2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients with Syncope

Check out the link below to read more on the new 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society!

AHA Logo

http://circ.ahajournals.org/content/early/2017/03/09/CIR.0000000000000499

Tired of wasting time in ER waiting rooms?

Value added wait time is a big focus for our patients, they want to get back home ASAP and stop being a patient.  This study from the Annals of Emergency Medicine looks at the effects of waiting room work-ups.  Pretty intuitive…they work!

Initiating Diagnostic Studies on Patients c AP in the Waiting Room Decreases Time Spent in an ED Bed (and Total ED LOS): A RCT

Begaz T, et al. Ann Emerg Med. 2017 Mar;69(3):298-307.

STUDY OBJECTIVE: The effect of clinician screening of patients in the emergency department (ED) waiting room is unclear. This study aims to determine the effect of initiating laboratory and imaging studies from the ED waiting room on time in a bed, total ED time, and likelihood of patients leaving before completion of service.

METHODS: This was a prospective, randomized, controlled trial evaluating 1,659 nonpregnant adults with a chief complaint of abdominal pain, conducted in a public hospital ED when all ED beds were occupied and patients were in the waiting room awaiting definitive evaluation. After a brief screening examination, stable patients were randomized to either rapid medical evaluation (RME)+waiting room diagnostic testing (WRDT) or RME-only groups. Patients randomized to the RME+WRDT group had laboratory and imaging studies ordered at the discretion of the screening provider while in the waiting room. The primary outcome was time in an ED bed. Secondary outcomes were total ED time and rate of leaving before completion of service. Linear and logistic regression models were used to compare outcomes between groups.

RESULTS: Between July 2014 and May 2015, 1,659 patients completed the study, 848 patients in the RME+WRDT group and 811 in the RME-only group. Baseline demographic characteristics were similar between groups. Patients in the RME+WRDT group had a significantly shorter mean time in an ED bed than the RME-only group, 245 minutes compared with 277 minutes (adjusted difference of 31 minutes; 95% confidence interval [CI] 16 to 46 minutes). The RME+WRDT group also had significantly shorter mean total ED time from arrival to disposition than the RME-only group, 460 minutes compared with 504 minutes (adjusted difference 42 minutes; 95% CI 22 to 63 minutes). Of the 1,659 patients enrolled, 181 left before completion of service: 78 of 848 patients (9%) in the RME+WRDT group compared with 103 of 811 (13%) in the RME-only group (difference 3.5%; 95% CI 0.5% to 6.5%). By the end of their ED visit, patients in the RME+WRDT group had significantly more types of diagnostic studies ordered than those in the RME-only group, 2.59 versus 2.03 total unique test categories by location ordered (difference 0.56; 95% CI 0.44 to 0.68).

CONCLUSION: Initiating diagnostic testing in the waiting room reduced time spent in an ED bed, total ED time, and rates of leaving before completion of service. For clinicians screening patients in the waiting room, initiating diagnostic evaluations may improve throughput in crowded EDs.

 

https://drvinsonlitbits.blogspot.com/

Management of Sepsis and Septic Shock: JAMA Clinical Guidelines Synopsis Howell MD, et al. JAMA 2017 Jan 19

This article serves as a counterpoint to my previous post calling into question current dogma around evidence based sepsis protocols.

http://jamanetwork.com/journals/jama/article-abstract/2598892

Food For Thought “Six myths promoted by the new surviving sepsis guidelines”

I will admit to having been on the Rivers train (EGDT) and many subsequent iterations related to protocolized sepsis therapy for over a decade.  This article by Josh Farkas does a good job of summarizing some different perspectives on the current state of evidence bases sepsis therapy.  What it doesn’t address is how protocolized sepsis therapy helps to create a shared mental model across disciplines which, I would argue may often be as important as individualized therapies with regard to patient outcomes.

https://emcrit.org/pulmcrit/sepsis-myths/

Advanced Cardiovascular Life Support (ACLS) – Renewal Certification on Wed 8/31/2016 from 9:30 AM to 4:30 PM

Audience /Overview

ACLS is designed to provide healthcare professionals the ability to participate in the management of cardiopulmonary arrest and other cardiovascular emergencies. It emphasizes the importance of BLS to patient survival, the integration of effective BLS with ACLS interventions, and the importance of effective team interaction and communication.

