Almost last semester...

It has gotten curiously quiet on this blog…and for good reason, my friend!

I’ve been busily heralding the last semester of nursing school—and this even before the semester has officially begun.  Just to start it off with a bang, 30 eager classmates, students from the junior cohort, and I, spent 3 hours yesterday listening to an awesome lecture by ICU nurse Tony about how to read EKGs.  It was great and prepared me well for today—day 1 of 2 of ACLS (Advanced Cardiovascular Life Support) training. 

Still in vacation mode until yesterday, I had somehow missed out on the fact that one is supposed to prepare for ACLS…  Ouch!  Review of Basic Life Support, self study of the 10 ACLS Core Cases (100 pages!), review of the relevant thirty-something drugs, and—yes—the ability to identify the most common and most deadly EKG rhythms.  So, Tony’s lecture helped with the latter, but for the rest I spent a good ten hours frantically cramming last night and early this morning… 

I must have completely lost my mind doing this during my vacation!

However, it turned out to be a fantastic day today.  I got lucky with five incredible instructors, who together brought a wealth of knowledge to the classroom, were funny and engaging.  Even better, they broke down the 120-pages textbook in easily chewable bites.  The most important concepts got boiled down into one readily remembered flow-chart, starting with step 1—is the patient stable, unstable or dead?  I can do that!  Now my arms hurt from giving rounds and rounds of chest compressions, in my head EKG patterns twirl around with drug doses and contraindications, and ACLS algorithms play tag with the “Rule of 3s.”  Information overload!  I think I won’t last long tonight because it’s back to the classroom tomorrow at 8am for 4 hours straight of mock codes…

One piece of new information I learned today, I’d like to share nevertheless.  Did you know that the most recent changes in the AHA standards for Basic Life Support (BLS) have reversed the A-B-C-D order to C-A-B-D?  It’s all about chest compressions now. Wait.  Not only chest compressions, but HIGH QUALITY CHEST COMPRESSIONS (this is the answer to questions #4 and #21 on tomorrow’s test…).  Instead of the 1.5 to 2 inches of compression depth, it is now 2 inches or more at a rate of 100/minute.  That’s fast!  Hence my sore arms…  Studies have shown that chances of survival to hospital discharge or neurologic outcome are significantly increased if chest compressions are started immediately and interrupted as little as possible, no more than 10 seconds at a time.  See the video clip below for more on these changes.

I also learned that Seattle, WA is the US city with the best survival chances for out-of-hospital cardiac arrests—38%.  That’s pretty darn good!  What do they have that other cities don’t?  Apparently it’s a very high percentage of lay people trained in CPR and use of AEDs, in conjunction with many accessible AEDs in public places.  

So much for now!  Stay save, my friend, and if you have never or not recently taken a CPR class—do it!  I bet we could reach 38% or more here, and in your hometown too.