Saturday, June 30, 2012

Advanced Life Support

An AED. This is a rep, not me. ; )




"Annie! Annie! Are you okay?"

Anybody here know what that means? If you do, you most likely have taking a Basic Life Support Class, an Advanced Cardiac Life Support Class, or a Pediatric Advanced Life Support Class from the Red Cross or the American Heart Association. "Annie! Annie! Are your okay?" is said while shaking the shoulder and shouting at someone who might have need for chest compressions.

I just took the class today. We take it every two years. I taught it once, even. It took a special course about a two hour drive away, all day, for me to be able to be an instructor. So much has changed since I first took it, that as a Reiki Master/Teacher I see a lot of transition and enlightenment in both the way it is taught, and the way CPR is done inside the hospital.

1988


This is my first class. It is at the company where I work, in a nameless, faceless building in an industrial park. I am honored to be one of the assigned people in the company to be a first responder in the event someone has an event at work.

The class is strict. Some people don't pass. Our competency has to be proven, under stress. This is to ensure we can perform under pressure.

1996


Medical school and the main medical center have a class. Anyone can sign up. You purchase a guide book for forty dollars. You study the night before, and take a pre-test that must be turned in.

The class is lecture format, again with the dummies in infant, pediatric, and adult sizes, like before.

I apply myself and memorize the answers, for there is no guarantee that anyone will pass. Failures have to come  back to another class to retake the test.

1998


This class is part of the residency training hospital. I am in the class with nurses, respiratory techs, doctors. I still have to pay for the book. With a check. And study. People are stressed because without that card, they cannot go back to work.

But class is taught by Barbara, an ER RN. She is funny! And she makes her point: this is the dose for a dead person (no pulse, no respirations). I learn more and retain it.

She also lets us 'remediate' our mistakes on the written exam.

In spite of this, people are pushy, in a rush, and not willing to help the other guy in the Megacode test.

2000


I go the the private place designed for these courses where most of the ER nurses go to renew in the community. Barbara is also teaching here. She is wonderful. The facilities are terrific. It costs more. There is tuition in addition to the books. I have to study a packet and take the tests. Everything and everyone is ALL BUSINESS.

The course takes all day, on a Saturday. From nine until four. We get lunch, as well as breaks.

I  feel held back. Due to the nature of my work, I use my advanced skills every day. The day drags on. But no one is made to feel incompetent or dumb. There is more support.

(I wanted to become an ACLS instructor as a Chief Resident, but the guidelines are being redefined, and I must wait.)

2002


I take the ACLS instructor course. This is fascinating. I am with people from far, each of them hoping to start their own business teaching ACLS. There are paramedics, nurses, but no doctors.

The class is more video format. And sadly, we learn that our personalities get in the way of education. The course has been changed from a lecture format to a 'teacher plays the DVD where the actor instructs the class'. It goes so far as to have students watch how to do chest compressions on a video next to them sitting on the floor with resusc-a-Annie. I am disappointed. I don't feel like there is a connection to my future students this way.

There is also a lot of psychology of adult education in the course. About half of the training is how to teach an adult and not make them feel dumb so that they want to come back.

I get my card, and am eager to teach.

2004 - 2008


I teach at the University where I work. I am amazed at how difficult it is to set up all of the equipment for a class, and how some of it does not always work. I had to use cut up pieces of paper with heart rhythms on it because the monitor with the dial on it did not work.

I feel funny because the medical center does not financially support this important function enough. It is like public schools where the teachers have to pay out-of-pocket for supplies to give the students a good experience. A huge introduction is the AED (automated external defibrillator) that kind of takes the work out of the whole experience. It analyzes the rhythm and recommends a shock. No more decision to synchronize or asynchronize the shock any more!

When we teach the anesthesia department, we cut that class back to one hour! It's the best.

I enjoy teaching, and am supportive and fun for my students. I sign them off and see them in two years.

Although the American Heart Association is making great strides in reaching adults to increase learning and decrease fear, a scandal breaks out in the area. A nurse is making fake ACLS cards and selling them to people to make it easier for them to renew. They get caught, and everyone involved gets fired.

2010


I go to the private class again. I let my teaching certificate lapse, because it was too much time in my busy schedule. Most of my friends are renewing 100% online.

I can see why. We look at lots of video footage for the class. Our lead instructor just cues it up and sits.

The course is only four hours now. No lunch. Short breaks. I breeze through. The airway station is painful, because I do that every day, and know more than the instructor. I try to keep quiet but I keep adding helpful hints the whole time. Megacode can't come fast enough so I may pass and leave.

2012


Everyone is happy. No one seems upset to be 'wasting their time'. It is an older crowd, many I recognize from earlier. The business office has moved to a smaller suite, although the lecture and practice rooms are the same. We also have a course online directly through the AHA to take to renew our BLS. We needed a 'key' code, and after doing the work online, were expected to bring in a certificate.

I pick up a strong sense of unity. We are healers, and 'if you get one question wrong, that means you have three more options to choose from when you take it again' said the teacher with a smile. There was no pressure. There was accommodation for fast test takers (me) and slow ones.

People seemed to 'get' that their role and purpose in a code was to help others. No one was annoyed or confused that the 'rules have changed' since the 2010 guidelines came out.

To be honest, I am scratching my head, and wondering how everybody got to be so nice in all this. The AHA, the course and instructors, and the students. It's like a whole new world. I really like it!


ACLS is a specialty where we take the moribund and try to bring them back. At first it was a high-pressure, high-stakes venture with only the best being able to 'save a life'. Over time, the drugs have had some changes (Bretylium anyone? That is an inside joke for those like me that work in medicine)...and also the mystique of being able to decide how much electricity to give to a patient is usurped by the AED.  Patient and family rights are considered now, such as family-present CPR and also when to terminate efforts. Stroke and choking are included, as well.

ACLS. BLS. Community First Aid. All of them are good things to know. And the community is becoming more warm and open, and in my opinion, more effective. Maybe you might want to consider taking a class so you will know what to do, too?

Healers with CPR skills! That would totally make my YEAR!

Namaste,

Reiki Doc

P.S. I am working on a book about the ones that do not make it. They come back and talk to me. From the Other Side. They always have a message, and it fascinates me. I want to share their messages with you. Keep watching!






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