 

Prerequisites

  • Must have a current/non-expired ACLS card
  • What to do BEFORE class:

    Every student is required to take the Precourse Self Assessment Evaluation and review the 2015 ACLS Provider Manual before attending class.

    1. Visit heart.org/eccstudent

    2. Enter manual code: “acls15″ to begin

    3. Re-take this Precourse Self Assessment Evaluation until you receive an 84%

    4. Print and bring your score to class

 

Course Content

  • Key changes in ACLS from the new 2015 AHA Guidelines
  • Basic life support skills, including effective chest compressions, use of a bag-mask device and use of an (AED)
  • Recognition and early management of respiratory and cardiac arrest
  • Recognition and early management of peri-arrest conditions such as symptomatic bradycardia
  • Airway management
  • Related pharmacology
  • Management of acute coronary syndromes (ACS) and stroke
  • Effective communication as a member and leader of a resuscitation team
  • Effective Resuscitation Team Dynamics

 

Course Format

ACLS Renewal Course: 7 hours over 1 day, time for breaks and lunch included

*course time based on 1 instructor: 8 students: 2 manikins

 

Features

  • Course uses learning stations for practice of essential skills and simulated clinical scenarios that encourage active participation
  • Hands-on class format reinforces skills proficiency
  • Classroom-based works well for learners who prefer group interaction and instructor feedback while learning skills

 

Course Completion Card and Continuing Education

American Heart Association ACLS Provider Course Completion Card, valid for two years.

Board of Registered Nursing Provider approved for 7 CE’s

EMS CE’s available and may vary by license type

 

Textbook Requirement

2015 ACLS Provider Manual

ISBN #: 978-1-61669-400-5

 

You are required to have the current textbook for this course. If you already own one or have access to one before, during, and after the class, you do not need to purchase one here. Please choose from the following optional items:

Pediatric Advanced Life Support (PALS) – Renewal Certification on Tue 8/30/2016 from 9:30 AM to 4:30 PM

Audience

The PALS Course is designed to provide healthcare providers a refresher on their ability to respond to emergencies for infants and children. Providers will enhance their skills in the treatment of the child victim of a cardiac arrest or other cardiopulmonary emergencies. PALS is based on simulated clinical scenarios that encourage active, hands-on participation through individual and team learning stations.

 

Prerequisites

  • Must have a current/non-expired PALS card otherwise you will not be admitted into class.
  • What to do BEFORE class:Every student is required to take the Precourse Self Assessment Evaluation and review the 2010 PALS Provider Manual before attending class.

    1. Visit heart.org/eccstudent

    2. Enter manual code: “PALS” to begin

    3. Re-take this Precourse Self Assessment Evaluation until you receive an 84%

Course Content

  • Key changes in PALS from the new 2010 AHA
  • 1- and 2-rescuer child CPR and AED use
  • 1- and 2-rescuer infant CPR
  • Management of respiratory emergencies
  • Rhythm disturbances and electrical therapy
  • Vascular access
  • Resuscitation team concept
  • Cardiac, respiratory and shock case discussions and simulations
  • Systematic Approach to Pediatric Assessment

 

Class Format

PALS Renewal Course: 7 hours over 1 day, time for breaks and lunch included

 

Features

  •  Course uses learning stations for practice of essential skills and simulated clinical scenarios that encourage active participation
  • Hands-on class format reinforces skills proficiency
  • Classroom-based works well for learners who prefer group interaction and instructor feedback while learning skills
  • Co-branded with the American Academy of Pediatrics (AAP)

 

Certification

American Heart Association PALS Provider Course Completion Card, valid for two years

PALS Renewal: 7 CEU credits

 

