EMS Education - Advisor: Basic Life Support (BLS)

 

The Advisor: Basic Life Support (BLS) program is a specialized certification pathway developed by the AHA for individuals who have successfully completed the cognitive portion of the HeartCode® BLS course but cannot physically perform the motor skills of CPR due to a disability.

Rather than demonstrating the physical actions (like chest compressions or AED pad placement), participants demonstrate competency by advising another person through those steps — showing they fully understand the why, when, and how of BLS.

Purpose & Importance

This program:

• Promotes inclusivity in lifesaving education by recognizing that knowledge is just as critical as physical ability.
• Allows people with physical disabilities to become certified in BLS and empowered to guide and direct others during a real cardiac emergency.
• Increases the number of trained individuals in a given community who can contribute during a medical crisis — even if they aren't able to perform CPR themselves.

Eligibility and Certification

To earn the Advisor: BLS certification card, participants must:

1. Pass the HeartCode® BLS Provider Course cognitive exam (the same as all BLS providers).

Successfully demonstrate their ability to verbally direct another person in performing:

• High-quality CPR
• AED use
• Basic resuscitation team skills

This is assessed by an AHA instructor, who ensures that the candidate can provide accurate, timely, and effective instructions that align with AHA guidelines.

The issued certification card is an Advisor: BLS card, which is distinct from the standard BLS Provider card — but still represents formal AHA-recognized certification.

Who Is It For?

This program is designed for:

• Individuals with physical disabilities that prevent them from completing hands-on CPR testing.
• Candidates who want to contribute to emergency preparedness in workplaces, schools, or communities, even if they cannot perform compressions themselves.

Impact and Accessibility

The Advisor: BLS program aligns with the AHA's commitment to diversity, equity, and inclusion in resuscitation science and training. By expanding the definition of who can be trained and certified, the program:

• Acknowledges the contributions and capabilities of persons with disabilities.
• Increases the total number of CPR-capable bystanders in society — a crucial factor in improving out-of-hospital cardiac arrest outcomes.
• Encourages organizations to embrace broader emergency readiness by including all capable team members.

Learn more about it here: https://newsroom.heart.org/news/new-program-developed-for-persons-with-disabilities-to-advise-others-on-cpr

EMS Basic Life Support - Debunking Common Myths About CPR

Proper education and awareness about the lifesaving practice of CPR are essential. Unfortunately, several widely held misconceptions discourage many people from becoming CPR-certified.

While the following information is not intended to replace the instruction provided in certification courses, it is valuable knowledge that can help dispel myths and encourage more individuals to pursue CPR training.

Myth #1: Only Professionals Can Safely and Effectively Perform CPR

Truth #1: According to the American Heart Association, CPR initiated immediately by a bystander can triple a victim’s chances of survival. Anyone can learn and perform CPR after basic training, making widespread education and certification crucial in improving survival rates.

Myth #2: You Can Learn CPR by Watching an Online Video

Truth #2: While online videos can provide useful information, they should be produced, sponsored, and taught by reputable organizations. More importantly, CPR training includes a critical hands-on component - effective chest compressions - that cannot be mastered through video instruction alone. Proper technique requires in-person training and practice.

Myth #3: You Can Get in Trouble or Injure Someone If You Perform CPR Incorrectly

Truth #3: Good Samaritan laws protect individuals who perform CPR in good faith and without willful misconduct or negligence. The risk of legal consequences is minimal, and the potential harm of not performing CPR far outweighs the risk of performing it incorrectly. Immediate intervention can make the difference between life and death.

Myth #4: You Must Perform Mouth-to-Mouth Breathing When Performing CPR

Truth #4: The idea of providing mouth-to-mouth resuscitation to a stranger may be uncomfortable for some, but hands-only CPR is highly effective. When chest compressions are performed at the correct rate and depth, they help circulate oxygenated blood until emergency responders arrive.

Myth #5: CPR Should Be Performed Only After Calling 911

Truth #5: CPR should begin immediately when a person is unresponsive and not breathing normally. Ideally, one person should call 911 while another starts CPR. Delaying CPR can significantly reduce a victim’s chance of survival. Additionally, victims who exhibit irregular, noisy breathing or gasping may still benefit from immediate chest compressions.

The Importance of CPR Certification

Beyond addressing these common myths, formal CPR training provides in-depth knowledge and hands-on practice to ensure confidence and competence in a real emergency. Becoming CPR-certified is not only an invaluable skill but also a profound act of service to your loved ones, those under your care, and your community.

Recommended CPR Training Providers: 

Bethesda, Wales, UK: Active First Aid

Littleton, Colorado, USA: Colorado Cardiac CPR

International: Crossing Latitudes 

EMS Education - Are You BLS Certified?

