode D (Unstable Tachycardia to VF/Pulseless VT to PEA)
Megacode E (Unstable Tachycardia to VF/Pulseless VT to PEA)
Megacode F (Bradycardia to VF/Pulseless VT to Asystole)
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Faculty Information General Instructions (Training)

1. These training scenarios are designed to train the participant acting as
Team Leader to follow the ACLS guidelines.
2. Scenarios will open with the following screen. Click on Start Scenario to
begin the scenario and the built in timer (6 to 10 minutes depending on the
scenario).
3. Team Leaders should be instructed to verbalize actions and decisions

that may not be apparent otherwise. Team Leaders must direct or
acknowledge each required action.
4. Facilitators should click on each menu item as it occurs. Categories will
appear and disappear automatically as time limits are reached or as tasks
are completed.
5. There are a few menu items that should be automatically sensed by the
manikin. These include: Check pulse; Attach 3-Lead ECG; Measure Blood
Pressure; Attach Pulse Oximeter; Start Compressions; Deliver Shock. If
the manikin DOES NOT SENSE one of these items when it is performed,
click on the item to register the action.
6. Scenarios that require CPR will include CPR evaluation menu items.
Indicate any actions that were performed incorrectly.
7. In the Training scenarios, the Team Leader must first identify the heart
rhythm. The scenario will not proceed until the correct rhythm has been
identified.
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Faculty Information Specific Instructions (Training)

Asystole In-Hospital 1 (Jane Johnson):
SCENARIO OVERVIEW--You are a hospital interventionist and respond to a
cardiac arrest in the hospital admission area. A patient collapsed while giving
registration information. She had been referred for elective cardiac
catheterization. Hospital admissions personnel initiated CPR and called a code.
CORRECT STEPS for Asystole Scenario--Required Steps to revive Patient:
a. Identify Asystole
b. CPR start (sensed or override)
c. Epi or Vasopressin
Drug therapy that leads to recovery--Epi or Vasopressin.
OTHER GRADING POINTS--6-minute time limit for this scenario.
OPERATOR NOTES--Team Leader must acknowledge or direct each action.
Asystole In-Hospital 2 (John Wiggins)

SCENARIO OVERVIEW--You are a nursing supervisor and code Team Leader
on night shift. You respond to a code on the general medical floor. A patient is
found unresponsive. Personnel initiated CPR and called a code.
CORRECT STEPS for Asystole Scenarios--Required Steps to revive Patient:
a. Identify Asystole,
Drug therapy that leads to recovery--Epi or Vasopressin.
Bradycardia In-Hospital 1 (Ed Stokes)

SCENARIO OVERVIEW-- An elderly man was brought from triage complaining
of dizziness. He tells you that his symptoms began about an hour ago. He is lying
on a stretcher and becomes poorly responsive, but regains consciousness in a
few seconds.
CORRECT STEPS--Required Steps to revive Patient:
a. Identify Bradycardia
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b. Atropine 0.5 mg. (No pacing, because patient improves)

Bradycardia In-Hospital 2 (Grace Hardy)

SCENARIO OVERVIEW--This patient is brought by EMS. They report finding her
on the floor at home. Her husband said she clutched her chest and collapsed.
EMS gave her 1 mg of atropine, she improved and had stable vital signs, but now
she is complaining of dizziness again and her HR has dropped to 28. After initial
Atropine therapy, the patient is conscious but confused. Monitor shows thirddegree AV block, HR 40.
a. Identify Bradycardia
b. Transcutaneous Pacing (Note: initial Atropine already administered;
additional drug therapyEpinephrine or Atropine may be given prior to
pacing.)
PEA In-Hospital 1 (Mary Kettle)

on night shift. You respond to a code on the general medical floor. A patient is
CORRECT STEPS --Required Steps to revive Patient:
a. Identify PEA
c. Epi or Vasopressin, then
d. Epi or Vasopressin (Vasopressin may be given as first or second dose,
not both)
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PEA In-Hospital 2 (Ellen Engles)

on day shift. You respond to a code on the general medical floor. A patient is
CORRECT STEPS --Required Steps to revive Patient:
a. Identify PEA
c. Epi or Vasopressin, then
d. Epi or Vasopressin (Vasopressin may be given as first or second dose,
not both)
PEA In-Hospital 3 (Bradycardia PEA) (Peter Pumpkin)

SCENARIO OVERVIEW--You are a physician and respond to an in-hospital
cardiac arrest. You find CPR already in progress by the nursing staff. They report
that the patient was admitted for observation following a motor vehicle collision
and planned surgery for treatment of an open leg fracture. He was the unbelted
driver of the car.
a. Identify PEA
OTHER GRADING POINTS - This scenarios has a 6-minute timer.
VF Pulseless VT In-Hospital Scenario I (Neal Hannity)

SCENARIO OVERVIEW--You respond to a cardiac arrest in the ED registration
area. A patient, brought by car, collapsed while complaining of chest pain. The
triage personnel have initiated CPR.
CORRECT STEPS for VF Pulseless VT -- Required Steps to revive Patient:
a. Check Rhythm and correctly identify VF-Pulseless VT
b. Start CPR (sensed or override)
c. Give 1st shock
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d.
e.
f.
g.
Start CPR (sensed or override)

2nd Shock (start CPR after each shock) and Epinephrine or Vasopressin
Amiodarone 300mg IV or Lidocaine 1-1.5mg/kg
3rd Shock
OTHER GRADING POINTS--There is a 10-minute time limit built into this

scenario - Second dose of Epi or Vasopressin is allowed, but not required.
OPERATOR NOTES-- The team leader must acknowledge or direct each action.
VF Pulseless VT In-Hospital Scenario 2 (Julia Ann Moore)

SCENARIO OVERVIEW--You respond to a cardiac arrest in the hospital
admission area. A patient collapsed while giving registration information. She had
been referred for elective cardiac catheterization. Hospital admissions personnel
initiated CPR and called a code.
CORRECT STEPS for VF Pulseless VT -- Required Steps to revive Patient:
a. Check Rhythm and correctly identify VF-Pulseless VT
b. Start CPR (sensed or override)
c. Give 1st shock
d. Start CPR (sensed or override)
e. 2nd Shock (start CPR after each shock) and Epinephrine or Vasopressin
f. Amiodarone 300mg IV or Lidocaine 1-1.5mg/kg
g. 3rd Shock
OTHER GRADING POINTS--There is a 10-minute time limit built into this
scenario - Second dose of Epi or Vasopressin is allowed, but not required.
OPERATOR NOTES-- The team leader must acknowledge or direct each action.
Stable Tachycardia In-Hospital 1 (Narrow, Regular) (Nancy Nero)

SCENARIO OVERVIEW--You are in the ED and are evaluating a 63-year-old
female who presented complaining of palpitations. She tells you she has had a
history of recurrent fast heart rates, but several episodes today brought her to the
ED. While you are doing her examination, she suddenly complains of
palpitations.
CORRECT STEPS-- Required Steps to revive Patient:
a. Identify Stable Tachycardia, narrow QRS, regular
b. Attempt Vagal Maneuver
c. Give 6 mg Adenosine
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d. Followed by 12 mg Adenosine
OTHER GRADING POINTS - This scenario has a 6-minute timer.
Stable Tachycardia In-Hospital 2 (Wide, Regular) (Willy Coyote)

SCENARIO OVERVIEW--A 35-year-old male arrives in the ED complaining of
palpitations. He tells you he has had a history of recurrent fast heart rates. He
has been having palpitations for several days. Today symptoms were worse and
coworkers phoned 911. He thinks he is having a heart attack.
CORRECT STEPS-- Required Steps to revive Patient:
a. Identify Stable Tachycardia, wide QRS, regular
b. Attempt Vagal Maneuver
c. Adenosine 6 mg
OTHER GRADING POINTS-- This scenario has a 6-minute timer.
OPERATOR NOTES--The Team Leader must acknowledge or direct each
required action.
Unstable Tachycardia In-Hospital 1 (Johnny Jett)

SCENARIO OVERVIEW--You are a nurse on a monitored unit. A 55-year-old
man is recovering from an anterior MI following fibrinolysis in the ED. The
monitor alarms and you go into the room.
CORRECT STEPSRequired Steps to revive Patient:
a. Identify Unstable Tachycardia
b. Synchronized Cardioversion (sedation should be considered prior to
Cardioversion)
required action.
Unstable Tachycardia In-Hospital 2 (Mary Contrary)

SCENARIO OVERVIEW-- In the ER you are evaluating a 26-year-old woman.
She was born with heart abnormalities and has chronic palpitations. A corrective
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surgical procedure was performed as a child. She has passed out once in her
life. Today her palpitations will not stop, and she came to the ER.
CORRECT STEPSRequired Steps to revive Patient:
a. Identify Unstable Tachycardia
b. Synchronized Cardioversion X 2 (sedation should be considered prior to
Cardioversion)
required action.
Post Cardiac Care In-Hospital 1 (Jane Johnson)

SCENARIO OVERVIEW--You are a hospitalist who has responded to a cardiac
arrest in the hospital admission area. After performing appropriate Asystole
treatment, you are responsible for the Post Arrest Care.
CORRECT STEPS--Follow ACLS Guidelines for Post Cardiac Arrest Care:
a.
b.
c.
d.
e.
f.
g.
h.
i.
Identify Return of Spontaneous Circulation

Verbalize Intubation Need
Monitor O2 Saturation
Verbalize Capnography Need
Measure Blood Pressure
Consider Hypotension Treatment
Obtain 12-Lead ECG
Order Labs
Consider Therapeutic Hypothermia
OTHER GRADING POINTS--6 minute time limit for this scenario.

This scenario is designed for the evaluation of the Team Leader.
Post Cardiac Care In-Hospital 2 (Neal Hannity)

triage personnel called a code. After performing appropriate VFib treatment, you
are responsible for the Post Arrest Care.
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CORRECT STEPS--Follow ACLS Guidelines for Post Cardiac Arrest Care:

1.
2.
3.
4.
5.
6.
7.
8.
9.

Obtain 12-Lead ECG
Order Labs
OTHER GRADING POINTS--6 minute time limit for this scenario.

This scenario is designed for the evaluation of the Team Leader.
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Faculty Information Specific Instructions (Testing)

All Megacode Scenarios
Initial Required Steps are:
1.
2.
3.
4.
5.
6.
7.
Check Pulse within 10 seconds

Check Airway Patency within 30 seconds
Check Breathing within 30 seconds
Assign Roles within 1 minute
Place AED or ECG within 1 minute
Attach Pulse Oximeter within 1 minute
Identify Rhythm within 1 minute
Required Steps for Pathway are listed in the following sections.

Post Cardiac Care Required Steps are:
1.
2.
3.
4.
5.
6.
7.
8.
9.

Obtain 12-Lead ECG
Order Labs
ACLS In-Hospital Megacode A (Michael Jones)

GENERAL OVERVIEW-- You are evaluating a 57-year-old man complaining of
indigestion. He is brought immediately from triage (arrived by personal car) and
placed in ED room 2. He is cold, clammy, and diaphoretic. He states that he feels
as if he is about to faint. The triage nurse is working with you and has obtained
vital signs: HR 38, BP 70/P, RR 16.
CORRECT STEPS--This scenario will move from Bradycardia to VF/Pulseless
VT to Asystole Pathways.
Bradycardia Required Steps are:
1. Identify Bradycardia
2. Give Atropine 0.5 mg IV/IO
3. Verbalize consideration of TCP
4. Seek Expert Opinion
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5. Complete Rx within 3 minutes

VF/Pulseless VT Required Steps are:
1. Identify Ventricular Fibrillation rhythm
2. Start CPR within 15 seconds
3. Defibrillate initially
4. Give either epinephrine or vasopressin IV and Defibrillate (either may be
given first; two doses of epi or epi and vaso may be given)
5. Give Amiodarone and Defibrillate
6. Perform CPR correctly throughout
Asystole Required Steps are:
1. Identify Asystole rhythm
3. Give either epinephrine or vasopressin IV
4. Complete Rx in 2 minutes
OTHER GRADING POINTS--The Megacode is designed to test the ACLS
participant in the Team Leader role. The Team Leader must acknowledge or
direct each required action.
ACLS In-Hospital Megacode B (Alvin McIntosh)

GENERAL OVERVIEW--In the ED you are evaluating a 65-year old man
complaining of palpitations. He is in no distress. He has a history of coronary
artery disease and had a stent in the past. Otherwise he is healthy with no other
medical problems.
CORRECT STEPS--This scenario will move from Stable Tachycardia to
VF/Pulseless VT to PEA Pathways.
Tachycardia Required Treatment Steps are:
1. Identify Stable, Narrow Complex, Regular, Tachycardia
2. Attempt vagal maneuvers
3. Give adenosine 6 mg
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PEA Required Steps are:
1. Identify PEA rhythm
3. Give epinephrine or vasopressin IV
4. Complete Rx in 2 minutes.
OTHER GRADING POINTS--This Megacode is designed to test the ACLS
ACLS In-Hospital Megacode C (Joanna Miles)

