Every 5 years the AHA puts out new science guidelines and updates their administration guidelines as well as updating the look of the cards. This year the Basic Life Support for Healthcare Providers class, better known as BLS for HCP, also got a name change. The AHA felt that the term “Healthcare Provider” could be both exclusory and confusing. So the new name is just Basic Life Support or BLS. You will see this change on our calendar in the coming weeks. Don’t be alarmed if your new BLS card looks a little different, ITS LEGIT!
The Heart Center is now proud to offer AHA’s HeartCode®BLS web-based certification. The 3 part course targets healthcare providers that prefer a self-directed alternative to learning Basic Life Support, and delivers its content through eSimulation, where students will interact in real-time with virtual critical patient scenarios.
About Heartcode® BLS
Part 1 of the course is taught online in an interactive format. After completion, parts 2 and 3 (skills practice and testing) will be conducted by an authorized AHA BLS instructor for the completion of the certification. You will be supplied with a pocket mask and bag-mask device to practice responding to emergency situations, which helps to prepare you to respond correctly if a real emergency occurs in the future. A demo is available at AHA.org.
HeartCode®BLS prerequisites are minimal, as this certification is typically earned for educational purposes or for employment qualification. This course is a great fit for healthcare providers that prefer the online format to a classroom, for either their initial or renewal BLS certification.
Course Breakdown for Part 1
• 14 BLS videos and 2 tutorials
• 5 interactive eSimulation patient cases in critical conditions
• Multiple choice 25 question exam testing cognitive knowledge
• Test will immediately alert to incorrect answers and refer to appropriate section
Key changes in Basic Life Support reflecting 2010 AHA Guidelines will be covered. The class is not only for nurses, physicians, and EMS responders – college students and allied health professionals such as physical therapist can also sign up.
Heartcode® PALS is one of three courses offered by The Heart Center to satisfy an AHA certification. This particular course aids healthcare providers when developing knowledge and skills necessary to properly evaluate and manage seriously ill infants and children.
About HeartCode® PALS
Amongst key changes to the 2010 AHA guidelines, healthcare professionals can anticipate learning to explain the importance of effective team dynamics during resuscitation and applying appropriate cardio respiratory monitoring. Upon completion, students will be able to describe the timely recognition and interventions required to prevent respiratory and cardiac arrest in pediatric patients.
While there are no prerequisites for taking this online class, you should have a mastery of infant and child BLS skills and be able to identify heart rhythms and different types of airway management tools. It is helpful to be familiar with drugs commonly used to treat cardiovascular irregularities.
Course Breakdown for Part 1
• 12 Interactive, pediatric, hospital-based scenarios using eSimulation
• Debriefing and coaching after each simulation
• Multiple choice 33-question exams to test cognitive knowledge.
• Program will immediately identify incorrect answers and provide a hyperlink to the appropriate section
This course has been approved for 11.74 contact clinical hours for nurses by the Emergency Nurses Association, and 12.00 advanced CEHs for Emergency Medical Services by the AHA.
HeartCode® PALS is a suitable alternative for physicians, nurses, and healthcare members who prefer self-directed learning and are first responders to the care of pediatric patients. Personnel in emergency response, intensive care and critical care units will also find the course beneficial.
HeartCode® ACLS is a web-based course targeted for healthcare professionals who are first responders to cardio related emergencies. In a non-classroom environment, this program builds on the foundation of lifesaving BLS. It also stresses the importance of advanced life support skills and team management and communication through interactive scenarios. Students can return to the course as many times as they like over a two year period to refresh their skills or to access the current ACLS Provider Manual which is included with the purchase.
About HeartCode® ACLS
Part 1 of the course covers key changes to the 2010 AHA guidelines. The modifications will mainly reflect resuscitation and emergency cardiovascular care. Students will learn recognition and early management of respiratory and cardiac arrest, periarrest conditions, and airway management. Students will also learn to effectively communicate as a part of a resuscitation team.
Course Breakdown for Part 1
• 10 interactive adult patient cases presented by eSimulation
• Debriefing and coaching after each simulation
• Multiple choice 50 question exam testing cognitive knowledge
• Up to 10.25 hours of continuing education credit
Parts 2 and 3 (skills practice and testing session) will be completed with an AHA ACLS Instructor or by using a voice assisted manikin system. Be sure to bring your printed certificate from Part 1 to the skills session.
HeartCode® ACLS requires prior knowledge of applying algorithms. Be able to identify ECG rhythms and know pharmacology related to cardiopulmonary arrest before beginning the online program. A pre-course self-assessment is offered to help prepare you for HeartCode® ACLS.
