Crisis Resource Management
CRM for code blue and code stroke: the framework, a video debrief, Code Blue Rounds decks, the zero point survey, the hot debrief, CRM applied to stroke, and ICU boot camp videos.
SiLab — CritCare & NeuroICU Si(mulation) Lab
Resources to help medical teams run better resuscitations — from the code blue to the code stroke — through shared best practices, protocols, and simulation-based training. Talks, courses, quick references and topic pages, recreated here on ncrit.dev.
01 / Mission
Better resuscitations, from code blue to code stroke
Our mission at SiLab is to empower medical teams to enhance medical resuscitation care, encompassing conditions such as cardiac arrest (code blue) and neurovascular resuscitation, through the sharing and implementation of best practices, protocols, and simulation-based training methodologies.
We strive to reduce the door-to-intervention time — whether that’s how efficiently a code is run for medical resuscitations or, in the context of stroke, critical metrics such as door-to-needle time and door-to-groin puncture time.
Core focus areas
Stroke-specific simulation training. Simulation provides an essential opportunity for clinicians to gain repeated exposure to variations in hyperacute stroke scenarios within a safe learning environment. Through stroke simulation exercises, healthcare teams undergo stress inoculation, becoming more likely to recognize immediate threats and respond appropriately, in controlled and effective ways, during actual code stroke situations.
Crisis Resource Management integration. Our simulation-based approach emphasizes both the technical and nontechnical skills essential for high-performing stroke teams: situational awareness, cognitive load management, role clarity, effective communication, and structured debriefing — all practised through realistic stroke simulation scenarios.
Evidence-based protocols. Sharing best practices and protocols for acute stroke resuscitation, validated through simulation training, is a key factor in improving the quality of care at individual centres. By sharing and comparing protocols tested and refined through simulation, centres can identify and implement proven strategies to reduce response times and improve patient outcomes.
02 / Explore
Inside SiLab Resus
Courses
Course decks and companion material: SRC Ottawa 2025 (the national Stroke Resuscitation Course at CNSF), Hospitalist Medicine 2025, and Neurology Update 2025 — plus how to mix TNK.
Code blue quick reference
Quick references to look up on call after code blue teaching: the zero point survey and the AHA adult cardiac arrest algorithms.
ACLS–ICU talks
“How to get things done — in medicine”: a series of talks on resuscitation leadership, decision-making, airway and arterial lines, plus the “Getting things done” deck.
03 / Topics
Topics & resources
Selected topics — stroke, ICU and neurocritical care.
Anaphylaxis with TNK/tPA
Thrombolysis-associated anaphylaxis and orolingual angioedema: incidence, presentation, mechanisms, monitoring and management — plus new code blue charts on anaphylactoid vs IgE-mediated anaphylaxis, coding, toxidromes and antidote doses.
Reversal of sedation
Flumazenil for midazolam and naloxone for fentanyl: dosing tables, seizure and resedation risk, and neurocritical care considerations.
QI in hyperacute stroke care
Lectures on improving door-to-intervention times: grand rounds and Neurodiem talks.
Status epilepticus
Definitions, abortive benzodiazepines, urgent-control antiseizure loading doses, the SiLab deck, and key guideline papers.
Intracerebral hemorrhage
ICH teaching deck from Program Director Education Days.
Infective endocarditis
MDCT and brain MRI findings, empiric antimicrobial choices and dosing, and when CNS coverage matters.
04 / Impact
Why simulation
Educational impact through simulation
Skill transfer and retention. Research demonstrates that Crisis Resource Management skills learned during stroke simulation training are effectively transferred to clinical settings, with measurable improvements in patient outcomes. Our simulation-focused resources address communication challenges encountered with ad hoc stroke teams, helping participants modify their communication behaviours and enhance teamwork after structured training.
Continuous improvement. SiLab facilitates in situ stroke simulation programs that use realistic scenarios, ad hoc teams, and comprehensive checklists to foster CRM principles. Combined with regular debriefing and knowledge-sharing, these experiences provide cumulative marginal gains in operational performance.
Collaborative learning. As an educational resource for stroke resuscitation care and simulation methodology, SiLab promotes collaboration and knowledge-sharing among healthcare providers. Simulation-based learning modules and shared protocols let teams practise hyperacute stroke management in controlled environments before applying these skills in real clinical scenarios.
Our commitment
Through the sharing of information, simulation resources, and evidence-based protocols, our goal at SiLab is to facilitate continuous improvement in stroke resuscitation care. By emphasizing simulation-based skill development alongside traditional knowledge transfer, we aim to create high-performing “brain resuscitation” teams that deliver timely, precise, and effective hyperacute stroke interventions — ultimately leading to better patient outcomes and a reduction in the devastating impact of acute stroke.
For the lab’s program-level history, outcomes and spread, see Stroke Resuscitation & Simulation.
05 / Contribute
Evaluate & get involved
Evaluation forms
- Simulation sessionSimulation evaluation ↗
For participants in a SiLab simulation session. - Didactic teachingCode Blue Rounds — Resuscitation Rounds evaluation ↗
For didactic rounds teaching, including Code Blue Rounds. - CourseSRC Ottawa 2025 evaluation ↗
For participants in the 2025 Stroke Resuscitation Course.
Forms open on Google Forms. This site has no forms and collects no data.
Get involved
Are you a resident physician interested in resuscitation? Want to make these resources better?
06 / About
About & disclaimer
About SiLab
SiLab is a QI and educational resource developed by Dr. Houman Khosravani, Assistant Professor, Division of Neurology, University of Toronto. It began in June 2023 as a separate resuscitation- and simulation-focused website; this section recreates it within ncrit.dev. Check back for updates on stroke simulation protocols and training resources.
The lab’s wider work — stroke resuscitation and simulation, AI4QI / ML4QI, and palliative care in acute stroke — is described on Initiatives and About.
Important disclaimer
There is no duty of care; everything here is for educational purposes only and is not a replacement for expert advice or expert medical care. All simulation scenarios and protocols shared are intended for training and should be adapted to local practice parameters and institutional guidelines.
Disclaimer for SiLab — Dr. Houman Khosravani
This website section, SiLab, and its content (“Site Content”) are provided for informational and educational purposes only.
The information available on SiLab does not constitute and is not intended as medical or healthcare advice, diagnosis, or treatment. It is not a substitute for professional medical advice, diagnosis, or treatment from a qualified healthcare professional.
While every effort is made to maintain updated and correct information, we make no guarantees, warranties, or representations of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability of the Site Content or any information, products, services, or related graphics contained on SiLab for any purpose. Any reliance you place on such information is strictly at your own risk.
SiLab does not create a doctor–patient relationship or a duty of care by your use of this website or by your reliance on any Site Content.
Under no circumstances shall we be liable for any loss or damage, including without limitation indirect or consequential loss or damage, or any loss or damage whatsoever arising from loss of data or profits arising out of, or in connection with, the use of SiLab and its Site Content.
Always consult your physician or another qualified healthcare provider with any questions about a medical condition. Do not disregard professional medical advice or delay seeking it because of something you have read on SiLab.
In case of a suspected medical emergency, call your doctor or emergency services immediately. SiLab does not recommend or endorse any specific tests, physicians, products, procedures, opinions, or other information that might be mentioned on the site.
Your use of SiLab signifies your agreement to this disclaimer and your understanding that any information derived from it should be considered general knowledge only, not a comprehensive guide to healthcare. See also the ncrit.dev site disclaimer.