Let me preface this essay with a cliché but realistic revelation about using ACLS and BLS skills in an emergency. Forget what you saw on TV shows like The resident, House, or Gray’s anatomy, it isn’t some dramatic show where intense music is playing and once you are finished everything fades to black and everything is ok. Suffice it to say, it is a physically, mentally, and emotionally draining experience to be performing life saving measures on an individual and not something that should be taken lightly or haphazardly. There are steps that should be taken before having to engage in a situation where someone’s life could potentially hang in the balance that I believe are crucial to being prepared for when that times come.
We as humans sometimes do not have the capacity for rogue memorization. That is to say that some people do not remember the exact calculation of medication that needs to be administered over this time or the exact number of seconds one must wait between respirations in a cardiac arrest. Like many generals and coaches do before battle as well as before the big game, preparation and reviewing of protocols is paramount in being the best provider you can when the time comes. Studying and brushing up on skills, techniques, as well as information increases the likelihood of not being caught off guard. Although, let’s say as a new student in medicine disaster strikes, someone passes out and no pulse can be felt. What do you do? First things first, relax. I know, I know that dreaded “R” word, yuck, but being of calm mind and focusing on the task ahead is much more beneficial to the outcome of the patient than freaking out and not focusing. Another point of consideration, in this age of marvel movies, D.C movies where everyone wants to be a hero and everyone wants to save the day, that’s not the philosophy one should adopt in these sorts of situations. “Being the hero” and not realizing where your knowledge is at an impasse may be more detrimental to your patient then asking for help. In EMS, a tiered system of jobs and responsibilities are assigned to everyone on the scene of a cardiac arrest. Everyone is of vital importance from the scribe who writes down medication times and times of interventions to the paramedic who acts as the conductor of the symphony to bring about the best outcome for the patient. There are no big I and little u, each person has a role and does not overstep their scope of practice because of a false sense of pride and nobility. The patient is who is important so as a new provider and student of medicine its important to also know to put your pride aside and recognize that the emergency system is a kin to a piano,one key does not make a song and each note has its place.
So, you as the student have mentally accepted the role of learning to be a great provider. Fantastic, now the physicality of the job is another point in of itself. Physically I would say that cardio is probably going to be your best friend. I know, I know cardio is no Bueno to a lot of these fitness gurus out their but consider this situation. You are alone and someone falls and goes into cardiac arrest. You are going to be doing compressions by yourself until help arrives. In ACLS as well as BLS CPR the general rule is 2 mins of compression and a change in provider to stop fatigue. You have no change of provider, its just you. For most lay people one minute of straight compressions is a taxing ordeal. Muscles ache, arms begin to burn, and the mental stress begins to affect your physical stature. It is important to be physically fit and to maintain a good diet as well as stay away from harmful activities such as smoking, drugs, excessive amounts of alcohol, and binge eating. You want to be the best provider you can and taking care of your self is number one in being able to care for others.
ACLS, BLS, PALS, ITLS are the benchmark courses which help us grow as providers in emergency medicine. Covering a wide array of topics from cardiac to trauma they are important tools to help providers in emergency situations obtain the most optimum outcome. It is important that we take these classes seriously and take care of ourselves as well. Now as for myself, my end goal is to become a nurse practitioner and the tactics and advice that I outlined, I will be adhering to during my studies. To be the best provider for others I believe fervently that one needs to be the best version of themselves and at the end of the day realize that it may not be my emergency at that time but my patient is important and deserves the best me I can be.