We are pleased to announce The Heart Center is now offering three American Heart Association classes online. Heartcode® is the only set of AHA online courses and we are glad to have it. Each Heartcode® class consists of three parts. The first sections allow you to complete certification while working at your own pace and in the comfort of your own home. They are interactive realistic situations powered by e-simulation technology. If you live outside of the DC metro area or want to cut time and gas, our virtual classes are convenient and satisfy AHA certification and continuing education requirements.
The first sections of Heartcode® courses include a self-directed tutorial and virtual realistic critical health situations. To complete certification for this part, the student will respond, assess, and treat patients using real time decision making. You can register for either or all of these classes in 3 steps on healthtrainingcenter.com
Heartcode® BLS helps physicians, nurses, EMS professionals, med students, and allied health professionals to renew or complete BLS certification using an alternative method. Upon passing the online written test, a hands-on test including CPR and bag mask test with an AHA BALS instructor is required.
Heartcode® ACLS lessons assist healthcare professionals participating in the management of cardiopulmonary arrest and other cardiovascular emergencies. Upon passing part 1, students will work with an AHA ACLS instructor or voice assisted manikin.
Heartcode® PALS features 12 interactive realistic hospital pediatric situations in addition to a cognitive portion. Coaching will follow the simulations. Lessons on preventing cardiopulmonary arrest in infants and children are also included. Following is a hands-on skills session with an AHA PALS instructor. It is recommended that students already possess the ability to apply the PALS algorithms to effect treatment prior to taking this course.
Video and help documents can be accessed from the main screen anytime during the lessons. Parts 2 and 3 will be completed in one skills session with an AHA instructor specializing in each respective field. The classes will cover changes in basic life support, reflecting new knowledge from the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. In three easy steps on our website you can achieve AHA certification and an AHA card at your own pace.
Compression Only CPR
There have been 2 studies released in the last month in The New England Journal of Medicine that focus on the benefits of “Compression Only” or “Hands Only CPR”. In an effort to clear up any confusion I will attempt to answer the most common questions I am faced with regarding “Compression Only” CPR during a Heart Center CPR class.
1. What is “Compression Only” CPR?
Answer: Think of Compression Only CPR as the same as regular CPR but without the mouth-to-mouth portion. All rescuers have to do is call 911, check for breathing, and then start compressions.
2. Is it better than regular CPR?
Answer: No, it is not better but it does provide a great alternative to traditional CPR if someone has never taken a class before or they cannot remember what to do. In the most recent study patients who received compression only CPR had the same rate of survival as those patients receiving traditional CPR.
3. What are the benefits of “Compression Only CPR”?
Answer: First, when someone collapses from cardiac arrest there is usually some drool, blood, or vomit around the victims mouth which can understandably make a would be rescuer reluctant to provide mouth-to-mouth. What researchers found is that bystanders trained in CPR were not using their training because they were afraid of the mouth-to-mouth contact and potential exposure to bacteria and viruses. “Compression Only” CPR removes this barrier to implementation of CPR by removing the requirement that the rescuer provide mouth-to-mouth ventilations. The theory is that by removing the requirement for mouth-to-mouth more people will be willing to get involved and more victims of cardiac arrest will receive the CPR they desperately need.
Second, compressions are the most important part of CPR. Breathing helps too but not nearly as much as compressions. Picture a Windex bottle you haven’t used in a long time. You have to squeeze it and squeeze it before it starts shooting out any Windex right? Well that’s exactly how the heart works during CPR. You have to pump and pump on the Heart to get it to move any blood around but if you stop your compressions for more than 10 seconds you lose all the progress you have made and the Heart turns right back into that old unused Windex Bottle. Even really good CPR only moves about 15% of the blood your heart normally pumps. Research has shown that even brief interruptions in compressions can significantly reduce the effectiveness of CPR thereby lowering a patient’s chance of survival. This is where the second benefit of “Compression Only” CPR comes into play. By not stopping my compressions to give breaths I don’t risk losing all the good squeeze and blood flow I have built up from doing continuous compressions.
Finally, when someone collapses from cardiac arrest there is still oxygen in their blood. Researchers now believe that for about the first 5 minutes of cardiac arrest no other oxygen is needed.
4. How does this new information effect what I learned in the past about CPR?
Answer: If you have taken a CPR class in the last five years you know everything you need to know about CPR. “Compression Only” CPR is great but it doesn’t replace traditional CPR that requires mouth-to-mouth. Proof of this can be seen in that nurses, doctors, and paramedic still perform ventilations when they perform CPR.
5. What about CPR for infants and children?
Answer: Another problem with “Hands Only” CPR is that it is not appropriate for children or infants. Kids still must receive mouth-to-mouth during CPR.
