In almost all cases this type of training is tax deductible and will be a write off for the company. In addition, basic level training can give companies a bit of a buffer in the case of litigation related to emergencies that happen on the premises. OSHA approved CPR and First Aid training is not an insurance against litigation, but can help show evidence that you and your staff responded appropriately to the emergency and did what should have been done at a basic level. That a little better then having staff totally clueless when a coworker falls or has chest pain, and everyone is standing around clueless. It also shows that your organization is interested in the safety of staff and visitors.

Training also communicates to employees that safety is always of utmost importance and not to be neglected for the sake of more gold coins. CPR and First Aid training can often be conducted on the premises for a very nominal fee, ranging from $35.00 to $75.00 per student depending on the class size and exact type of training needed. Most agencies offer discounts to groups of more then 10 students will scheduled training at the most convenient time for you and with an invoice at 30 days net. In most cases certification cards are issued on site, but sometimes can be provided by mail typically a few days after class. Although programs and certification type vary, there are many that are OSHA approved. If your organizations reason for training are to comply with OSHA, be certain that the training you are receiving is in fact OSHA approved.

Although episodes of chest pain may be very frightening, it should be emphasized that angina is only one of many possible causes. Indigestion, anxiety, muscle disorders, infection or structural abnormalities are just a few of the many causes of chest pain. This is why a number of tests may be required before it is determined that the chest pains are, indeed, angina. Even then, there are different types of angina, and distinguished the specific type involved may be a factor in prescribing the most effective treatment.

Classic Angina Pectoris

The most common form of angina is associated with coronary artery disease. As we grow older, our blood vessels tend to “harden” or lose some of their elasticity, a process known as arteriosclerosis. They also may become narrowed or clogged with deposits of fatty material. These are gradual processes that may go on for years, even decades, without causing any problems or symptoms. But if the narrowing progresses to the stage where 75 percent or more of the artery is blocked, the result may be angina or a feeling of breathlessness. Typically, classic angina is brought on by exertion or other activities that cause the heart to work harder; for example, the increased blood flow required to digest a large meal. Cold weather, emotional upsets or anxiety are other common factors that may provoke angina.

Variant Angina Pectoris

Variant angina is not necessarily related to exercise or other stresses. It may come on while asleep or sitting quietly or performing exercise that is usually well tolerated. This type of chest pain, which is sometimes referred to as Prinzmetal’s angina, has puzzled doctors for many years. Recent studies, however, indicate that it is often caused by a spasm or constriction in the coronary artery, which cuts off the blood flow and results in pain like that of classic angina.

Unstable Angina Pectoris

Some patients experience both classic effort-induced angina and variant angina, with attacks coming on during periods of exertion as well as during restful times. Others experience an acceleration of symptoms, with attacks occurring more ad more frequently after less and less exertion. These syndromes are generally referred to as unstable angina, which usually requires more intensive treatment because it is associated with a higher risk of heart attacks than classic, stable angina. It should be noted, however, that heart attacks often occur in people who have never experienced any chest pain, and, conversely, there are many people who live with angina for many years without having a heart attack.

Treatments of Angina Pectoris

In most instances, the angina will subside with rest. If an attack occurs, stop whatever you are doing and rest until it passes. Angina caused by coronary spasm may not respond as well to rest as classic angina. Aside from rest, there are three major approaches to treating angina: life-style changes, drugs and surgery.

Life-Style Changes

If you smoke, you should make every effort to stop. Smoking stimulates the heart to work harder; it also causes other changes that many researchers think may be instrumental in triggering chest pain and heart attacks. People who are overweight are usually advised to gradually lose weight by eating less and exercising more. However, a person with heart disease should not embark on a weight reduction or exercise program without close medical guidance. Avoiding stressful situations or learning relaxation techniques are still other life-style modifications that may be recommended.

Drugs to Treat Angina Pectoris

The two major classes of drugs used to treat angina are nitrates and beta blockers. Nitrates come in several forms: as nitroglycerin or other tablets that may be slipped under the tongue to bring relief during an attack, as an ointment to be absorbed through the skin to prevent or relieve an attack, as long-acting tablets or capsules to be taken orally to prevent an attack. Recently, still another form–a disc to be applied to the skin to provide a steady release of the drug over a period of several hours–has become available.

