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!
Using it to unite your staff.
For many workplaces, building team unity is a challenging task. The traditional way to address a lack of team spirit within the ranks is with group outings, company parties, and other various team building exercises. However workplace CPR training may be the one practice that ends up saving the morale of your employees, not to mention their lives.
The Heart Center
When your team is in disarray, bringing them back together takes exercises that force them to rely on each other. With communication, members begin to bond and gel with each other. And as they work with each other to complete a common goal, in this case CPR, that familiarity translates into the workplace. They develop a trust through training, which is a valuable characteristic for a working team.
At The Heart Center Emergency Response Training & Stimulation, our instructors are not just instrumental in building your team’s knowledge and trust of each other. They are also key in teaching an immensely valuable skill, one that can save both the life of an employee and the company.
We are authorized providers of CPR training from the American Heart Association and are qualified to help you and your employees. Visit our website or call (202)-536-7972 for more information!
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.
When first time pregnant couples are expecting a new baby, there is so much to anticipate and get excited about. Too often, in the mix of decorating rooms, hosting baby showers, and announcing the news to loved ones, mothers and fathers either forget or don’t see the need for taking a CPR class. No matter how attentive parents are, babies still put objects in their mouths. In many cases, what can save a chocking infant is not the ambulance worker; it is the parent on the phone with the ambulance worker. Even though infant mortality in DC has dropped, the importance of CPR training for expectant parents has not decreased. Little ones can still accidentally suffocate themselves or block their air passages with small items, including food.
Choking and suffocation are the leading causes of death for infants under one year old. Respiratory scares and submersion can be immediately responded to with CPR. Pediatric attention in critical situations doesn’t have to start with a medical professional; parents and parent groups can learn First Aid and CPR. Classes in the DC metropolitan area are made convenient by The Heart Center. We offer classes at childcare facilities, community centers, hospitals, government sites and more locations around the metro area. We now also offer our PALS certification online, along with our other certification courses.
Having these lifesaving skills are beneficial for other babies too. When chaperoning your toddlers field trip or on the playground, you can potentially relieve choking or open blocked passage ways using skills learned in pediatric CPR education. A parent’s emergency response preparation for infants and children can be what stands between life and death for a baby.
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.
It’s old school. It looks cool. Its rarely done. It’s back. The precordial thump is now back in the 2010 ACLS guidelines.
2010 (New): The precordial thump should not be used for unwitnessed out-of-hospital cardiac arrest. The precordial thump may be considered for patients with witnessed, monitored, unstable VT (including pulseless VT) if a defibrillator is not immediately ready for use, but it should not delay CPR and shock delivery.
2005 (Old): No recommendation was provided previously. Why: A precordial thump has been reported to convert ventricular tachyarrhythmias in some studies. However, 2 larger case series found that the precordial thump did not result in ROSC for cases of VF. Reported complications associated with precordial thump include sternal fracture, osteomyelitis, stroke, and triggering of malignant arrhythmias in adults and children. The precordial thump should not delay initiation of CPR or defibrillation.(2010 AHA Guidline Review Summary)
The only real problem I have with the guidelines is that they don’t tell you how to do it. I would love to tell you how but I have never it done it myself. However, I have a good friend, Nurse M for this story, who is a paramedic turned nurse (this proves he is smart) who did it twice while we were working together at VHC* . So, the story as he detailed to me was the exact situation recommended in the guidelines above. The patient he was caring for was monitored and went into V-tach (I can’t remember if it was pulsed or pulseless). Nurse M witnessed the V-tach and immediately attempted a precordial thump. Without success. Thinking he hadn’t tried hard enough Nurse M then tried again. This time it worked and the patient walked home healthy and led a full life** .
The precordial thump works because all the cells in the heart can emit an electrical signal***. The precordial thump can cause an electrical discharge from those heart cells which can reset the V –fib or V-tach which is killing the patient. Its kindof the poor mans version of a defibrillator. If you really want to learn how to do the precordial thump you should read about it in the new 2010 AHA Advanced life support guidelines or join one of our ACLS classes at The Heart Center and we will teach you how to do it.
##As always, this is a blog not the New England Journal of Medicine, and therefore none of the information in it should be used for any medical purpose whatsoever. *I give these details as provenance because I HATE “this one time” stories which are never true.
**The last half of that sentence is not true at all.
***Ok, not all of them but some—we are keeping this basic.
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.