Textbook Requirement

2010 PALS Provider Manual

1616691123

You are required to have the current textbook for this course. If you already own one or have access to one before, during, and after the class, you do not need to purchase one here. Please choose from the following optional items:

Advanced Cardiovascular Life Support (ACLS) – Renewal Certification on Sat 8/27/2016 from 9:30 AM to 4:30 PM

Audience /Overview

ACLS is designed to provide healthcare professionals the ability to participate in the management of cardiopulmonary arrest and other cardiovascular emergencies. It emphasizes the importance of BLS to patient survival, the integration of effective BLS with ACLS interventions, and the importance of effective team interaction and communication.

 

Prerequisites

  • Must have a current/non-expired ACLS card
  • What to do BEFORE class:

    Every student is required to take the Precourse Self Assessment Evaluation and review the 2015 ACLS Provider Manual before attending class.

    1. Visit heart.org/eccstudent

    2. Enter manual code: “acls15″ to begin

    3. Re-take this Precourse Self Assessment Evaluation until you receive an 84%

    4. Print and bring your score to class

 

Course Content

  • Key changes in ACLS from the new 2015 AHA Guidelines
  • Basic life support skills, including effective chest compressions, use of a bag-mask device and use of an (AED)
  • Recognition and early management of respiratory and cardiac arrest
  • Recognition and early management of peri-arrest conditions such as symptomatic bradycardia
  • Airway management
  • Related pharmacology
  • Management of acute coronary syndromes (ACS) and stroke
  • Effective communication as a member and leader of a resuscitation team
  • Effective Resuscitation Team Dynamics

 

Course Format

ACLS Renewal Course: 7 hours over 1 day, time for breaks and lunch included

*course time based on 1 instructor: 8 students: 2 manikins

 

Features

  • Course uses learning stations for practice of essential skills and simulated clinical scenarios that encourage active participation
  • Hands-on class format reinforces skills proficiency
  • Classroom-based works well for learners who prefer group interaction and instructor feedback while learning skills

 

Course Completion Card and Continuing Education

American Heart Association ACLS Provider Course Completion Card, valid for two years.

Board of Registered Nursing Provider approved for 7 CE’s

EMS CE’s available and may vary by license type

 

Textbook Requirement

2015 ACLS Provider Manual

ISBN #: 978-1-61669-400-5

 

You are required to have the current textbook for this course. If you already own one or have access to one before, during, and after the class, you do not need to purchase one here. Please choose from the following optional items:

Advanced Cardiovascular Life Support (ACLS) – Initial Certification on Thu 8/25/2016 from 9:30 AM to 4:30 PM This class also meets on: Fri 8/26/16 from 9:30a to 4:30p

Audience /Overview

American Heart Association ACLS for healthcare providers includes management of Bradycardia, Tachycardia, and Pulseless arrest using 2015 AHA Advanced Cardiovascular Life Support guidelines as well as Stroke and Heart Attack, ACS.

 

What to do BEFORE class:

Every student is required to take the Precourse Self Assessment Evaluation and review the 2015 ACLS Provider Manual before attending class.

1. Visit heart.org/eccstudent

2. Enter manual code: “acls15″ to begin

3. Re-take this Precourse Self Assessment Evaluation until you receive an 84%

4. Print and bring your score to class

 

Course Content

  • Key changes in ACLS from the new 2015 AHA Guidelines
  • Basic life support skills, including effective chest compressions, use of a bag-mask device and use of an (AED)
  • Recognition and early management of respiratory and cardiac arrest
  • Recognition and early management of peri-arrest conditions such as symptomatic bradycardia
  • Airway management
  • Related pharmacology
  • Management of acute coronary syndromes (ACS) and stroke
  • Effective communication as a member and leader of a resuscitation team
  • Effective Resuscitation Team Dynamics

 

Course Format

  • ACLS Initial Course: 16 hours over 2 days, with time for breaks and lunch.