Beta-blocking drugs help prevent angina attacks by slowing the rate at which the heart beats, thereby reducing the heart’s workload and lowering the amount of oxygen it needs. These drugs should be taken exactly as instructed, and should not be stopped abruptly.

A new class of anti-anginal drugs known as calcium-blocking agents appears to be particularly effective in controlling the type of angina associated with coronary spasm. All muscles require varying amounts of calcium in order to constrict; by reducing the amount of calcium that enters the muscle cells in the coronary vessel walls, the spasms that choke off the heart’s blood supply may be prevented.

Surgical Treatment

In some patients, coronary bypass surgery may be recommended. This operation entails taking a portion of a vein, usually from the leg, and grafting it to the coronary artery to bypass the clogged area. Many factors are considered in deciding whether or not to operate, including the extent of coronary disease, degree of disability from the angina, and the age and general physical condition of the patient.

Summing Up

Angina is a common manifestation of a progressive narrowing of the coronary blood vessels. It also may be caused by a temporary spasm of these vessels. Most angina patients can be effectively treated through a combination of life-style changes and drugs. No one treatment works for all patients; each person must be evaluated by his or her doctor, who can then prescribe the most effective treatment.

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Victims of cardiac arrest DO NOT respond to any stimulus, so be careful to check real good prior to starting CPR. Before doing chest compressions you should also be looking for breathing. Consistent breathing is a better indication of a working heart then checking a pulse. The keyword here is “consistent” breathing. Even if it is slow, if it is consistent it means that the heart is working and CPR is not needed. Remember, when you are doing chest compressions you are manually pumping the heart. If the victim is consistently breathing on their own, their “pump” is working automatically and you do not need to pump it. Finding the pulse on an unconscious victim can be challenging even for experienced health care providers. Currently, industry standards do not recommend lay responders check the pulse on victims. The CPR recommendation for lay responders is to begin chest compressions if the victim is unconscious and breathing is absent or not normal.

However, if you are a professional and know how to check a pulse, it can be done very easily while you check for breaths. Can you find a victim breathing with no pulse? The answer is YES. While you cannot have breathing without a working heart, the pulse may not be “palpable” or “unable to be felt” in some circumstances. Take for example a large victim with a high percentage of body fat around the neck and a low blood pressure. Even experienced professionals will have a challenge finding a pulse. If the victim is breathing “consistently” (even if it is slow) their heart is working. A lot of people struggle with this reality. Many times overdose victims and victims of diabetic coma look like they are dead. However, a careful assessment may reveal that they are in fact breathing. If that is the case, the best position for them may be in the recovery position of their side until EMS arrives (unless you are EMS) While assessment priorities are the same with children and infants as with adult, starting chest compressions on a child or infant is appropriate anytime you have no breathing, abnormal breathing and of course no pulse, OR a pulse with a rate of less then 60 beats per minute.

It is not enough to have a pulse for an unresponsive child or infant who is not breathing. They must have a pulse with a rate of at least one beat per second in order to sustain life. Professionals should always assess carefully prior to doing chest compressions on anybody. Patient assessment is a skill in itself and one that should be understood clearly before the application of any treatment like chest compressions.

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One of the key prerequisites required of individuals who want to be highly efficient dialysis technicians, is a solid educational background. There are minimum standards of education that must be met for those individuals who desire to enter this field, but those requirements only serve as the basics to acquire employment. Meeting the minimal educational standards required to work in this field will only go so far, and those seeking to reach the highest level possible in this career, will have to increase their level of education and knowledge of this field. Having a high level of education is very good for those who are seeking initial employment in this area of work, due to the fact that a higher level of educational achievement will help them to stand out among other applicants for this position. The fact that an applicant has more education and or experience than is required for entry level positions, shows potential employers that this individual has the inner drive and desire to surpass minimal standards.

For those who are employed as dialysis technicians, it is imperative that they continuously seek to improve their knowledge of this profession in order to perform their duties better. One of the results that is readily apparent when an individual develops a greater base of knowledge in his or her profession, is an increased level of competence in the performance of his or her duties. Competence serves to increase the efficiency in which one carries out their duties, which invariably leads to a higher quality of work performed in a shorter amount of time, which is an asset to any organization seeking efficiency and effectiveness. As an individual develops higher and higher levels of competency resulting from increased educational attainment and experience, the individual will develop a much higher level of self confidence. The confidence that this individual develops will further increase the individual’s ability to perform their duties at a very high level of skill and expertise. Due to the nature of the medical field and the continued technological advances that this field experiences, educational upgrade is an absolute must. Individuals must continuously evolve and develop as their profession continuously evolves.

