Vital Ethics - ACLS PALS BLS/CPR & First Aid Classes » general 1

¿Cuándo debe estar buscando el pulso?

admin — Sun, 23 Oct 2011 23:50:28 +0000

El control del pulso desde hace mucho tiempo que una gran parte de soporte vital básico (también conocido como CPR), las clases y la formación. Sólo hasta hace poco ha sido llevado a esta cuestión re-evaluado y hecho un poco confuso para algunos. ¿Es como proveedores de atención sigue siendo verificar el pulso de la víctima que no responde? La respuesta es sí y no. Para los proveedores de salud que el nivel profesional de clase básica de la vida de los que la respuesta sea afirmativa. Sin embargo, el control del pulso no tiene la misma preeminencia que ha tenido en el pasado.

Quiero señalar que la respiración constante es siempre un mejor indicador de un centro de trabajo de la comprobación del pulso. Cuando el corazón deja de bombear, la respiración también fallan. Es posible buscar un pulso y ser incapaz de localizar, incluso si el paciente está respirando. Esto puede ser debido a la mala circulación, presión arterial inadecuada o simplemente puede significar que el proveedor no está comprobando el pulso en el lugar correcto. Sin embargo, cuando usted tiene un paciente que no responde con la presentación de respiraciones coherente, tiene un corazón de trabajo. ¿Cómo continuar desde ese punto dependerá de sus circunstancias individuales, nivel de atención profesional, la disponibilidad de equipos, instalaciones, etc.

Nivel de proveedor de salud BLS cursos para instruir a los profesionales que respondieron Verifique el pulso a cada paciente que no responde. Note sin embargo que los proveedores de atención de la salud también verificar el pulso en cada paciente consciente y al realizar una evaluación. Comprobación del pulso es parte de la comprobación de signos vitales que es lo que nosotros como profesionales se espera que hagan, a fin de obtener información necesaria antes de tomar decisiones de tratamiento. No sólo estamos interesados en la existencia de un pulso, estamos interesados en la tasa y la calidad del pulso, como parte de nuestra evaluación.

Los que están obligados a tener capacitación en RCP, pero no son centros profesionales no se espera que realizar en este nivel. Por esta razón, el nivel de las clases de CPR a los estudiantes que van directamente a la RCP si la víctima adulta que no responde no tiene respiración y sin signos de vida. En la mayoría de los casos, ni la respiración y sin signos de vida no significa pulso. Hay algunas excepciones, pero encontrar una víctima que no responde con un pulso y sin respiración no es muy común. Hay una ventana muy pequeña de tiempo (sólo unos minutos) hasta que el corazón también dejará de lo que significa que el pulso va a cesar.

Para el nivel de la comunidad (también llamados laicos respondedores) que se enfrentan los proveedores con el cuidado de un infante o un niño que no responde la comprobación del pulso será necesario. Poco probable que los niños sufren “de repente” un paro cardíaco como en adultos. Ellos simplemente no han existido registro suficiente para tener enfermedades del corazón, que es la principal causa de insuficiencia cardíaca. Más comúnmente los niños dejan de respirar antes de que entren en la insuficiencia cardíaca. Que con más frecuencia ahogan, sufren de una enfermedad reactiva de las vías respiratorias como el asma o la anafilaxia, la pueden ahogar o no responde, como consecuencia de un traumatismo o envenenamiento. Cualquiera que sea la razón, la probabilidad de encontrar una víctima que no responde sin respiración y el pulso es mayor con los niños, entonces es con los adultos.

¿Dónde verificar el pulso en una víctima que no responde? Con los bebés (menores de 1) el mejor lugar es en la arteria braquial en el bíceps de cada brazo. Con los niños más de 1 y adultos, la ubicación preferida será la arteria carótida en cada lado del lado del bien de la nuez de Adán.