*course time based on 1 instructor: 8 students: 2 manikins

 

Features

  • Course uses learning stations for practice of essential skills and simulated clinical scenarios that encourage active participation
  • Hands-on class format reinforces skills proficiency
  • Classroom-based works well for learners who prefer group interaction and instructor feedback while learning skills

 

Course Completion Card

American Heart Association ACLS Provider Course Completion Card, valid for two years and 14 CE credits

 

Textbook Requirement
2015 ACLS Provider Manual

ISBN #: 978-1-61669-400-5

You are required to have the current textbook for this course. If you already own one or have access to one before, during, and after the class, you do not need to purchase one here. Please choose from the following optional items:

Basic ECG Interpretation & Pharmacology on Tue 8/23/2016 from 9:30 AM to 4:30 PM

Audience /Overview

Basic ECG Interpretation & Pharmacology is designed to provide healthcare professionals the ability to interpret basic ECGs (electrocardiograms) and recognize myocardial infarction (MI) and Pharmacology. Students will increase their confidence in interpretation and practice through this course.

 

Course Content

  • Anatomy, Electrophysiology and Action Potential
  • Vectors and Hexaxial System
  • Rate and Rhythm Recognition (SVT, Heart Blocks, WPW, Torsades, etc.)
  • Bundle Branches Blocks and Hypertrophy (LAE, RAE, LVH)
  • Acute Myocardial Infarction

 

Course Format

7 hours over 1 day, time for breaks and lunch included.

 

Features

  • Practice in various case scenarios reinforces skills proficiency
  • Classroom-based works well for learners who prefer group interaction and instructor feedback while learning skills

 

Course Completion Certificates

  • American Heart Association ECG & Pharmacology Course Completion Certificate
  • EMS CEU’s are available and vary by license type/state

 

Textbook

  • A lecture manual will be handed out at the beginning of class to each student at no additional charge
  • Optional workbook: AHA ECG & Pharmacology Student Workbook (for additional practice but not required, available for purchase during check out)
No textbook is required, you will received a lecture manual at no additional charge on the day of class. For added practice, you may purchase the optional student workbook.

Pediatric Advanced Life Support (PALS) – Initial Certification on Mon 8/22/2016 from 9:30 AM to 4:30 PM This class also meets on: Tue 8/23/16 from 9:30a to 4:30p

Audience

The PALS Course is designed to provide healthcare providers the ability to respond to emergencies for infants and children. Providers will enhance their skills in the treatment of the child victim of a cardiac arrest or other cardiopulmonary emergencies. PALS is based on simulated clinical scenarios that encourage active, hands-on participation through individual and team learning stations.

 

What to do BEFORE class:

Every student is required to take the Precourse Self Assessment Evaluation and review the 2010 PALS Provider Manual before attending class.

1. Visit heart.org/eccstudent

2. Enter manual code: “PALS” to begin

3. Re-take this Precourse Self Assessment Evaluation until you receive an 84%

 

Course Content

  • Key changes in PALS from the new 2010 AHA
  • 1- and 2-rescuer child CPR and AED use
  • 1- and 2-rescuer infant CPR
  • Management of respiratory emergencies
  • Rhythm disturbances and electrical therapy
  • Vascular access
  • Resuscitation team concept
  • Cardiac, respiratory and shock case discussions and simulations
  • Systematic Approach to Pediatric Assessment

 

Class Format

PALS Initial Course: 14 hours over 2 days, plus additional time for breaks and lunch.

 

Features

  • Course uses learning stations for practice of essential skills and simulated clinical scenarios that encourage active participation
  • Hands-on class format reinforces skills proficiency
  • Classroom-based works well for learners who prefer group interaction and instructor feedback while learning skills
  • Co-branded with the American Academy of Pediatrics (AAP)

 

Certification

American Heart Association PALS Provider Course Completion Card, valid for two years.

PALS Initial: 14 CEU credits

 

Textbook Requirement

2010 PALS Provider Manual

1616691123

You are required to have the current textbook for this course. If you already own one or have access to one before, during, and after the class, you do not need to purchase one here. Please choose from the following optional items: