CICO Priming
Jul 29, 2024
Before the introduction of the Vortex Approach, we would have our 9 attempts at lifelines (3 attempts for each lifeline), or maybe even have more than that. Then someone would finally declare that we have a CICO situation π¨. Then, reluctantly, the CICO equipment would be found, opened, prepared, and then a very stressed anaesthetist would perform CICO on a very blue patient π«π΅.
How could we do this better? π€
Instead of waiting for all 3 lifelines to fail, why not start preparing for CICO as the lifelines are lost? If we break up the priming into 3 stages, we can still keep things fairly simple.
Let’s call the 3 stages of priming: Ready, Set, Go.
1οΈβ£ When we lose our first lifeline, it should prompt the team to move to CICO status READY. This means you get the CICO kit out and ready to open π
2οΈβ£ When you lose your second lifeline, you move to CICO Status SET. This means you open the package and set up the equipment βοΈ
3οΈβ£When you lose your third lifeline, you move to CICO Status GO, which means you perform CICO rescue π.
By employing this priming technique, you do three essential things:
1οΈβ£ You have a shared mental model π§ , where the whole anaesthetic team understands that as each lifeline is lost, the CICO status escalates π
2οΈβ£ You save vital seconds β³ when it’s finally time to declare CICO because your team is equipped and ready to go as soon as the third lifeline is lost.
3οΈβ£ You improve your team’s willingness to act πβοΈπβοΈ. Don’t underestimate the delays associated with fixation error and denial in this scenario!
Build knowledge β
Improve safety β
Ref: The Vortex Approach: vortexapproach.org
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