CPR Reminder wallet cards are here!

My CPR Cards - simple reminders, designed to be folded and fit into a wallet, feel free to distribute: (docx format, click the link below) http://www.carpentercprsolutions.com/1/post/2013/08/cpr-reminder-wallet-cards-are-here.html

Post Arrest Hypothermia

So, your cardiac arrest patient now has a pulse. Great work! Now what? The new AHA guidelines really stress post-resuscitative care. Induction of "therapeutic hypothermia" immediately after return of spontaneous circulation has been clinically proven to preserve brain function. This is due to the decreased metabolic demands on the brain in the hypothermic patient. The criteria for this is essentially any patient post arrest who is comatose, and not septic. The studies were done on post-arrest patients that had been in ventricular fibrillation, but patients with a history of PEA or asystole are also candidates for therapy. The goal is to induce low body temperature for the first 12-24 hours post-arrest. The goal temperature is 32-34 Celsius (about 90-93 Fahrenheit.) This can be accomplished with ice packs to the armpits and groin, but that takes a while. A faster way is to begin chilled saline boluses. Fridge temperature saline is fine. If given at around 100ml per minute IV, (via a pressure bag,) each 100ml is expected to drop body temperature around 1 degree Celsius every 10 minutes. A 500ml bolus may well be sufficient, as the average adult body temperature is 37 Celsius. So, rechecking a temperature in 30 minutes should reveal a temp of about 34 Celsius. To maintain this temp for 12-24 hours, automatic cooling blankets are best. They often are placed under and over the patient. These utilize a temperature probe (esophageal probe, or bladder probe) connected to the device to maintain the temperature of the patient within the desired range. There are medications that are also commonly used to assist in maintaining the temperature. A Fentanyl drip can be useful here, as it decreases the body's shivering response (shivering will raise temperature) as well as keeping the patient sedated. A non-sedated patient may have increased brain activity, which is counter- productive. Tylenol via suppository is also useful to blunt the body's hypothalamic (temperature control) response. The patient does not necessarily need to be paralyzed. Some would say don't paralyze the patient, as the non-sedated, or poorly sedated paralyzed patient will surely have increased brain activity which will not be recognized. Potential complications include coagulopathy- hypothermia can cause bleeding. Another problem is that hypothermia causes a decreased immune response, so it is not really indicated for septic patients. Frequent blood sugar checks are Again, the non-comatose patient who achieves return of spontaneous circulation is not a candidate for this therapy. Cessation of therapeutic hypothermia generally consists of ceasing cooling measures, and allowing the body temperature to come up naturally.

Improving our service!

We are always striving to improve our service. You may now purchase your online course externally, either through the AHA, or a third party vendor, like Laerdal (some health care agencies even offer the online portion internally, and refer out for the skills session!), and then simply sign up for a skills session when you have completed it!. We hope that this will allow our clients the flexibility to truly complete the online portion of the course in their time frame, not ours! from our Online Learning section "Simulation is the most useful tool in teaching. Simulation is research proven to help students retain. Additionally, self guided learning leads to the best retention rates. Online content means consistent quality, content, and delivery. This is why we wish to bring you this e-simulation technology. The best part is that these courses are done at YOUR pace. Please feel free to contact us with questions or to explore more traditional (classroom) course options. " Thank you for your continued support of our service!

EpiPen for severe allerrgic reactions

Someone having a severe allergic reaction with trouble breathing and/ or swelling of the airway may need help in using their epinephrine pen. An EpiPen is device often carried by people with a known history of these types of severe reactions. These reactions can be caused by anything from bee stings to peanut butter. EpiPens are designed to go through clothing, and should be injected into the outside part of the leg, halfway between the hip and knee. Heart Association recommends keeping the pen in place 10 seconds to allow the medication to auto inject into the patient, and to massage the area for a few seconds afterwards to promote blood flow. Be aware that EpiPens have a safety on the top of the injector that must be removed before use. Do not touch the orange bottom part of the injector. This is where the needle comes out. The needle is automatically shielded when removed from the leg, so that should not be a major worry, but it needs to be "inserted" into the leg firmly. Follow up after using an EpiPen should be 911, as the patient will need close monitoring for some time. Note the time that the EpiPen was used.