FROM THE DESK OF JOHN BLAUCH, RN, BSN, M.ED, EMT-P - Manager. H.E.A.R.T.

Class Location Changes for 2008:

12/2007 - We've posted a few upcoming classes as we transition to several new locations within the Lake, Geauga, and Cuyahoga County region. In addition to CPR, ACLS, First Aid, and Bloodborne Pathogen training, we will soon be adding PALS, PEPP, and some other exciting surprises. Stay tuned...

New ACLS Schedule posted for 2006:

12/15/05 - The HEART ACLS Schedule of classes for 2006 has been placed on-line. Click on the title above to take you there.

New 2005 CPR Recommendations dramatically change ratios and gadgets designed to enhance survival:

11/05 - The latest changes in the CPR guidelines for all providers dramatically change the way we have utilized this essential skill. While ACLS guidelines have not yet changed, the implications are great for any person trained to provide CPR to a victim of cardiac arrest. While the new guidelines have been published, they are not expected to be "rolled out" to the CPR community until at least March of 2006. Click the link above to learn more information.

BLS Healthcare Provider Controversy Addressed:

AHA gives clarification on teaching the Healthcare Provider CPR Course

10/01 - Due to a controversy involving how hospitals and training centers teach experienced CPR providers, the American Heart Association has issued this clarification (taken from AHA Intranet Website):

"We have listened to your concerns regarding the Healthcare Provider (HCP) Renewal Course and have designed a new flexible HCP Course Agenda. This new Agenda acknowledges that students have different needs. Many Healthcare Providers practice their skills daily and need only a quick cognitive and new skills review and then are ready to be tested. Other Healthcare Providers do not use their skills on a regular basis and should have more time allowed for review and practice of skills. Enclosed is a flexible Renewal Agenda that can be used with both groups of Healthcare Providers. The Lead Instructor can determine which option of this Agenda should be used with his/her students. We believe this document will meet the needs of both groups.

This new agenda includes:
- An opportunity to include any new BLS skill or cognitive information and a time to review any specific information that your Training Center feels appropriate in a Renewal Course.
- An opportunity to use the new videos to review new skills.
- The flexibility of an optional, Instructor facilitated skill practice and review
Both options require a BLS skills evaluation, written examination and course evaluation. The new BLS for Healthcare Providers or Fundamentals of BLS for Healthcare Providers text must be available to the student for review prior to the Renewal Course.
If you have specific questions, please contact your Regional Service Center at (888) 277-5463."

Also click on : http://www.cpr-ecc.org/instructors/instructmenu.htm

ACLS Instructor Rollout : Have you expired ?:

October 1st was last day to attend rollout

10/1/01 - All ACLS Instructors were to have attended a rollout as of October 1, 2001. If you have not attended a rollout, your ACLS Instructor Card has EXPIRED. You will need to retake the ACLS Instructor class in order to continue teaching.

AHA ACLS Instructional Materials Are Out !:

New Curriculum now included in all classes, except PALS

8/1/01 - All H.E.A.R.T. ACLS classes now utilize the new 2000 American Heart Association Guidelines for Emergency Cardiac Care. The new course includes a pretest, an improved book (with lots of practice questions and annotated answers), and the addition of new equipment (Combitube, LMA airway, ET Tube Holders, End Tidal CO2 monitors, and AED, to name a few). All existing instructors need to attend a rollout by October 1, 2001 to retain their ACLS Instructor card. Click on the link for a list of rollouts through HEART.

Also click on : http://www.cpr-ecc.org/instructors/instructmenu.htm

AHA BLS CPR Instructional Materials Released March 2001:

Existing instructors must attend rollouts by June 2001

3/2001- The new CPR BLS Instructional materials became available in March, 2001. All instructors are required to attend a Guidelines 2000 rollout, attend a CPR-AED Instructor Orientation (if they haven't already), and present verification that they have taught 4 courses over the past 2 years, with one course being monitored by a Regional Faculty or Instructor Trainer. Any instructor that has not done this will expire in June 2001. For more information, click on the link:

http://www.cpr-ecc.org/instructors/instructmenu.htm

An Overview of the changes to CPR/AED/ACLS & PALS Guidelines:

Pulse Check Dropped from Layperson CPR Standard

8/15/2000 - The new guidelines for ACLS, CPR, AED use, and PALS were released to the public today. These guidelines will be addressed in detail, as the American Heart Association's Emergency Cardiac Care Committee (ECC) makes its latest recommendations at the Fall 2000 ECC conference in Atlanta, GA. These guidelines, which change every 7-8 years, herald the lastest innovations and research advances in cardiovascular care and training.