When Should You Be Checking For a Pulse?

admin — Sun, 23 Oct 2011 11:50:05 +0000

The pulse check has long be a big part of basic life support (aka CPR) classes and training. Only until recently has this been brought into question re-evaluated and made a bit confusing for some. Do we as care providers still check the pulse of the unresponsive victim? The answer is both yes and no. For health care providers taking the professional level basic life support class that answer will be yes. However, the pulse check does not have the same preeminence as it has had in the past.

I do want to point out that consistent breathing is always a better indicator of a working heart than checking the pulse. When the heart fails to pump, respirations also fail. It is possible to look for a pulse and be unable to locate it, even if the patient is breathing. This can be due to poor circulation, inadequate blood pressure or it can simply mean that the provider is not checking for the pulse in the right place. However, when you have an unresponsive patient presenting with consistent breaths, you have a working heart. How you proceed from that point will depend on your individual circumstances, provider care level, availability of equipment, facilities, and so forth.

Healthcare provider level BLS courses instruct professionals responders to check for a pulse on every unresponsive patient. Note however that health care providers also check the pulse on every conscious patient as well when doing an assessment. Checking the pulse is part of checking vitals signs which is what we as professionals are expected to do in order to gain necessary information needed prior to making treatment decisions. Not only are we interested in the existence of a pulse, we are interested in the rate and quality of the pulse as part of our evaluation.

Those who are required to have CPR training but are not professional responders are not expected to perform at this level. For this reason, community level CPR classes instruct students to go directly to CPR if the unresponsive adult victim has no breathing and no signs of life. In most cases, nor breathing and no signs of life mean not pulse. There are some exceptions, but finding an unresponsive victim with a pulse and no breathing is not very common. There is a very small window of time (just a few minutes) until the heart will also stop which means the pulse will cease.

For community level (also called lay responders) providers who are faced with caring for an unresponsive infant or child checking the pulse will be necessary. Children are unlikely to suffer “sudden” cardiac arrest as in adults. They simply haven’t been around log enough to have heart disease which is the leading cause of heart failure. More commonly children stop breathing first before they go into heart failure. They more commonly choke, suffer from a reactive airway disease like asthma or anaphylaxis, the may drown or become unresponsive as a result of trauma or poisoning. Whatever the reason, the probability of finding an unresponsive victim with no breaths and a pulse is higher with children then it is with adults.

Where do you check the pulse in an unresponsive victim? With infants (under 1) the best place is in the brachial artery under the bicep of either arm. With children over 1 and adults, the preferred location will be the carotid artery on either side of the either side of the adams apple.

Acute Coronary Syndrome

admin — Thu, 30 Sep 2010 20:29:01 +0000

Acute Coronary Syndrome or ACS is a catch all term used to describe a set of symptoms consistent with acute myocardial ischemia when the symptoms are not pathognomonic. Myocardial ischemia is a condition in which insufficient blood flow is reaching the heart muscle. This is usually a result of atherosclerotic plaques building up in the coronary arteries. Symptoms The symptoms of ACS are typically tightness in the chest that radiates into the left arm, anxiety or a sense of impending doom, and shortness of breath. Other symptoms that might occur are nausea, vomiting, sweating and palpitations. In female patients, the elderly, and those with diabetes there is a higher occurrence of atypical presentation. This can translate to other, non-specific, symptoms such as feeling weak or lightheaded to a complete absence of symptoms.

There are three distinct subtypes of ACS:

• Unstable Angina
• non-ST segment elevation myocardial infarction
• ST segment elevation myocardial infarction

Diagnosis

Diagnosis of ACS usually involves an Electrocardiogram. Elevation in the ST segment indicates that damage has occurred to the muscle and that intervention is required immediately. In the absence of ST segment elevation, it is more difficult to distinguish between unstable angina and non-ST segment elevation myocardial infarction. Blood tests can be administered to look for increases in cardiac enzymes. The most accurate indicators for myocardial infarction are increased Troponin I and Troponin T. A second, common predictor is an increased Creatine Kinase level. Another diagnostic tool that can be employed is the ACI-TIPI. The ACI-TIPI is a rough algorithm that uses demographic information and EKG information to provide an estimate of the likelihood of myocardial infarction.