I hope this helps explain a little about these new changes to CPR. While I believe strongly that “Compression Only” CPR is great and will save lives I also feel strongly that excellent hands-on instruction by an experienced CPR instructor cannot be overlooked as a key step in the chain of survival. CPR classes also cover many other very important topics like how to relieve choking and how to use an AED. For more information on CPR or to sign up for a class please visit www.heartcentertraining.com.
TOP TEN CPR MYTHS
CPR can be a life saving skill that anyone can learn. However, over the last 7 years of working as a paramedic inside hospital emergency rooms and “on the street”, as well as teaching CPR to both medical and non-medical people, I have heard many different “myths” surrounding CPR. The problem with these myths is that they can prevent someone from taking a CPR class or using the life saving skills they have learned when an emergency occurs. In an effort to increase the number of people who learn CPR we have compiled this list.
10. “To relieve choking in a child you should lift the child up by the feet and shake”. What? Definitely not. I’ve heard this one twice this week during infant CPR classes for new parents. This is a great example of why you should take an American Heart Association CPR class. You will learn not only how to do CPR but also the proper way to relieve choking.
9. “Someone else will be able to help”. The key to surviving cardiac arrest is the quick response of someone trained in CPR. A patient who collapses and does not immediately receive CPR has almost no chance of survival.
8. “You can learn CPR on-line”. While it is true that you can learn the steps of CPR from an on-line class it is absolutely ridiculous to think you could properly perform CPR on a real person after taking a computer based CPR class. Think about it like this; when you were sitting in driving class being taught how to handle a car on wet pavement was it anything like the first time you actually were driving on the highway in the rain??? Hands on practice is the key to developing muscle memory and proper technique. If you are looking for a CPR class make sure it includes hands-on practice and is approved by the AHA or Red Cross.
7. “CPR does more harm than good”. I am not sure where this one started but it is absolutely false. When you are performing CPR it is on someone who has no heartbeat. I hate to state the obvious here but, if someone has no heart beat it means they are DEAD. How can doing CPR possibly make being dead worse? It is true that you may possibly break some ribs while performing CPR but I know that if my heart stopped beating I would much rather wake up with broken ribs than not wake up at all.
6. “Too expensive” or “Too long”. CPR classes are very inexpensive when you consider the peace of mind they bring and the life changing effect a little knowledge can have. New parents spend 20 or 30 dollars on new baby outfits all the time. Many infant CPR classes, which cover CPR as well as choking, cost the same amount. CPR class times can run between 2- 6 hours. The information and skills learned can last a lifetime.
5. “CPR is only for Adults”. It is true cardiac arrest is very uncommon in children and kids. However, infant and child CPR classes also cover how to relieve choking and a good instructor can provide extremely helpful information on accident prevention.
4. “I already know CPR”. The American Heart Association is constantly researching and reviewing the best way to provide CPR. Every few years the guidelines change and it is always best to learn the most current guidelines. The American Heart Association recommends renewing your CPR certification every 2 years.
3. “I will never have to do CPR”. The chances that you will ever have to perform CPR are very small. However, choking is much more common an emergency and all AHA CPR classes also teach how to save someone who is choking.
2. “I could get sued”. All states now have some form of what is commonly called The Good Samaritan Law. These laws protect you, a Good Samaritan, from being sued, if in the course of trying to save someone, you cause injury.
1. “CPR always works”. Unfortunately this is not true and is a very common belief that has been perpetuated by T.V and movies. The actual adult survival rate from out-of-hospital cardiac arrest is about 5-10%. Survival rates increase if there is an AED present and if it is able to deliver a shock. However, if your heart stops and no one starts CPR then your chance of survival is zero.
As you can see there is a lot of bad information out there regarding how, when, and why people should be performing CPR. The real issue with all these “myths” is that they could possibly stop someone from learning CPR or providing CPR to a victim of cardiac arrest. It is the belief of The Heart Center that everyone should take a CPR class and get involved in the safety of their family, friends, and community.
Moms on The Hill
(A thank you from The Heart Center)
Moms on The Hill (MoTH for those in the know) is a moms group located on Capitol Hill. MoTH is a huge, fairly exclusive parenting group, and an excellent resource for any current or soon-to-be-mom. Through an incredible stroke of luck the very first Infant CPR class The Heart Center ever taught was for a member of MoTH and her husband. Starting a new business is an incredibly stressful and nerve wracking endeavor and if it wasn’t for MoTH I am not sure we would have survived those first few months. All the parents I have met through this group have been extremely kind, friendly, and helpful parents.