You can find more information on the changes below or click on the link:

http://www.cpr-ecc.org/

Here is a brief synopsis of the changes:

BLS CPR - Pulse Check Eliminated in Bystander CPR:

These changes represent the most dramatic and controversial of the 2000 guidelines update. Research has indicated that at least 35% of lay rescuers are wrong about whether an arrested victim has a pulse or not. For this reason, the new guidelines recommend that the general public look for normal breathing, movement, response to stimulation, and other signs of circulation when deciding whether to begin chest compressions. The pulse check has been eliminated to save time & confusion, and get automated defibrillator, ventilation, and compression techniques initiated. This change had already been implemented successfully in England, and in the European Resuscitation Councils. It is important to note that it remains the recommendation of the AHA for Healthcare Providers to continue to initiate a pulse check before starting cardiac compressions.

Mouth-to-Mouth resuscitation has caused a stir of controversy since the AIDS epidemic. Many rescuers cannot correctly perform the procedure, and others refuse to perform CPR due to the mouth-to-mouth contact issue. For this reason, the new recommendation is that mouth-to-mouth is optional. In essence, "something is better than nothing", and good chest compressions, with the integration of an AED, clearly saves lives.

The Heimlich manuever will continue to be taught, however it is no longer recommended as a first action for the UNCONSCIOUS CHOKING patient. The guidelines now recommend chest compressions as the primary treatment, rather than the Heimlich manuever.

The BLS CPR guidelines continue to emphasize early use of the AED (automated external defibrillator) as the number one tool in saving lives from cardiac arrest. Save rates of over 50% are being reported by areas where AED programs have been instituted, such as at O'Hare International Airport, in Chicago.

The new BLS Healthcare Provider textbook will be released in early 2001.

ACLS (Advanced Cardiac Life Support) Changes - Addition of Cordorone (Amiodarone), Promotion of Endotracheal Airways, and Continued Emphasis on Early Thrombolytic Treatment for Stroke and MI:

The ACLS changes involve:

	Continued promotion of the endotracheal airway as the "gold standard" for airway management.
	Continued promotion of early thrombolytic treatment for non-hemorrhagic stroke (within 3 hours of onset of symptoms).
	Continued promotion of the use of 12-lead EKG's in the pre-hospital setting
	Updated recommendations on the use of thrombolytic agents in acute MI.
	Pharmacology changes relate to the addition/deletion of various emergency cardiac drugs. Vasopresssin is now recommended as the first line catacholamine, replacing Epinephrine as the first drug given. All subsequent catacholamine doses are Epi 1mg IVP. The use of high dose and escalating epinephrine has been deemphasized, secondary to the poor evidence of it's effectiveness.
	Other pharmacologic changes in antiarrhythmics include: Cordorone (Amiodarone) is now recommended as the front-line antiarrhythmic agent in pulseless, refractory ventricular fibrillation & pulseless ventricular tachycaridia. This does not rule out the use of Lidocaine, however research indicates it has very poor effectiveness in changing refractory v-fib/v-tach (almost class III - yikes). Bretylium has been eliminated from the protocol secondary to it's limited effectiveness in studies, as well as the fact it is now very difficult to obtain. Magnesium sulfate is now used only in known or strongly suspected hypomagnesemic states. It's routine use is not recommended. Procainamide has now re-entered the ACLS arena as the primary, second line agent for refractory v-fib/v-tach.

The new ACLS textbook is scheduled for release in May 2001.

PALS (Pediatric Advanced Life Support) Changes:

Recommendations on new drugs to treat life-threatening abnormal heart rhythms are new treatments for emergencies such as drug overdoses or poisonings are updated.

The new PALS textbook is scheduled for release in late 2001.

For more information, PLEASE click on the American Heart Association's "Guideline Update" link at: http://www.cpr-ecc.org/

Currents Magazine full of great information, and best of all....its FREE:

To get your free copy of CURRENTS - click here:

http://www.currentsonline.com/currents_options.html

Stay tuned for more updates

-John Blauch, RN, BSN, M.Ed, EMT-P - AHA BLS/ACLS Regional Faculty

For More Information Contact:
Health Education And Rescue Training
Tel: (440) 286-4680
FAX: (440) 286-4784
Internet E-mail: info@heartco.com