Treatment

In the event of ST segment elevation myocardial infarction, there are several treatment options. Aspirin is often administered on-site by paramedics to reduce clot size. Beta blockers are often administered to reduce the work load on the heart. Anticoagulants, such as heparin, may be administered to prevent further clots. ACE inhibitors are often administered to prevent some of the heart enlargement. Clearing the blockage as soon as possible is key to patient survival in the case of ST segment elevation myocardial infarction. In most cases an angioplasty and stent placement is performed within an hour or two when possible. Doctors can also use intravenous Thrombolytics to break up clots. For non-ST segment elevation myocardial infarction, the treatments tend to be the same, though without the same time constraints. If an angioplasty is not a viable option due to recent surgery, a bleeding disorder, or multiple blocked arteries, coronary artery bypass surgery can be used to restore blood flow.

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EMT Basic — Sat, 28 Aug 2010 06:52:40 +0000

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ACLS Pharmacology: Magnesium Sulfate

admin — Sat, 10 Jul 2010 17:47:15 +0000

Advanced Cardiac Life Support (ACLS) is a protocol that is set up and updated by the American Heart Association. Many health care providers have to be certified in ACLS in order to treat the patient. Doctors with this certification usually work in the Emergency Department, a trauma center, the operating room and the Intensive Care Unit. Nurses practitioners, paramedics and respiratory therapist as other medical personal who will have the certification in ACLS protocols.

Part of the ACLS Protocol is a drug called Magnesium Sulfate which is administered by two routes. Intravenous is one way to deliver this drug into the patient’s system and another is through an intramuscular injection. Both routes get the drug into the system quickly. Infusion of this drug is done if the patient has been diagnosed as having a myocardial infarction or a recent myocardial infarction. Health personnel infuse this drug to counteract the chemical imbalance that a heart attack causes. The patient will develop hypomagnesemia which is an electrolyte imbalance with magnesium levels in the blood being very low. Having an imbalance such as this will effect other organs in the bottom. One of the symptoms of low magnesium is cramping in your muscle. Your heart is a muscle and that is the reason to restore balance as soon as possible.

Low magnesium can also cause heart arrhythmias such as ventricular tachycardia, ventricular fibrillation and tachycardia, to name a few. Any type of arrhythmia is a potential danger but when in the midst of a heart attack, it is even more worrisome. To summarize, not any medical personnel can use the ACLS protocol. It takes training and certification by the an accredited program approved by the American Heart Association. Personnel who are certified usually work in high-risk areas of the hospital such as a trauma center, Emergency Department, Intensive Care Unit or Progressive Care Unit, Surgi-Centers and Operating Rooms. Magnesium Sulfate is a drug that is administered per ACLS Protocol to help counter hypomagnesemia a condition that happens when a patient has either a myocardial infraction or an impending myocardial infarction. This infusion will replete magnesium in a patient and prevent further complications of arrhythmias.

Online Surgical Technician Programs

admin — Tue, 22 Jun 2010 20:48:41 +0000

Studying and completing an online course at home is an easy way to earn a qualification in the comfort of your own environment and the freedom to work when you want. A Surgical Technician or Surgical Technologist program will provide you with the skills and the certificate get into employment at basic entry level. There are a number of different courses available to complete online most, if not all are recognized by the industry. Depending on where you live or want to work you may be able to check with your local health department if they have a preferred certification. Although it would be unlawful and unfair to dismiss an application because of where you have gained your certificate you will certainly be able to gain an advantage over others if you have exactly what the employer is asking for.

The vast majority of courses for a job as a Surgical Technician cover the basics of working in an operating and delivery room. The main points of study on most courses include learning the medical language and terms, surgical tools, general health care and pharmacology. Although studying a Surgical Technician program at home will take you quite a long time depending on how much time you can spend on the course every week the benefits are great. It means you can continue with whatever job you currently have not have to worry about earning a living. An online program for Surgical Technicians will prepare the student for the working environment and what they can expect to come across in a modern operating room. Although there will be no practical work involved students are encouraged to research certain things independently and occasionally may have to, to pass a certain section. Of course this will be no trouble for a student who is genuinely interested in the career path.