The Heart Center provides CPR and First Aid classes and we have been honored to be recommended by many MoTH to other expecting or current moms. In an attempt to show our incredible appreciation for the wonderful word of mouth we offer our very best discount to MoTH hill members and preferential scheduling. The Heart Center endeavors to provide not only the best experience based CPR and First Aid classes in the DC area but also to be extremely accommodating to new or current moms. We realize that moms have very little free time and that child care can be expensive and problematic so we are happy to have parents bring their children to our classes.
The Heart Center is indebted to MoTH and we hope to continue to be a helpful resource in the future. If you are a MoTH and wish to schedule a CPR or First Aid training class please call or email and we will provide you with the best CPR training in the DC metro area.
When we were designing the website we forgot to include a special area just for reviews and comments from students who have taken our classes. Our solution to this will be a monthly blog containing recent reviews and comments. We will include both positive and negative comments and promise to be as impartial as possible.
“John’s mastery of basic and advanced life support skills and principals, I believe, provide him with the strong evidence-based foundation that he uses to teach. In addition, I believe it is the smart, collegial, and relaxed atmosphere he creates while teaching that really sets him apart from other instructors I have worked with. Students in John’s classes not only learn an incredible amount, but they leave class feeling more confident in their abilities to perform in stressful situations.”—Chair, WHC Code Blue Committee.
“Very informative”—CPR student
“Very efficient and effective”—CPR student
“I heard this was a good class, everyone should take this class!”—CPR Student
During the months of February and March 2010 more than 50 students filled out class satisfaction surveys after completing a training session. The possible rankings on multiple questions can range from 1 (bad) to 5 (excellent). Our average ranking was a 4.9 out of 5. In fact, only one person gave us less than a 5.
“I have no hesitation in writing that John’s ability to teach basic and advanced life support skills are exemplary.” Vice Chair, Dept. of Emergency Medicine
“I feel much more confident in my ability to protect my baby”– Infant CPR Student
“I was always nervous about my baby choking now I’m not”—Infant CPR Student
“Convenient and informative…much better than previous classes I’ve taken.”—CPR Student
“(The Instructors) experience made class much more interesting”-CPR Student
This is a snapshot of comments during the previous month or so. I swear if there were any negative or even slightly less than positive comments I would include them. There just weren’t any.
ABC. Airway, Breathing, Circulation. This is the mantra of all CPR courses. Those 3 letters and their respective actions form the basis of all patient assessment. In this article I will attempt to break down these 3 letters into the simplest of parts. This first installment will cover letter A-the airway. Please excuse the simplistic terms I may use in this blog article but remember THIS IS FOR BEGINNERS.
A. Airway. To put it simply this letter comes first because without a passage way for air, specifically oxygen, to make it to your lungs you will die. I can pump on your chest and breathe for you but unless air is filling your lungs compressions and ventilations don’t matter. Think of it like a car and oxygen is the gas. It doesn’t matter if I have new tires and a brand new engine. If there is no gas that engine aint gonna start.
The A in your ABC’s is the step where you try to align and clear the airway of anything that might inhibit air passage to the lungs. Forgive me for being so simple here but this is for beginners. There are two “pipes” exiting the back of your mouth. One goes to the stomach and one goes to the lungs. The “windpipe” or trachea leads from the mouth to the lungs. This is the passage we must protect. The trachea is most often blocked by the patient’s own tongue. One easy way we can correct this blockage is by doing the head-tilt chin-lift maneuver you will learn about in your CPR class. By tilting the head back we “straighten” out the trachea and lift the tongue from the back of the throat. The trachea can also be blocked by countless other things much more nasty than the tongue. Do not be surprised if your patient vomits or drools. Deal with it. You are trying to save a life. You must do whatever is necessary to open that air passage.
I have found that aligning and clearing the airway is the second most common omission while people perform the ABC’s. Often students, even experts, will go directly to the breathing check passing quickly by the obvious need to align and suction a patient’s airway. Then when they realize air isn’t going in they have to go back to the airway step and align and clear the airway. This leads to precious time away from chest compressions and other important tasks. Keep in mind that there is now “hands only” CPR that doesn’t requiring breathing in case you are confronted with an airway issue that is just too gross or intimidating for you to deal with. “Hands only” CPR is okay but it is only meant to buy you a few minutes and it is not for medical professionals. It is not the optimal solution but is better than nothing.
Believe me, these are the airway basics. Whole medical careers and texts have been written on managing airways. But, this explanation of the A in your ABC’s is only meant to briefly explain in the simplest of terms why A comes first and why it is so important. The next installment of the ABC’s –Beginners guide will cover B. Breathing.