GENERAL OVERVIEW - You are called to the ICU, where you find a post-op
patient experiencing chest pain.
Tachycardia Required Treatment Steps are:
1. Identify Stable, Narrow Complex, Regular, Tachycardia
2. Attempt vagal maneuvers
3. Give adenosine 6 mg
4. Complete Rx in 2 minutes.
14
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ACLS In-Hospital Megacode D (Mary Ann Fremont)
GENERAL OVERVIEW-- You are called to a patient room where you find an
elderly woman. She was admitted for a total knee replacement and was moved
from ICU this morning.
CORRECT STEPS--This scenario will move from Unstable Tachycardia to
Unstable Tachycardia Required Steps are:
1. Identify Unstable Tachycardia
2. Consider Sedation before Cardioversion
3. Synchronized Cardioversion
15
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ACLS In-Hospital Megacode E (Lois Lane)

elderly woman. She was admitted three days ago for a fractured hip.
CORRECT STEPS--This scenario will move from Unstable Tachycardia to
Unstable Tachycardia Required Steps are:
5. Identify Unstable Tachycardia
6. Consider Sedation before Cardioversion
7. Synchronized Cardioversion
ACLS In-Hospital Megacode F (Forrest Gump)

GENERAL OVERVIEW - You are evaluating a 63-year-old man in the
Emergency Room. He arrived by personal car and is cold, clammy and
diaphoretic. He states that he feels as if he is about to faint. The triage nurse is
working with you and has obtained vital signs of HR 50 BP66/P RR18.
CORRECT STEPS--This scenario will move from Bradycardia to VF/Pulseless
VT to Asystole Pathways.
16
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Bradycardia Required Steps are:

1. Identify Bradycardia
2. Give Atropine 0.5 mg IV/IO
3. Verbalize consideration of TCP
4. Seek Expert Opinion
Asystole Required Steps are:
1. Identify Asystole rhythm
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Setup and Equipment

Suggested Scenario Logistics:
For use with the 2010 ACLS approved curriculum

6 in-hospital Megacode scenarios
15 in-hospital training scenarios
Individual Scenario Run Time - 6 to 10 minutes
Debriefing time varies per group - Estimate 20 minutes per scenario
Equipment Needed:
Simulated IV in place
Nasal Cannula or O2 Mask
Defibrillator or AED
Crash Cart or simulated Crash Cart with at least:
o BVM
o Backboard
o Simulated drug vials and syringes
Epinephrine
Vasopressin
Atropine
Amiodarone
Adenosine
Procainamide
Sotalol
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Case Information (Training)

Asystole In-Hospital 1
Patient Name: Jane Johnson
Age: 59
Height: 65 in
Weight: 175 lbs.
SCENARIO OVERVIEW--You are a hospital interventionist and you respond to a
cardiac arrest in the hospital admission area. A patient collapsed while giving
registration information. She had been referred for elective cardiac
catheterization. Hospital admissions personnel initiated CPR and called a code.
Asystole In-Hospital 2
Patient Name: John Wiggins
Age: 60
Height: 70 in
Weight: 220 lbs.
SCENARIO OVERVIEW--You are a nursing supervisor and code team leader on
night shift. You respond to a code on the general medical floor. A patient is found
unresponsive. Personnel initiated CPR and called a code.
Bradycardia In-Hospital 1
Patient Name: Ed Stokes
Age: 98
Height: 68 in
Weight: 160 lbs.
SCENARIO OVERVIEW-- An elderly man was brought from triage complaining
of dizziness. He tells you that his symptoms began about an hour ago. He is lying
on a stretcher and becomes poorly responsive, but regains consciousness in a
few seconds.
Bradycardia In-Hospital 2
Patient Name: Grace Hardy
Age: 72
Height: 62 in
Weight: 110 lbs.
SCENARIO OVERVIEW--This patient is brought by EMS. They report finding her
on the floor at home. Her husband said she clutched her chest and collapsed.
19
Rev. 1/13/13
EMS gave her 1 mg of atropine, she improved and had stable vital signs, but now
she is complaining of dizziness again and her HR has dropped to 28. After initial
Atropine therapy, the patient is conscious but confused. Monitor shows thirddegree AV block, HR 40.
PEA In-Hospital 1
Patient Name: Mary Kettle
Age: 82
Height: 62 in
Weight: 155 lbs.
night shift. You respond to a code on the general medical floor. A patient is found
PEA In-Hospital 2
Patient Name: Ellen Engles
Age: 74
Height: 56 in
Weight: 130 lbs.
day shift. You respond to a code on the general medical floor. A patient is found
PEA In-Hospital 3 (Bradycardia PEA)
Patient Name: Peter Pumpkin
Age: 54
Height: 69 in
Weight: 185 lbs.
SCENARIO OVERVIEW--You are a physician and respond to an in-hospital
cardiac arrest. You find CPR already in progress by the nursing staff. They report
that the patient was admitted for observation following a motor vehicle collision
and planned surgery for treatment of an open leg fracture. He was the unbelted
driver of the car.
Stable Tachycardia In-Hospital 1 (Narrow, Regular)
Patient Name: Nancy Nero
Age: 63
Height: 64 in
Weight: 160 lbs.
20
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SCENARIO OVERVIEW--You are in the ED and are evaluating a 63-year-old