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Signs and Symptoms
Signs and symptoms usually develop slowly as the body temperature decreases and can include confusion, shivering, pale skin, frostbite, bradycardia (slow heart rate), shallow breathing, fatigue, memory loss and dehydration.

First Aid Care
If you see someone suffering from hypothermia, call 911 immediately, and then gently move them indoors. If moving them indoors is not possible, then cover their head and body with a coat, a scarf or a blanket. Always monitor the person’s breathing for any changes. If breathing becomes shallow or stops, begin cardiopulmonary resuscitation (CPR) immediately.

Once inside, remove wet clothing and cover with a warm blanket. Apply a warm compress or hot water bottle to the victim’s head or neck. Provide the victim with hot liquids, such as water or tea. Avoid giving alcohol or caffeine because it constricts the blood vessels leading to increased heat loss and frostbite.

If the victim has frostbite, rewarm the skin by submerging the affected area into a bath of warm water about 100 to 105 degrees F. Once the skin is soft, wrap in sterile gauze. Keep the affected area elevated to reduce swelling. There may be some pain after rewarming the skin. Aspirin or ibuprofen can be given but first, consult with a physician before administering medication.

Training
For more information on first aid care, enroll in a first aid class at your local American Red Cross. A first aid class teaches you how to provide basic care to treat injuries, illnesses and life-threatening emergencies, such as hypothermia. Students also learn about bloodborne pathogens, oxygen administration, CPR and how to use the automated external defibrillator (AED). After passing a practical and written exam, graduates of the first aid class receive a certification card, which is valid for three years.

If your child comprehends well and does well in school, then they can learn a lot from a CPR/AED first aid class. Depending on the age, and type of emergency, a child will be very limited in what they can do in some circumstances. However, simply being able recognize some emergencies and cal 911 is enough in many cases. Recognizing difficulty breathing, seizures and chest pain are within the ability of some perceptive children and knowing when to call 911 is not a difficult concept to teach them.

The parent or guardian of a child plays a significant role in the child’s ability to retain the information taught in a CPR and First Aid class. Periodic review of the book that is included with the class as well as re-taking the class every year or so is an excellent way to give your child a strong foundation in understand and handling emergencies. Repetition of concepts and practice is key with children just as it is with adults. In order for your child to get the maximum benefit from taking such a course. You may consider preparing them by watching video, looking at books or actually auditing a class prior to them actually taking a class. Note that children often think very highly of the certification, if they understand it as a reflection of accomplishment. With this in mind you may want to take a class were your child can be sure to leave with this small but important reward. Be sure to encourage their efforts and praise their accomplishment, as their success can literally make the difference in someone else’s life.

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The AHA does not approve or disapprove these programs. The AHA provides the current science and guidelines as well as its own certification programs. PALS programs can be accredited by different agencies. Because they are not AHA certification programs does not mean they are not legitimate. They can be legitimately accredited by another agency other then the AHA. Which program a provider should take will vary based on the individual provider needs. If an LPN wants to take a PALS course to broaden their understanding then almost any accredited program that follows AHA guidelines will do.

However, if taking PALS is an employment or academic requirement then the provider would be wise to understand what program is required. Although, the AHA PALS programs is the most common, it is not at all the only one. Many health care professional do not know this. However, if YOU are required by any organization to have the PALS certification, make sure that you know exactly which one is required or what programs are accepted BEFORE you take a class. In any case, you cannot get your PALS certification from the American Red Cross. Another thing to consider is that the AHA certification is generally accepted by all hospital systems and health care schools. So having completed and AHA course, you can rest assured that your certification is accepted anywhere in the U.S.A. The downside is that these classes are not always available, in which case another program may have to do.

PALS programs are now available online by a number of different companies. Online programs that are legit usually have a skills session in addition to the course work. These programs work for a lot of people, but not for everybody. You may have to do a bit of traveling to find the program you want to take. Don’t be surprised, this is very common. Good luck.

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