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Has anyone used one of these before. Did your school/employer accept it? I took my first CPR class from my college about 6yrs ago..it was a 2 day course. I'm thinking about working as a CNA again...hopefully applying for an OB tech position next spring and I know a lot of places require an active cpr cert. I've been looking at this site BLS CPR Training and Classes for Infant, Child and Adult $14.99 | CPR AED Certification it seems legit...
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I'm 66 and on Occupational Health Nurse Manager at a Fortune 500 company. In November one morning I woke up unable to stand on my right leg. Subsequently I was hospitalized, had a MRI then a CAT and given an spinal epidural of steroids whereupon I recovered over the next two months. I have severe bilateral neuroforaminal stenosis. This was quite to my surprise as I work out regularly in the gym (aggressively which may have caused the issue) and my lumbar radiograph is none to pretty. I returned to work half days and my doc said: "What do you want for restrictions?" I answered: "Stand no more than one minute; Walk no more than 5 minutes and No lift/push/pull greater then 7 lbs. Well, I was at work for about two hours and someone came running into my clinic: "Come quick, someone is having a heart attack." Indeed, that appeared to be the case. I said to one of our first responder team: "I can't do compressions, you do compressions, I'll bag." We did exactly that. The person giving compressions did an excellent job, we ventilated him, I shaved, slapped on the pads, analyzed and shocked. I thought we might save the fellow because of "shock advised," but it wasn't to be. It was great teamwork and I'm proud. However, my CPR card just expired and now I must get a AH CPR card but I should not do compressions. Since CPR is an essential function of the job, I could be terminated because of this. So I wonder, am I covered under ADA? I'd argue yes, as I would never be doing CPR one on one and there would always be another first responder to do compressions. Any thoughts? Anyone face this sort of issue before?
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You're standing at your computer, charting on your patients. The end of the shift is nearing, and you really want to get this done so that you can get home. As you are typing, you hear a loud snoring noise coming from your patient's room. Suddenly alert, you abandon your computer and walk quickly toward the source of the sound. It's coming from the room where your patient, an 82 year old man with COPD, was expecting to go home today. You flip on the light, and he's slumped in his bed, his face blue, his dentures hanging out of his mouth. From the door, you call his name, but he doesn't respond. He just keeps making that snoring, gurgling sound. Gloves. You put them on quickly, your hands shaking. No matter how many times you've been through this, your hands still shake. It comes from the adrenaline of knowing that a life is at stake. With the gloves on, you enter the room and shake the patient by the shoulder. His eyes are at half mast, the part you can see is milky white. His lips are the color of a bruise. Immediately, you grab the CPR handle and lower his bed to a flat position. You can't leave the bedside, so you call for some help. Coworkers appear at the door while you check for breathing and a pulse. He has the snoring respirations, but they are getting fewer. You can't feel a pulse. One of your coworkers runs to get the crash cart. As you open up the patient's gown, tearing away the snapped shoulders, you notice that the patient has stopped breathing. A pulse check still shows nothing, so you get on the chest for compressions. You lace your hands, straighten your elbows, and piston your hips as you press down onto the sternum. It gives under your assault, bowing and cracking with each thrust. You can hear the cart coming down the hall, the rattle of the wheels that seem worse than any grocery store cart. The compressions are wearing you out, but another coworker appears across the bed. He nods at you, and takes over the compressions. Suddenly, the room is full. The crash cart is beside the bed, and multiple sets of gloved hands work over the body. Telemetry leads are placed. The blood pressure cuff is wrapped to the upper arm. The shock pads are put at the top right and bottom left of the rib cage. All are plugged into the cart as your coworker hands off compressions to someone else. The patient is rolled and a backboard is placed under his shoulders. Respiratory takes over the airway as the monitor clicks on. Compressions are halted, and asystole is confirmed. The doctor strides into the room, and she politely but firmly asks for a report. This is your patient, so it is your responsibility to run down the situation for the doctor. You have five patients, though. Do you remember enough about this patient to give an accurate history? Your brain is spinning. You reach for your notes while watching the respiratory team use the bag valve mask to give respirations. Already someone else is on the chest, pumping out compressions. Frantically, you search for the patient's history and find your notes. The history is sketchy from when you took report at the start of the shift, but you know enough to get by. The doctor nods as you tell her how you found the patient. One of your coworkers has gotten an IV started, and the doctor immediately orders a dose of epi. Pharmacy hovers just outside the door, and you can see the pharmacist pulling up the medicine. The nurse from the ICU picks up the recording clipboard and starts to write down the actions of the team. As the epi is getting ready, the doctor orders a score of lab tests. A phlebotomist winds his way into the melee and finds an open part of the patient's arm. It is too late to draw from the started IV. This is hospital policy. You hear the snap of a tourniquet, and the epi is handed to you. You announce that you are about to administer the epi. The phlebotomist gets his vein and draws a handful of brightly topped tubes, the blood like red lacquer in the glass. You announce the epi is in, flush it fast, and watch the recorder mark it down. It has been a while since there was a pulse and rhythm check. You aren't sure how long, but the doctor says it is time. You go with it. Everyone backs off the patient, including respiratory. You check for a pulse, find none. The monitor looks like a squiggly line. You know that's vfib. The doctor announces a shock, and you press the button on the AED to fire it up. The machine analyzes the rhythm, announces a shock is advised, and winds up like a siren going up a hill. Everyone backs up, holding their hands up. You ensure everyone is clear, and when the machine beeps, you press the shock button. The patient twitches in his bed, his body arching slightly off the mattress. Immediately, compressions are continued for a cycle. At this point, the chart has been brought to the room, and although you knew your patient was on dialysis, you didn't know that he missed it before coming into the hospital. Back inside the patient's room, the compressions are halted for a rhythm check. Still no pulse. Still vfib. The shock procedure continues again, and another person takes over compressions. By this time, the anesthesiologist has arrived. She comes into the room, and the bed is moved away from the back wall. The headboard is removed. While the new doc gets ready to intubate the patient, the blood work results come back. It shows that the patient's potassium is sky high, explaining why he coded. Following the Hs and Ts, you and the team have discovered why the patient coded. You watch as the anesthesiologist tilts the patient's head back, grabs the laryngoscope, and smoothly slides the tube in. The respiratory therapist begins bagging the tube, and you listen for bilateral breath sounds. Perfect. Got it on the first try. As the airway is secured, the doctor orders the standard treatment for high potassium. She orders 15 units of regular insulin IV push, and pharmacy is already handing you the syringe. You push the insulin into the IV port, and immediately hear the doctor call for dextrose. Flush, push the dextrose. Next bicarb comes at you, and you push that in, too. Check the rhythm. The patient has converted to tachycardia, but at least he has a pulse now. The ventilator is brought into the room, and the ICU nurses prepare for transport. A travel monitor is connected to the leads, and the bed is pushed from the room, a cadre of support personnel following in its wake. For the first time in half an hour, you breathe. You look around the room, and it is covered with discarded wrappers, a whole bevy of syringes, and disposable gloves that were tossed on the floor in the emergency. Your coworkers look as tired as you feel. You sign off on the recorder's sheet in a daze, and you give report to the ICU nurse that is now in charge of your patient. Everyone works to get the room back into decent shape. The crash cart is put back in position, and the routine for checking the cart is gone through. It takes a while, but you have to replace several items. Then you write up an incident report so your manager knows what happened. In all of this time, your other four patients have been out of your mind. Smacking yourself in the forehead, you run to check on them, but your coworkers have already answered their bells, administered a few meds, and taken some to the bathroom. You thank them profusely, and check on your patients anyway. End of shift looms. Your replacement is on her way down the hall, and you still haven't finished charting. With a mixture of relief and anxiety, you give report on the remaining four patients. The adrenaline still hasn't worn off, so you go to the bathroom, sit on the toilet, and cradle your head in your hands. You saved a life today, but now you can cry about it. When you are through, you march back out to the desk, sit in the most comfy chair you can find, and chart as quickly as possible. You have to get done and get out of here because you're going to do it all again tomorrow. anatomy-of-a-code.pdf
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Our small town newspaper's headline screamed the story: "Baby Saved by CPR." Choking and turning blue, the infant had stopped breathing when a neighbor, trained in CPR, was able to appropriately address the choking and proceed with CPR until the baby revived. By the time EMS arrived, the baby was alert and crying to the joyful gratitude of his mother. In our heads we hear the repeated phrase, "Annie, Annie, are you all right? YOU, call 9-1-1. Get the AED!" The training plays back in our heads because of the the familiarity of the often repeated training. But something has happened to CPR: over the last few years we have seen increased prices and increased length of classes and more demands on training centers regarding equipment. All of this begs the question: Is Annie going to continue to thrive or simply survive? What can we do together to apply the KIS (Keep It Simple) principle to CPR? Statistics vary, but it is estimated that only 18% persons in the United States of the US population is current in their CPR certification. While 65% of people responding to a survey stated they have had training at some point in their lives,much smaller numbers respond that they are willing to actually perform CPR as a bystander, reporting feelings of inadequacy or lack of preparedness and fear of injuring someone. Fewer than 1 in 5 U.S. adults have CPR training In October of 2017, CPR instruction and certification changed drastically when the American Heart Association increased the prices for their cards from $2.20 to $17, a price increase of 772%. Concurrently, they drastically decreased the prices of the student booklet from $15 to $2.50, in an effort to encourage each student to purchase and use their own books. The change caught many off guard and has made CPR instruction and certification even more challenging than it was previously. A careful look at American Heart Association (AHA) vs. American Red Cross (ARC) shows more similarities than differences. The American Red Cross has classes that are a little longer, maybe a little easier, but priced very similarly to their American Heart Association counterpart. The AHA is the flagship organization for doing the research and promoting universal CPR training. Their classes are the ones often required by hospitals and health care institutions. Both have provisions for 2 year certifications and are moving toward more online formats, although these formats are always combined with some type of check-off system which contributes to make the whole process take a longer total time. In addition to increased prices, the AHA class time has increased. In order to offer a class with a 2:1 manikin ratio, instructors are looking at approximately 4-5 hours of class time, a requirement that leads many to delay or totally omit optional training. It is hard for anyone to set aside that much time, especially if it is not paid for by their employer, and it is simply a personal skill they wish to obtain. It also makes it nearly impossible to complete training in an evening after work, requiring instead that the participant set aside week-end time or take time off from work. The AHA's abrupt move to increase the prices of their cards, has caused a great deal of turmoil in the ranks of instructors and students. Many persons who are required to have CPR certification in order to do their jobs, now face increased prices and those who depend on being a CPR instructor for their income, find it challenging to continue to be able to make ends meet. The central question in all of this upheaval is this: how will the patient be affected? Will fewer persons know how to do CPR? Will fewer persons be willing to offer this life-saving intervention to someone in need? Have we gone to the extreme of making CPR less accessible instead of more? At their core, providing compressions, breaths, using an AED and relieving choking are all pretty basic practices. While these skills require some instruction and some review, they are, in essence easy. By raising prices, increasing time demands, and requiring electronic retrofitting of manikins, we see new and costly barriers being created; barriers that can potentially affect the total numbers of people being trained and staying current. Both the ARC and the AHA ultimately have a mission to teach CPR well and to as many as possible. Presumably, they would like to see every single person in this country know how to do CPR and feel competent to respond in an emergency situation. What steps can we take to help instructors to help people learn without being unduly hampered by excessive restrictions and cost? Is it possible that in recent times, these organizations may have lost site of one of their central helping missions? As professional nurses, we have a vested interest in seeing even more of the public trained to do CPR. Let us all work together to ensure continued access to competent, excellent training. Maybe we need to re-examine our approach and move back toward the KIS principle: Keeping it simple-streamlined, quick, efficient and well-taught. Let's remove barriers and get back to helping one another, to reaching out in our communities. Let's find ways to offer CPR for a minimal fee or-no charge at all! Let's train our young people, our old people, our babysitters, our grocery clerks. Instead of moving toward tight control and less people trained, let's turn this thing on its head and move in the other direction-CPR for all!
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Natalie Davies, a senior at Sacred Heart University, was on Spring break when she selflessly presented herself to the aid of a man who collapsed at John F. Kennedy Airport, stated a report from ScrubsMag. "With my clinical experience, plus my work in the emergency room at Yale New Haven Hospital, I just reacted,” stated Davies. This is often the reality of nurses, whether working on the frontlines or on holiday, such as in Natalie's case, when an emergency arises, you automatically switch into nurse mode. Despite being only a nursing student, Natalie trusted her ability and began performing CPR and was eventually able to get the man talking again with the administration of an AED by the time EMS arrived. Related: $100 Million Fake Nursing Diplomas Scheme: Twice as Many Florida Schools Now Under Investigation Cardiopulmonary resuscitation (CPR) is one of the many skills taught to nursing students. CPR is used when an individual's heart stops beating or beats ineffectively, causing poor blood perfusion to body organs. No one wants to ever be in a situation where they may have to perform CPR or receive CPR, especially when you are still a student learning your trade. AEDs are essential tools that are needed in addition to high-quality compressions in order to get a heart beating again. "We were lucky the AED was so accessible,” Davies added. Recognition from Sacred Heart University Natalie's quick thinking and action caught the attention of Karen Daley, dean of the school's nursing department, and Heather Ferrillo, undergraduate nursing program chair. "We are proud of her and commend her for taking this life-saving action. She translated our mission of caring and compassion into action, which is at the heart of what we do in nursing,” Daley mentioned. "Natalie exemplifies what it means to be a SHU nursing student. She put into practice what she has learned over the last four years and didn't hesitate to share her knowledge and skills in an unexpected situation,” said Heather. Importance of Learning CPR Davies' passion for helping people grew from a young age, being the daughter of a physician and spending countless days in a doctor's office. Davies is on course to graduate this Spring and has accepted a critical care registered nurse position at Yale New Haven's Emergency Department. "In this case, there were a couple of us right there who knew what to do. It's important for everyone to learn how to administer CPR when needed,” advised Davies. This article was originally reported by Scrubs Magazine. -
Guest posted a topic in Career Advice ColumnDear Nurse Beth, I was injured at work, requiring two shoulder surgeries within 10 months. I re-injured the same shoulder and now have permanent restrictions (sedentary duty, nothing greater than 10 lbs push/pull/lifting). I am facing a reverse total shoulder replacement. I had a FCE done that correlated 100% with my restrictions. I cannot do CPR. It is physically impossible. I work in a long-term care facility and am often the only RN in the building. My CPR expires at the end of March. I hate to say this but I know my time as a bedside nurse is over. Where can I go from here? Isn't CPR mandatory for all RNs, regardless of role? Dear Restrictions, So sorry to hear about your shoulder problems. Shoulder surgery and recovery are difficult. It is facility-specific as to which job descriptions include basic life support (BLS). Generally it is all employees who have patient contact or possible patient contact. If an employee (including an RN) has zero patient contact, BLS may be waived as a requirement. So you need a job that accommodates your work restrictions. The good news is there are a plethora of non-bedside clinician jobs. You may want to read 8 Stay at Home Jobs . There are also surveyors, who work for the state Dept of Health and survey facilities. There's case management and Documentation Specialists. This is closing a chapter in your life sooner than you planned, but a new chapter is just beginning. Best wishes, Nurse Beth Start your job search today! -
When do you accept that it is futile to code or prolong a code? I had a patient maxed on 5 pressors. He was saturating in the 70s on 100% vent settings and gradually dropping lower. He ended up being coded twice. It was a combined time of over an hour of CPR. I felt like the patient was being tortured half way through the first code. He ended up dying anyway which I felt was the obvious outcome from the onset. Am I wrong to feel this way? No one else seemed bothered by it.
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Natalie Davies, a senior at Sacred Heart University, was on Spring break when she selflessly presented herself to the aid of a man who collapsed at John F. Kennedy Airport, stated a report from ScrubsMag. "With my clinical experience, plus my work in the emergency room at Yale New Haven Hospital, I just reacted,” stated Davies. This is often the reality of nurses, whether working on the frontlines or on holiday, such as in Natalie's case, when an emergency arises, you automatically switch into nurse mode. Despite being only a nursing student, Natalie trusted her ability and began performing CPR and was eventually able to get the man talking again with the administration of an AED by the time EMS arrived. Related: $100 Million Fake Nursing Diplomas Scheme: Twice as Many Florida Schools Now Under Investigation Cardiopulmonary resuscitation (CPR) is one of the many skills taught to nursing students. CPR is used when an individual's heart stops beating or beats ineffectively, causing poor blood perfusion to body organs. No one wants to ever be in a situation where they may have to perform CPR or receive CPR, especially when you are still a student learning your trade. AEDs are essential tools that are needed in addition to high-quality compressions in order to get a heart beating again. "We were lucky the AED was so accessible,” Davies added. Recognition from Sacred Heart University Natalie's quick thinking and action caught the attention of Karen Daley, dean of the school's nursing department, and Heather Ferrillo, undergraduate nursing program chair. "We are proud of her and commend her for taking this life-saving action. She translated our mission of caring and compassion into action, which is at the heart of what we do in nursing,” Daley mentioned. "Natalie exemplifies what it means to be a SHU nursing student. She put into practice what she has learned over the last four years and didn't hesitate to share her knowledge and skills in an unexpected situation,” said Heather. Importance of Learning CPR Davies' passion for helping people grew from a young age, being the daughter of a physician and spending countless days in a doctor's office. Davies is on course to graduate this Spring and has accepted a critical care registered nurse position at Yale New Haven's Emergency Department. "In this case, there were a couple of us right there who knew what to do. It's important for everyone to learn how to administer CPR when needed,” advised Davies. This article was originally reported by Scrubs Magazine.
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I am doing my preceptorship and we had a code blue on someone else's patient . I did CPR but then noticed my pants got wet from his blood coming out of his IV. He was not contact precautions but he was positive for staph when I looked at his chart. I was wondering if that is common, and if I shouldn't worry. Thank you!
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I am at the point where I can no longer physically provide direct patient care (haven't been able to for several years). I have multiple health conditions that make it all but impossible, however, at only 55 my mind is still sharp and I'd like to look into remote work-case management, utilization review, or technical/medical writing-all of which require an active license. As such, I need to renew my CPR certification. The course isn't an issue but the check off is. I'm not able to get down and kneel on my knees at all. I have RA and currently need both knees and my left hip replaced. I also have difficulty preforming chest compressions as I have CRPS in my upper body (I can do it but it's extremely painful). So how do I renew my CPR? Can I ask for accommodations? I won't be looking for a job where I will actually preform CPR but CPR is a license requirement.
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After the cardiac arrest suffered by Demar Hamlin on Monday night, the NFL made the decision to cancel the Buffalo-Cincinnati game. In a statement Friday by NFL Commissioner Roger Goodell called the incident extraordinary and went on to state, "We saw the collective humanity of the coaches and players on the field Monday night. I cannot enough about Coach McDermott and Coach Taylor who led their teams with sensitivity and compassion. All that mattered was Damar, and the emotional health of the players1. The first indication the game would not continue was the equipment staff preparing to pack up team gear along the sidelines. As I watched the events unfolding with my son and husband, it was the contrast between my reaction watching this and theirs. They stood around like many of the fans with furrowed brows and arms folded while I sat in absolute confusion. I was genuinely surprised the game was cancelled because of this. I was surprised to see these tough men in tears, seemingly paralyzed with fear and sadness from witnessing these traumatic events. I heard a sportscaster describe the CPR given as "aggressive" and thought, is there any other kind? I realized then it was my reaction that was strange. As nurses, we witness and perform CPR as part of our assigned duties. Occasionally, assignments will rearrange as this patient gets upgraded to an ICU bed or requires a 1:1 status or, sadly, expires and requires post-mortem care. In any of these instances, family support is expected in the form of explanations, comforting, and answering questions. Often, due to the nature of the hospital world, the room will need to be turned over quickly for a patient who has waited 10-plus hours for a bed. The idea is the same; the nurse must carry on and move forward in the care of the patient assignment. Most of us, if not all, have found a supply room or a favorite bathroom where we can hide for a few minutes to "gather ourselves" by allowing tears to fall, drying them, having a silent moment to ourselves, and literally (and figuratively) catching our breath. Some of us, including myself, have learned "the art" of choking back the tears and carrying on until we clock out and sit alone in our cars to go home. Is the emotion felt at Monday night's game different for me because I am in scrubs and on the clock? Is this just something we signed up for and part of an expected performance ethic? In a statement to the American Psychological Association, sports psychologist and consultant to the Cleveland Browns, Sam Maniar, PhD stated, "We know that if you don't process these emotions, they are going to fester up and build up and bubble up to the surface in ways we don't want them to2.” What are the implications for nursing and other hospital staff involved in these precious life-and-death moments? The players were not allowed to return to work because the conditions could lead to possible injuries due to the distraction. Is it different because this was a teammate? What about a patient we have cared for and bonded with? Does this fester and bubble up for hospital staff in ways we don't want them to? I have worked for a few systems that offered chaplain services for staff, employee meditation rooms, and some that simply offered it was "just part of the job". Are there best practices for these situations? I am grateful Damar Hamlin appears to be on the mend, and there has been a renewal of interest for the public to learn basic CPR. Though traumatic to witness and perform, this seemingly favorable outcome has highlighted the miracles that occur in healthcare settings daily. References/Resources 1NFL Commissioner Roger Goodell statement on Damar Hamlin, AFC playoffs 2Damar Hamlin's collapse offers mental health lessons in trauma, vulnerability for NFL players and fans
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I don't know if the CPR course I signed up for is legitimate. They claim to give an American Heart Association certification, but their website is [email protected]. After I paid by credit card, they sent an email saying that I also have to sign up and pay for the "separate online element" prior to the skills session that I had already paid for. The skills portion is done by zoom, in a room by myself. The email said there is a no refund/no cancelation policy, and if I cancel, I will never be able to get another certification (I will be placed on a do-not-certify list). When I called the American Heart Association, I was told that they do not recognize this website. I looked into this at 3 am, after a 12-hour shift. The email they first sent me pointed out that I would soon need my CPR certification. When I looked at my CPR card, it showed that it had expired! I panicked. I didn't realize that I simply hadn't put the new one in my wallet. (I outdate in June.) What do you think? Is this legitimate?
