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ACLS is actually doable, but not like on TV

May 13, 2009

I’m in the midst of a two day Advanced Cardiac Life Support course. I only got the provider manual yesterday, so I did my best to cram before today. So much detail, but a lot is fluff too.

All the algorithms for ACLS protocols would be hard to memorize, if it wasn’t just logical. The instructors have been great, expecting us to learn patterns rather than by rote. ACLS, broken down, is about stable, unstable, and dead patients with hearts going too fast or too slow (or not at all). Chemicals and electricity can be used to try and fix these aberrations. Framing it like this was much less daunting than seeing box after box on a flowchart of decisions.

I fear I’m going to draw a blank on drug doses at the critical moment, but that’s why they invented pocket ACLS guides and PDA programs. Phew! Other than that, the process of resuscitation, although low-yield, can be highly satisfying and exhilarating. And that’s why it’s on TV.

Whenever I have done CPR courses or trauma sessions or mock codes, I am always impressed that CPR/ACLS instructors and ALS paramedics can quote the statistics of resuscitation on TV. They cited the fact that 60% of asystolic patients (on television) are ‘defibrillated.‘ But we all know defibrillation is not to start the heart, but rather to stop it when it is in a fast, wonky rhythm. At least, we all know that now!

Other TV medical myths about resuss?

Every time I watch House, I yell at the TV and get laughed at for offering my diagnosis, or getting mad that the residents are doing the lab tests themselves or that a neurologist is doing surgery.

But there are real life myths too. Now, lets just stop giving the epi already, shall we? (i.e. no evidence of survival benefit with giving it)

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2 Comments leave one →
  1. May 29, 2009 5:58 pm

    Goodness me, but I will always remember my first real life code. I think I blogged about it….I think I realized during my ACLS course that the best course of action for me would be to hide in the closet. HUNDREDS of codes later I still think the best course of action is to hide in the closet although I don’t pray for death myself anymore when I hear the code bells.

    PS I love House. LOVE him.

    • June 1, 2009 3:23 pm

      the first step when arriving at a code is to take your own pulse, (according to House of God), right!

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