Are you a pre-hospital, in-healthcare or care facility professional, then it is likely you are required to maintain certification in Basic Life Support (BLS) through the American Heart Association (AHA). 

However, BLS certification is not just a regulatory requirement to remain in good standing with  an employer, it is a critical asset and an occupational necessity that ensures you can perform your job effectively.

Why is BLS Certification Important?

The knowledge and skills associated with being BLS certified means you are prepared to respond to life-threatening emergencies involving cardiac arrest, respiratory failure, and choking incidents across adult to infant populations.

Also, beyond enhancing your professional skills, BLS certification empowers you to be a valuable resource for your family, community, and the patients you serve.

What Does an AHA BLS Course Cover?

The American Heart Association BLS course covers a wide range of life-saving techniques, including:

• Cardiopulmonary Resuscitation (CPR)
• Safe & Effective Automated External Defibrillator (AED) use.
• Bag-Valve Mask (BVM) Ventilations
• Choking & Airway Obstruction Management
• Rescue Breathing
• And much more!

Who Needs BLS Certification?

All healthcare providers in patient-facing roles - whether in a hospital or pre-hospital setting - are required to hold a valid BLS certification card. 

This includes:

• Emergency Medical Technicians (EMTs)
• Paramedics 
• Registered Nurses (RNs)
• Certified Nursing Assistants (CNAs)
• Medical Doctors (MDs)
• Firefighters & Law Enforcement Officers (LEOs)

Who Should I Train With?

Choosing the right BLS certification course is essential to gaining the confidence and skills needed to respond to life-threatening emergencies. Look for a program that offers small class sizes to maximize hands-on learning and individualized instruction.

Experienced instructors with real-world expertise can provide valuable insights, ensuring that every student leaves feeling fully competent in their abilities.

Investing in quality training means staying certified, staying prepared, and continuing to make a difference in the lives of those you serve.

Conclusion

BLS certification is more than just a credential - it is a vital skill set that can mean the difference between life and death in critical situations.

Whether you are an EMT, nurse, physician, or first responder, staying up to date with your BLS training ensures you are always prepared to act swiftly and effectively when every second counts.

By maintaining your AHA BLS certification, you contribute to a safer workplace, enhance patient outcomes, and reinforce your commitment to providing quality care.

If your certification is nearing expiration or you have yet to obtain it, consider enrolling in a BLS course today. Your knowledge and readiness could save a life.

Recommended CPR Training Providers: 

Bethesda, Wales, UK: Active First Aid

Rawlins, Wyoming, USA: Brian Eveleth, DTAC LLC

Littleton, Colorado, USA: Colorado Cardiac CPR

International: Crossing Latitudes

EMS Research - Chest Decompressions: The Driver of CPR Efficacy

The study aims was to optimize cardiopulmonary resuscitation (CPR) efficacy by investigating the relationship between key CPR metrics: compression rate, depth, and recoil velocity.

The goal was to model the impact of these variables on CPR effectiveness, particularly through their influence on end-tidal carbon dioxide (ETCO2), which is a marker of perfusion.

The study emphasizes the crucial role of chest recoil in CPR effectiveness. The findings suggest that CPR guidelines should prioritize maximum chest recoil to improve hemodynamics and increase the chances of survival during cardiac arrest.

The research advocates for an increased focus on chest recoil in CPR training and guidelines, potentially leading to improved outcomes in cardiac arrest scenarios by enhancing the quality of perfusion during resuscitation efforts.

Further Reading:

Chandran, K., AlgazeGonzalez, I.M., Wang, S., & Davis, D.P. (2024) Chest Decompressions - the Driver of CPR Efficacy: Exploring The Relationship Between Compression Rate, Depth, Recoil Velocity & End-Tidal CO2. Taylor & Francis Online Accessed May 25, 2024

EMS History - The Evolution of CPR

CPR is a lifesaving skill that has been performed on presidents, celebrities and regular people alike. Knowing about CPR, and its associated history, equips individuals with life-saving skills. In emergency situations, performing high-quality CPR could mean the difference between life and death for a loved one, a colleague, or even a stranger.

EMS providers should have a solid understanding of the evolution of cardiopulmonary resuscitation (CPR) as it provides the foundation for their life-saving interventions.

For instance, the term "cardiopulmonary resuscitation" was first coined in 1960, signifying the integration of chest compressions and artificial ventilation to revive individuals in cardiac arrest.

However, documented efforts to revive a person who has suffered a heart attack date back 600 years. That said, it wasn't until the early 20th century that more systematic approaches were developed.

The methods we use today may be considered far more efficient than those originally attempted as far back as the 1500s, such as whipping the patient, rolling them back and forth over a barrel, placing them on a galloping horse, or inflating them with a bellows.

Knowing about the development of CPR is valuable for several reasons:

Historical Context: Learning the history of CPR provides valuable context. It illustrates the progression of medical knowledge and techniques over time, highlighting the importance of scientific advancements in improving healthcare outcomes.

Life-Saving Skills: Understanding CPR and its history equips individuals with life-saving skills. In emergency situations, knowing CPR could mean the difference between life and death for a loved one, a colleague, or even a stranger.

Empowerment: Learning about CPR empowers individuals to take action in emergencies. It gives them the confidence and knowledge to intervene effectively until professional medical help arrives.

Community Resilience: A well-informed community with CPR knowledge contributes to overall community resilience. When more people are trained in CPR, the likelihood of survival from cardiac arrest increases, creating a safer environment for everyone.

As Dr. Peter Safar stated "CPR is the most effective first-aid treatment for sudden cardiac arrest. It buys time until further medical help arrives, increasing the chances of survival” while Dr. Mickey Eisenberg expressed the sentiment that "CPR is the ultimate act of kindness and compassion. It shows that we're willing to step in and help someone in their darkest moment.”

Further Reading:

American Heart Association (ND) History of CPR - Highlights from the 16th Century to the 21st Century. Retrieved from https://cpr.heart.org/en/resources/history-of-cpr

American Heart Association (2022, June 28) ‘Father’ of CPR: Guy Knickerbocker Obituary. Retrieved from https://cprblog.heart.org/2022/06/28/father-of-cpr-guy-knickerbocker-who-helped-pioneer-a-lifesaving-technique-dies-at-89/

American Heart Association (2024, February 15) The Presidential Heart Attack That Changed America. Retrieved from https://www.heart.org/en/news/2024/02/15/the-presidential-heart-attack-that-changed-america

Hazzard, K. (2022) American Sirens. New York: Hachette Books

EMS History - The American Heart Association

The American Heart Association (AHA) was established in 1924 by a group of six cardiologists in response to the growing concern over the lack of research and information about heart disease. At the time of its founding, heart disease was becoming a leading cause of death in the United States, yet there was limited understanding of its causes and prevention methods.

The rationale behind the establishment of the AHA stemmed from the need to address this gap in knowledge and to advocate for increased awareness, research, and education about heart health. The founders recognized the urgent need for a centralized organization dedicated to combating heart disease, promoting cardiovascular research, and disseminating information to both healthcare professionals and the general public.

The AHA's mission focuses on reducing disability and death caused by cardiovascular diseases and stroke. To achieve this mission, the association engages in various activities, including funding research grants, developing guidelines for the treatment and prevention of heart disease and stroke, advocating for public policies that promote heart health, and providing educational resources and programs to communities and healthcare professionals.

Over the years, the AHA has played a crucial role in advancing cardiovascular science and improving public health outcomes. Its initiatives have led to significant advancements in the prevention, diagnosis, and treatment of heart disease and stroke. Through partnerships with medical professionals, policymakers, advocacy groups, and the public, the AHA continues to work towards its goal of building healthier lives, free of cardiovascular diseases and stroke.

Further Reading:

American Heart Association (ND) History of CPR - Highlights from the 16th Century to the 21st Century. Retrieved from https://cpr.heart.org/en/resources/history-of-cpr 

EMS Patient Monitoring - Capnography 3

ETCO2 monitoring is a valuable tool for EMS Providers as it provides real-time information about a patient's respiratory status and overall physiological condition. Here's how ETCO2 is useful for EMS providers:

Ventilation Assessment: ETCO2 levels reflect the adequacy of ventilation. Monitoring ETCO2 helps EMS providers assess whether a patient is effectively eliminating CO2 through ventilation.

Confirmation of Airway Placement: ETCO2 is commonly used to confirm proper placement of an endotracheal tube or other advanced airway devices. A sudden increase in ETCO2 during intubation indicates successful placement within the trachea, whereas low or absent readings may suggest esophageal or misplaced airway.

Circulatory Status Indicator: Changes in ETCO2 levels can provide insight into the patient's circulatory status. A sudden decrease in ETCO2 may indicate reduced cardiac output, potentially signaling cardiac arrest or severe shock.

Monitoring During CPR: ETCO2 monitoring is crucial during cardiopulmonary resuscitation (CPR). A sudden increase in ETCO2 levels during CPR may indicate return of spontaneous circulation (ROSC), while persistently low levels may suggest poor perfusion and the need for intervention.

Detection of Respiratory Distress or Failure: ETCO2 is a sensitive indicator of respiratory distress or failure. A sudden decrease in ETCO2 may signal respiratory compromise, allowing providers to intervene promptly.

Prognostic Tool: Persistent low ETCO2 levels during CPR are associated with a poorer prognosis. Monitoring ETCO2 trends can help providers make informed decisions about the effectiveness of resuscitative efforts.

Guidance During Procedural Sedation: EMS providers can use ETCO2 monitoring to ensure adequate ventilation during procedural sedation. This is particularly important when administering sedatives or analgesics that may depress respiratory function.

Trauma Assessment: In trauma patients, ETCO2 monitoring can aid in identifying respiratory distress due to thoracic injuries or other traumatic conditions.

Early Detection of Respiratory Complications: Monitoring ETCO2 allows for the early detection of respiratory complications, such as hypoventilation or respiratory depression, enabling timely intervention.

Further Reading:

Capnography: Principles and Practice by Michael K. Copeland

Capnography, King of the ABC’s: A Systematic Approach for Paramedics" by Troy Valente

Paramedic Care: Principles & Practice" by Bryan E. Bledsoe, Robert S. Porter, and Richard A. Cherry 

EMS Pediatric Populations - Pediatric Emergencies

EMS providers should have knowledge and skills to effectively manage pediatric emergencies.

Here are some key points they should know:

1. Pediatric Assessment: Understanding the differences in anatomy, physiology, and vital signs between adults and children is crucial. Providers should be skilled in performing a thorough pediatric assessment, including assessing airway, breathing, circulation, disability, and exposure (ABCDE).

2. Airway Management: Pediatric airways are smaller and more easily obstructed than adult airways. Providers should be proficient in managing pediatric airway emergencies, including using appropriate airway adjuncts and techniques such as bag-mask ventilation and endotracheal intubation.

3. Respiratory Distress: Common respiratory emergencies in children include asthma, bronchiolitis, and croup. Providers should be familiar with respiratory assessment, oxygen therapy, and administering nebulized medications.

4. Cardiac Arrest and CPR: Pediatric cardiac arrest requires prompt recognition and intervention. Providers must be skilled in pediatric cardiopulmonary resuscitation (CPR), including chest compressions, ventilation, and the use of automated external defibrillators (AEDs).

5. Fever and Sepsis: Fever is a common presentation in pediatric patients. EMS providers should recognize signs of serious bacterial infections, sepsis, and know how to provide appropriate supportive care during transport.

6. Allergic Reactions: Anaphylaxis and severe allergic reactions can be life-threatening. Providers should be trained in recognizing and managing allergic emergencies, including the administration of epinephrine.

7. Trauma: Pediatric trauma may present differently than adult trauma. Providers should know how to assess and manage common pediatric injuries, including fractures, head injuries, and burns. They should also consider the psychological needs of the child and provide age-appropriate support.

8. Seizures: Seizures can occur in children due to various causes. Providers should be familiar with seizure recognition, seizure management, and appropriate administration of anti-seizure medications.

9. Dehydration: Children are more prone to dehydration due to their smaller fluid reserves. Providers should be able to assess and manage pediatric patients with suspected dehydration, including fluid resuscitation if necessary.

10. Communication and Psychological Support: Effective communication with both the child and their parents or caregivers is vital. Providers should use age-appropriate language, provide reassurance, and involve parents or caregivers in the decision-making process.

These are general considerations, and ongoing training and education in pediatric emergency care are essential for EMS providers to ensure optimal care for children in emergencies.

Resuscitation In A Time Of COVID-19

A new infographic by the American Heart Association outlines key considerations regarding resuscitation administered by healthcare providers who are treating suspected or confirmed COVID-19 patients.

#AmericanHeartAssociation ##HealthCareProviders #CPR #COVID19 #DuringATimeOfPlague

Training In A Time Of COVID-19

@NREMT @NAEMT #EMS #EMR 

#LifeIsPrecious #COVID19 #DuringATimeOfPlague

NOLS Wilderness First Responder

 

Wilderness first responder training courses focus on teaching the students to assess a situation, improvise solutions using available resources to stabilize the patient and identify the best way to get the patient to definitive medical treatment.

Go to: www.nols.edu

#WildernessMedicine #WildernessFirstResponder #CPR

AHA Stay Safe In The Water Campaign

Drowning is the third-leading cause of unintentional injury death worldwide, accounting for 7 percent of all injury-related deaths, according to the World Health Organization. The agency estimates there are 360,000 annual drowning deaths worldwide.

Go to: American Heart Association

AHA Basic Life Support (CPR and AED) Provider

Basic Life Support, or BLS, generally refers to the type of care that first-responders, healthcare providers and public safety professionals provide to anyone who is experiencing cardiac arrest, respiratory distress or an obstructed airway.

Go to: American Heart Association