All of the resources (textbooks) will be provided by the program tutor and as long as you are learning with a recognized college they will be up to date and will teach what you would expect if you started work as a Surgical Technician the next day. Another important part to the course is leaning and understanding how to be a good team player within the surgical group. As well as this other important areas covered will involve recognizing the key surgical equipment and setting up surgical trays. These are the 2 subjects that normally involve a practical lesson but with the internet at your disposal there really is no need.A student who is working on an online Surgical Technician program will be able to learn many things not just gain a certificate. As Surgical Technicians are working in the same environment as other staff such as Surgeons and Nurses they will soon pick up skills of other staff as well. If you have already gained a certificate in your own time you are showing a willingness to learn and improve your own skills and you may find that your employer will be able to help you go that one step further up the career ladder and complete another certificate on a higher leve

Online Dialysis Technician Programs

admin — Tue, 22 Jun 2010 18:46:28 +0000

Patients that are in end stage renal failure or chronic kidney disease have many worries in their life; the biggest one is the fear of dying from failing kidneys. Dialysis can enable them to go on with their lives in the most normal way possible having very compromised or no kidney function. For some dialysis patients it is a temporary situation until they can possibly undergo a kidney transplant. For others, it will continue to be a way of life for the rest of their lives. The dialysis machine is used to remove all of the waste, salt, and excess fluid that your body does not need and cannot rid itself of.

This is why the dialysis technicians play a vital role in someone’s life. It is very important for people with end stage renal failure to feel comfortable with dialysis technician; this makes the treatment process a little easier. As a tech, you will spend about three days a week with your patient, and it will take about 4 hours each day. The tech’s job is to monitor the dialysis machine, prep the patient, and administer any treatment that the patient may need after the treatment is completed. It is a vitally important job, as people’s lives really do depend on the technician’s knowledge of their job, so where do you go to acquire this knowledge?

There are many online programs that can help you to get the training that you need to be an excellent hemodialysis technician. One of the very best online schools would be Stafford University. They are in Falls Church, VA and they have an excellent online program that will enable you to receive your degree as a clinical hemodialysis tech. Stafford is recognized as an accredited school due to the fact that they are accredited by the Accrediting Council for Independent Colleges and schools. By attending Stafford you can earn any one of the following; your diploma, associate degree, bachelor degree or your master degree. Everest is another great choice for a Bachelor of Science degree in the health care administration field. You can obtain you diploma as a dialysis technician here at Everest College also.

Most often the best and most practical place to obtain the proper certification for a career as a hemodialysis technician is through your local Vocational technical college. Generally required are classes in venipuncture, anesthesia, vital signs, preparing patients for dialysis and being prepared to recognize the signs of any complications that may arise with a patient. The program should consists of both classroom and lab time. Your certification and license are both requirements for every dialysis tech in any state that you choose to work in. Obtaining and maintaining you license is all a matter of your continuing education. Each state has its own set of training and tests that will result in you receiving you Certified Hemodialysis Technician (CHT). In addition to your CHT, all states also require that you also be certified by the Board of Nephrology for Nurses and Technicians (BONENT). It does vary from one state to another on the number of continuing education hours you will need to renew every 2-4 years.

First Aid for Dehydration

admin — Sun, 13 Jun 2010 18:59:28 +0000

Dehydration can be serious and life threatening. As any first aid class will explain, dehydration can be treated and even prevented by having knowledge of what dehydration is. In order to understand how to treat dehydration with first aid it is important to understand the causes, symptoms, how to treat the ailment, and how to avoid it.

Dehydration occurs when the body looses too much water and is deprived of essential salts such as potassium and sodium. Dehydration can occur for a variety of reasons. The most common reasons are: not drinking enough water and sweating excessively; suffering from vomiting or diarrhea; and sometimes medications such as diuretics can cause dehydration as well.