female who presented complaining of palpitations. She tells you she has had a
history of recurrent fast heart rates, but several episodes today brought her to the
ED. While you are doing her examination, she suddenly complains of
palpitations.
Stable Tachycardia In-Hospital 2 (Wide, Regular)
Patient Name: Willy Coyote
Age: 35
Height: 69 in
Weight: 185 lbs.
SCENARIO OVERVIEW--A 35-year-old male arrives in the ED complaining of
palpitations. He tells you he has had a history of recurrent fast heart rates. He
has been having palpitations for several days. Today symptoms were worse and
coworkers phoned 911. He thinks he is having a heart attack.
Unstable Tachycardia In-Hospital 1
Patient Name: Johnny Jett
Age: 55
Height: 71 in
Weight: 220 lbs.
SCENARIO OVERVIEW--You are a nurse on a monitored unit. A 55-year-old
man is recovering from an anterior MI following fibrinolysis in the ED. The
monitor alarms and you go into the room.
Unstable Tachycardia In-Hospital 2
Patient Name: Mary Contrary
Age: 26
Height: 67 in
Weight: 125 lbs.
SCENARIO OVERVIEW-- In the ER you are evaluating a 26-year-old woman.
She was born with heart abnormalities and has chronic palpitations. A corrective
surgical procedure was performed as a child. She has passed out once in her
life. Today her palpitations will not stop and she came to the ER.
VF Pulseless VT In-Hospital 1
Patient Name: Neal Hannity
Age: 50
21
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Height: 72 in
Weight: 180 lbs.
triage personnel have initiated CPR.
VF Pulseless VT In-Hospital 2
Patient Name: Julia Ann Moore
Age: 62
Height: 70 in
Weight: 180 lbs.
SCENARIO OVERVIEW--You respond to a cardiac arrest in the hospital
admission area. A patient collapsed while giving registration information. She had
been referred for elective cardiac catheterization. Hospital admissions personnel
initiated CPR and called a code.
Post Cardiac Care In-Hospital 1
Patient Name: Jane Johnson
Age: 59
Height: 65 in
Weight: 175 lbs.
SCENARIO OVERVIEW--You are a hospitalist who has responded to a cardiac
arrest in the hospital admission area. After performing appropriate Asystole
treatment, you are responsible for the Post Arrest Care.
Post Cardiac Care In-Hospital 2
Patient Name: Neal Hannity
Age: 50
Height: 72 in
Weight: 180 lbs.
triage personnel called a code. After performing appropriate VFib treatment, you
are responsible for the Post Arrest Care.
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Case Information (Testing)

