!44: New Aed Pads: November 2011

Tuesday, November 29, 2011

Hardening and Narrowing of the Arteries

!±8± Hardening and Narrowing of the Arteries

Hardening and narrowing is a common condition affecting millions of Americans. Perhaps you are one of them? And even if you aren't, there is a good chance that you will be impacted, at least to some degree, at some point in your life. In this article delving into hardening and narrowing of the arteries we will briefly walk through some of the nuances of this condition, ultimately arriving at the a number of the most often mentioned causes.

Hardening and narrowing of the arties is more commonly known as arthrosclerosis, a condition which the arteries carrying blood from the heart to other parts of the body becomes narrowed due to plaque deposits. As an artery, or arteries, slowly start to close pressure is put on the heart to pump harder and faster to accomplish the same amount of work. Despite the body's best effort oxygen and blood supply will slowly start to dwindle leaving such areas as the eyes, brain, stomach, kidneys, and legs with a shortage of blood and oxygen. Additional pressure on the heart combined with limited blood and oxygen flow to important areas of the body opens the door for myriad of symptoms, conditions, and diseases including heart attack and stroke. According to American Heart Association 75% of heart attack deaths are linked to hardening and narrowing of the arteries.

What about symptoms?

There is a very good chance that in its earliest stages atherosclerosis will produce no symptoms at all. And if a few do occur they will be attributed to the aging process or working too many hours. This is one of the real dangers of the disease, putting people silently on the road to immanent disaster silently long before a serious heart attack or stroke occurs. And one interesting fact along these lines according to the Center for Disease Control is that almost half of heart attack victims fail to make it to the hospital before dying.

But as the grim reaper of hardening and narrowing of the arteries comes closer symptoms often will start to appear relatively often and become quite noticeable. The most common of these are chest pain, shortness of breath, sweating, anxiety, and fluid accumulation around the ankles and/or in the lungs (edema).

If the carotid or vertebral arteries supplying the brain has begun to narrow a person may notice speech problems, weakness, difficulty swallowing, blindness, and in advanced cases partial paralysis.

Does cholesterol play a role in hardening and narrowing of the arteries?

There are a number of different factors that play a role in hardening and narrowing of the arteries with cholesterol being one the most important. The reason is cholesterol is the primary building block for artery plaque. For this reason the American Heart Association warns that a diet consisting of more than 10 percent cholesterol laden saturated fat may put a person at risk, with a diet consisting of more than 30 percent total fat also presenting risks to heart and artery health. Warnings such as these have lead many people to seek out help for controlling dangerous high cholesterol through either prescription medications (statins) or natural cholesterol reduction supplements.

Other factors that have been shown to contribute to hardening and narrowing of the arteries are inactivity, obesity, cigarette smoking, high blood pressure, diabetes, genetics, age, and race.

Hardening and Narrowing of the Arteries

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Saturday, November 26, 2011

A Defibrillator Circuit Shocks the Heart

!±8± A Defibrillator Circuit Shocks the Heart

Automated defibrillators save lives and the defibrillator circuit provides the needed energy to do so. Defibrillators shock the heart back into a normal heart rhythm after a disruption such as cardiac arrest. Research shows that in order to best save lives, a unit has to provide a shock fast, at the proper dose, and adjust to changing obstacles.

In a portable automated defibrillator, such as those used in schools and other businesses, the source of electricity for the shock is a battery. But in order to transfer that energy to a patient in a beneficial waveform, a defibrillator circuit needs to operate. The waveform can be thought of a changing pattern in the current, so that a correct dose is administered throughout the shock and despite any impedance that the shock encounters.

The circuitry in the defibrillator connects the charge between the battery and the patient's chest. The current flows through the defibrillator pads to shock the heart. People often think that a person's body weight increases impedance to the current, creating a situation where more electricity is needed to provide a correct and consistent shock to the heart. However, research has not backed this up. The American Heart Association states that there is no evidence of a relationship between body weight and impedance.

Many defibrillators are now using a biphasic waveform rather than the older monophasic waveform. In a biphasic defibrillator, the circuit sends an electrical current that follows from paddle to paddle in both directions. With monophasic waveforms, the current went only from one paddle to the other, but it did not return in the other direction. Research has shown that biphasic waveforms are more effective.