Now that dehydration has been defined let’s look at the symptoms. In adults there are a variety of symptoms that can present themselves: excessive thirst; dizziness; dry mouth and dry skin; less urination; fatigue; increased heart rate and increased breathing. In children it is important to also look for no tears when they cry; sunken eyes, cheeks, or abdomen; high fever; increased irritability; and listlessness.

As soon as dehydration is spotted it is important to begin treatment. If dehydration is caught early enough it can be cured by increasing fluid intake. In the first aid class some instructors will inform you that it may be helpful to administer sports drinks or even Pedialyte. These drinks can help restore the lost electrolytes and salts. If the dehydration is severe it is necessary to get the person to the hospital as soon as possible. Once at the hospital the staff can administer intravenous fluids to assist the body in re-hydrating.

The good news is dehydration can be prevented. By taking in plenty of fluids, scheduling outdoor activities for the coolest part of the day, and drinking sports drinks to replace electrolytes, the chances of dehydration decrease.

In conclusion dehydration is a very serious problem. Dehydration is preventable but when it occurs as long as people know what dehydration is, what the symptoms are, and how to treat it, the person suffering from dehydration can get the help they need.

BLS Before ALS: A Necessary Approach to Patient Care

admin — Wed, 21 Oct 2009 01:52:33 +0000

Using BLS before ALS is the correct approach for care providers to use when providing care to the injured or ill. If you are student taking a practical skills evaluation, you can bet that the proctor will be looking closely at your ability to keep advanced intervention in their proper place. If you are a seasoned professional, the same rules apply. Often care providers who are at an advanced level are quick to think at an advanced level when basic interventions are all that is really needed. An example is the intubation of a cardiac arrest patient who has no airway complication whatsoever. With regards to cardiac arrest, the priorities are early CPR and defibrillation.

That is what is most likely to produce a positive outcome, not intubation. Each time intubation is attempted, valuable coronary and cerebral perfusion pressure is lost if chest compression are stopped. Unless there is some kind of an airway complication BLS airway management is sufficient in the management of the cardiac arrest patient. The basics, (as basic as they are) correctly applied often can make the most significant difference in the overall outcome and greatly improve the possibility of a hospital to discharge that is “successful”, with minimal neurological damage. The BLS course is designed to instruct new providers on the correct application of basic life support and also “remind” the advanced providers that the basics are still relevant and appropriate in many cases. The best care providers use the tools appropriate for the presenting condition as needed and not because they are licensed to do so. I am all for advanced interventions, but I am not for advanced providers who have poor BLS skills or simply start their care with advanced interventions.

The old adage “keep it simple stupid” does so often apply to patient care. Supplemental oxygen is among the most basic drugs and also one of the most effective. Remember that the chest pain patient gets a lot of it via non-rebreather (along with ASA) not a cannula. If you are thinking about nitro and morphine before you are giving oxygen you better at least be having someone reaching for the O2. That is BLS before ALS. One last thing that I think is most basic… If you don’t remember something, look it up. Grab your protocol book, cheat sheet, or ASK someone who knows. Ensuring that you have accurate information and that your interventions are correct is BASIC not advanced. Advanced providers are only human and we all forget something from time to time. Don’t be afraid to look it up.

Vital Ethics - ACLS PALS BLS/CPR & First Aid Classes » general 1

¿Cuándo debe estar buscando el pulso?

Popular Topics:

When Should You Be Checking For a Pulse?

Where do you check the pulse in an unresponsive victim? With infants (under 1) the best place is in the brachial artery under the bicep of either arm. With children over 1 and adults, the preferred location will be the carotid artery on either side of the either side of the adams apple.

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Acute Coronary Syndrome

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First Aid | USMLE Step 2 CS | Third Edition

ACLS Pharmacology: Magnesium Sulfate

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Online Surgical Technician Programs

Online Dialysis Technician Programs

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First Aid for Dehydration

Popular Topics:

BLS Before ALS: A Necessary Approach to Patient Care

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