ACLS In-Hospital Megacode A
Patient Name: Michael Jones
Age: 57
Height: 69 in
Weight: 245 lbs.
GENERAL OVERVIEW-- You are evaluating a 57-year-old man complaining of
indigestion. He is brought immediately from triage (arrived by personal car) and
placed in ED room 2. He is cold, clammy, and diaphoretic. He states that he feels
as if he is about to faint. The triage nurse is working with you and has obtained
vital signs: HR 38, BP 70/P, RR 16.
ACLS In-Hospital Megacode B
Patient Name: Alvin McIntosh
Age: 65
Height: 71 in
Weight: 250 lbs.
GENERAL OVERVIEW--In the ED you are evaluating a 65-year old man
complaining of palpitations. He is in no distress. He has a history of coronary
artery disease and had a stent in the past. Otherwise he is healthy with no other
medical problems.
ACLS In-Hospital Megacode C
Patient Name: Joanna Miles
Age: 54
Height: 65 in
Weight: 168 lbs.
GENERAL OVERVIEW - You are called to the ICU, where you find a post-op
patient experiencing chest pain.
ACLS In-Hospital Megacode D
Patient Name: Mary Ann Fremont
Age: 75
Height: 64 in
Weight: 140 lbs.
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elderly woman. She was admitted for a total knee replacement and was moved
from ICU this morning.
ACLS In-Hospital Megacode E
Patient Name: Lois Lane
Age: 95
Height: 61 in
Weight: 98 lbs.
elderly woman. She was admitted three days ago for a fractured hip.
ACLS In-Hospital Megacode F
Patient Name: Forrest Gump
Age: 63
Height: 70 in
Weight: 200 lbs.
GENERAL OVERVIEW-- You are evaluating a 63-year-old man in the
Emergency Room. He arrived by personal car and is cold, clammy and
diaphoretic. He states that he feels as if he is about to faint. The triage nurse is
working with you and has obtained vital signs of HR 50 BP66/P RR18.
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Debriefing Information
The Practical ACLS Training and Testing scenarios are designed and
programmed for debriefing using the Diagnostic Educational Objective-based
Reflection (DEOR) methodology. Dr. John Schaefer, HealthCare Simulation
South Carolina (HCSSC), developed DEOR to provide objective-based feedback
to scenario participants. More information about using the DEOR method of
debriefing can be found at the HCSSC website.
www.healthcaresimulationsc.com/simstore/
Sample Practical ACLS Megacode Testing and Training set debrief logs
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Rev. 1/13/13

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Practical ACLS Megacode Testing and Training Scenario Set for SimPad

Consolidated Instructor Manual

Frances Wickham Lee, DBA

Faculty Information-General Instructions (Training)

Faculty Information-Specific Instructions (Training)

Faculty Information-Specific Instructions (Testing)

Setup and Equipment

Megacode A (Bradycardia to VF/Pulseless VT to Asystole)

Faculty Information General Instructions (Training)

3. Team Leaders should be instructed to verbalize actions and decisions

Faculty Information Specific Instructions (Training)

Asystole In-Hospital 2 (John Wiggins)

Bradycardia In-Hospital 1 (Ed Stokes)

b. Atropine 0.5 mg. (No pacing, because patient improves)

Bradycardia In-Hospital 2 (Grace Hardy)

PEA In-Hospital 1 (Mary Kettle)

PEA In-Hospital 2 (Ellen Engles)

PEA In-Hospital 3 (Bradycardia PEA) (Peter Pumpkin)

VF Pulseless VT In-Hospital Scenario I (Neal Hannity)

Start CPR (sensed or override)

OTHER GRADING POINTS--There is a 10-minute time limit built into this

VF Pulseless VT In-Hospital Scenario 2 (Julia Ann Moore)

Stable Tachycardia In-Hospital 1 (Narrow, Regular) (Nancy Nero)

Stable Tachycardia In-Hospital 2 (Wide, Regular) (Willy Coyote)

Unstable Tachycardia In-Hospital 1 (Johnny Jett)

Unstable Tachycardia In-Hospital 2 (Mary Contrary)

Post Cardiac Care In-Hospital 1 (Jane Johnson)

Identify Return of Spontaneous Circulation

OTHER GRADING POINTS--6 minute time limit for this scenario.

Post Cardiac Care In-Hospital 2 (Neal Hannity)

CORRECT STEPS--Follow ACLS Guidelines for Post Cardiac Arrest Care:

Identify Return of Spontaneous Circulation

OTHER GRADING POINTS--6 minute time limit for this scenario.

Faculty Information Specific Instructions (Testing)

Check Pulse within 10 seconds

Required Steps for Pathway are listed in the following sections.

Identify Return of Spontaneous Circulation

ACLS In-Hospital Megacode A (Michael Jones)

5. Complete Rx within 3 minutes

ACLS In-Hospital Megacode B (Alvin McIntosh)

4. Give either epinephrine or vasopressin IV and Defibrillate (either may be

ACLS In-Hospital Megacode C (Joanna Miles)

OTHER GRADING POINTS--This Megacode is designed to test the ACLS

ACLS In-Hospital Megacode E (Lois Lane)

ACLS In-Hospital Megacode F (Forrest Gump)

Bradycardia Required Steps are:

Setup and Equipment

For use with the 2010 ACLS approved curriculum

Case Information (Training)

SCENARIO OVERVIEW--You are in the ED and are evaluating a 63-year-old

Case Information (Testing)

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