Patients with an implanted defibrillator do need to be cautious if they receive radiation therapy. The radiation can potentially damage the defibrillator circuit, but this can be prevented if the area is shielded or moved to another area. In general, today's models are not effected by interference from other sources, like microwaves.

A defibrillator circuit is an important part of the defibrillator. Without the circuit, the defibrillator would not be able to deliver a therapeutic dose of electricity to the heart. Thus, it could be said that the defibrillator circuit is the reason lives are saved by shocks to the heart.

A Defibrillator Circuit Shocks the Heart

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Thursday, November 24, 2011

10 Hot Tips for Passing the AHA PALS Exam the First Time

!±8± 10 Hot Tips for Passing the AHA PALS Exam the First Time

Here is a guide to help you improve your chances of passing the AHA - American Heart Association certification exam for PALS - Pediatric Advanced Life Support. If you take the advice given here seriously, you will do very well on the exam. But you must allow yourself plenty of time to learn all of this material - especially if you are new to this.

1. Study and memorize the Zombie Notes study guides

The Zombie notes focus on information from the literature, test questions and the real life everyday situations - information you need to provide safe care during a pediatric emergency. As you read the study guide, try to memorize the medications and their doses. You must memorize and understand the algorithms; the arrhythmias and in which situations the medications and treatments may be required. Memorizing the algorithms and drug doses is the most difficult part. Repeating the information over and over, and even saying it out loud really helps with the memorization. Once the hard part is memorized, you can start using critical thinking in adjusting treatments based on patient symptoms. The Zombie notes helps you study the 'need to knows' and it is easy to take with you to study in your spare time.

2. Read and study the AHA-PALS Certification Manual

The American Heart Association (AHA) PALS Certification Manual may be distributed by the instructor. The AHA provider manual comes with a DVD and cards to assist the learner learn and apply their knowledge and skills. The textbook is filled with information of topics around assessing and treatment of critical situations, shock states, airway management, treatments and pharmacological modalities.

3. Understand basic EKGs

Any critically ill patient of any age may have their heart rate and rhythm affected. Trauma, medications, dehydration, and heredity all play a part in a patient's arrhythmia. It is the practitioner's role to recognize potential cardiac changes and treat appropriately. Knowing the difference in synchronized and unsynchronized cardioversion (shock) is important. YOU MUST be able to recognize the lethal arrhythmias in the pediatric patient: bradycardia - 4 heart-blocks; ventricular fibrillation; ventricular tachycardia; pulseless electrical activity (PEA); asystole. Other important rhythms to know are: sinus tachycardia; supraventricular tachycardia (SVT).

4. Watch YouTube videos on EKG and other PALS/ACLS topics

The YouTube videos can teach you and remind you of the topics you are studying and clarify any questions you may have had. You can always contact Michele if you have any questions.

5. Take practice tests over and over until you get them all correct

Practice tests can reinforce what you know and help you find the areas you need to focus your studies.

6. Take a BCLS course and be sure you can perform high-quality-CPR at the class

The prerequisite to any American Heart Association Certification Course is the ability to perform BCLS skills. The instructor may ask you for your valid AHA certification card. During the PALS course you will have to perform in practice and testing sessions. Some of the BCLS skills will include: Chest compressions for neonates, infants, small children and large children (including the two-thumb technique); ventilations using a bag-mask-valve (Ambu bag); the AED and appropriate age-group pads.

7. Review all the PALS medications and their doses (oxygen, epinephrine, amiodarone, adenosine, atropine, and procainamide, etc.)

These medications are used throughout the PALS program. Oxygen, fluids, epinephrine and amiodarone are used the most. Infusions that one needs to be familiar with are dopamine, levophed, magnesium, and dobutamine.

8. Read about different diagnosis (dehydration, epiglottitis, croup, septic and cardiogenic shock, trauma, etc.)

Knowing the common diagnosis and the common treatments will ready you for the practice scenarios and testing mega codes.

9. Be prepared to work in a team setting and be able to participate verbally with hands on participation

You may be assigned to a different role in the mega code. You may be practicing skills that your scope of practice does not allow in the work place. The skills allowed in the classroom, allows you to see how we can help each other in an emergency situation. Feel free to speak up when the instructor allows teamwork. Also be prepared to run a mega code as the team leader as well.

10. Participate in class, and ask and answer lots of questions

Speaking up and asking many questions helps you understand and will facilitate your classrooms ask more detailed questions as well.