ACLS and PALS

Not much has been going on at work since my last post. I mostly sit in my office, working on one thing or another for the medics, taking care of people's stubbed toes, and getting annoyed when things happen without people telling me (which is often).

This past week, however, I've gotten a change of pace and scenery. I've gotten to spend a few days at Rescue Training, Inc, where 10 of our medics are currently in a six month paramedic course. This is the second group we've put through this training; we're pretty happy with the results.

Our first group of graduating medics

The medics currently enrolled are about to start their clinical training (time in the ambulance, time in ERs, etc). Before they can do that, they need to pass Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS). Since my ACLS expired in July and I've never done PALS, I decided to join them. 

ACLS was one day, which included reviewing cardiac rhythms (squiggly lines), reviewing various drugs, and memorizing algorithms. It was all sorts of not fun. 

Not a picture from our group, but practicing intubations is part of ACLS

One of the many algorithms that was memorized

PALS is pretty much the same as ACLS, but for children. The biggest difference here is that everything in pediatrics is weight-based dosing (because an infant doesn't need as much medication as a teenager). That means that instead of memorizing things such as, "give 3 mg of epinephrine," it turns into, "the dose of epinephrine is 0.01 mg/kg, for this 20 kg child, give 0.2 mg epinephrine."

The other big difference with PALS is that with children, the heart usually only fails because of respiratory problems. This actually makes things easier--in most cases, if you give oxygen, things usually improve pretty quickly. All algorithms for PALS start with "supplemental oxygen/assist respirations".

Ventilating a baby during PALS

I passed both ACLS and PALS (yay), which meant passing the mock code situations as well as the written test. It also means that it's two years until I have to even think about taking either again. And since neither is a requirement to be a preventive medicine physician in the Army, I might not. We'll see in 2015.