BLS Training
Hi all. Just a quick reference here for you so you can make sense of what we're trying to accomplish in our emergency preparedness. You'll also find a few pages from the BLS manual so if something is unclear, you can review it here. Want your own manual? Click here to buy your own BLS manual from the American Heart Assiociation.Or from Amazon (cheaper ). That yellow box to the right has all the main links within this mini-site. Keep scrolling down to get to our objective.
Scroll over and click on the guy in the picture to the right and you'll be whisked to a page with several useful YouTube linked videos (not to worry, they're approved as part of necessary practice). You can see short video's on:
If for some reason these specific YouTube links remains locked, you can always send yourself the link to this page to your home email. |
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Our Objective During a Code
OK. What's our objective in Urgent Care during a code? It's simple. Be prepared and feel confidant about your role and the two or three other roles performed during a code. In particular, be prepared to perform your role in the case of the collapsed patient in cardiac arrest or pulseless ventricular fibrillation / ventricular tachycardia. That's pretty specific. So, in a phase by phase process we want to get everybody comfortable with these things.
(Note: the links on this page will make more sense after a quick read of this first page - and not to worry - lots of pictures on the linked pages).
Here are some questions you want to ask - and soon - be able to answer:
- 1) What are, whom are, and where do we find our resources?
- 2) What are the ABCD's of CPR?
- 3) Where do you go?
- 4) What do you do?
Take a second and ask yourself those questions again: What are the ABCD's of CPR? What do I do? What equipment do I get? And where do I go? If you're feeling a little disoriented right now, don't worry - we're coming at you a little fast but you'll have this all down soon :-).
Let's Dive On In
The Alarm goes out. There's a patient down in the waiting room. We know that because it was announced on the overhead or some one knocks on an exam room door, pokes their head in, says firmly "we have a situation". As Urgent Care staff it's our responsibility to respond to the call.
Assessing
Usually there's never a shortage of help. The first person there generally takes over - that's usually the first clinician arriving. Most of the time the person is conscious. Every now and then the person IS actually coding: unconscious, not breathing, cyanotic - they're in arrest. And we have to be ready. Feel a little of that adrenaline?
Resource Number One
We, each other (MAs, nurses, clinicians) are our most important resource. Our experience and combined know-how, that's resource number one.
Resource Number Two - The Physical Tools of BLS
The physical tools of BLS means equipment. Most of the time the staff is great about grabbing everything, i.e. the actual tools of BLS, the 02, the masks, etc.
In addition to the actual physical tools, a lot of us carry that crummy, adrenalized eyes-wide-open, pounding heart, anxiety along with us. It's pretty unavoidable. Being more familiar with those roles, actually rehearsing those roles will help minimize that stress.
Getting This Down - And Saving a Life
So breathe easier as you picture that day when you'll know exactly where you'll go, what you'll need to bring, and what your hands will do. It's the Urgent Care clinicians goal you'll feel more comfortable, your attention will laser right on to the tasks you'll be doing, and we'll perform as a team. And what will you be doing? Nothing less than saving a life. Doesn't that feel good? Pretty cool :-)
The Tasks
Running a code breaks down to specific tasks. What are those tasks? You know what they are or at least have a pretty good idea. They all have to do with the ABC's, grabbing the defibrillator and calling 911:
The ABCD's
to top
| A | A is for Airway: that's anything from nose and mouth, through the pharynx, hypopharynx, through the epiglottis, into the trachea, through left and right bronchostems, bronchioles, right on down to the alveoli in the lungs. Since we're not a trauma center, and we no longer have crash carts, our attention is on the anatomy above the epiglottis; oral-pharyngeal airways, maybe nasopharyngeal airways. More on airway |
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| B | B is for Breathing. "Running" is the active form of the verb "to run". Breathing is the active form of the word "to breathe". Breathing requires a lot of anatomy that usually miraculously takes care of itself every second of every day. If we're breathing for someone, we need pocket masks, bag valve masks, oxygen tanks and tubing. More on Airway and breathing |
| C | C is for Circulation. That means if it isn't happening for the patient, we start compressions at a ratio of 30:2 chest compressions to every 2 breaths at a rate of about 100 compressions a minute. |
| D | D is for Defibrillator. |
| Click here for video demonstrations (These are YouTube links - and should qualify as necessary links) |
If we have a enough people (3-4) and we usually do, here's what we need to bring to the area:
Check out this graphic and you'll get a visual idea of what might be needed in a code situation.
You'll see it looks like a lot but it's not that much since the stab kit contains the drugs, saline, bag valve mask (BVM), saline tubing, interosseous needle, epi, etc. The AED contains the AED pads. Familiarize yourself with how they're made and with how they deploy - they were different than any pads I had seen before -- revisit this page again - scroll over and click the graphic by the dummy and that'll bring you to a larger self explanatory picture.
Here's a list of the most important equipment - (and again you can see
them graphically here ):
1. Endotracheal airways
2. Pocket mask
3. Bag Valve mask
4. Oxygen tank and tubing
5. AED (Automated External Defibrillator)
6. The shock pads for the AED
7. Saline - one liter bag
8. Our stabilization kit
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If the alarm goes out that someone is down or you see someone down, lets get in the frame of mind of thinking
if this is an emergency, and someone is coding or really ill, what are our resources?
outside the clinic: we have 911.
Inside the clinic we have