ACLS and running a code

[shammah98]

hey y'all!
so I decided to stop lurking and post one. having a section dedicated to residencies took away any last excuse i had I guess
so i just finished my ACLS cert, i know all GPRs have to do this, but do other residencies/post grad pgms have to do this as well? do u do it with the physicians (very intimidating, seeing as most of us have never read EKGs before or heard of those drugs) or is it in house.
u know of any dentists who've actually run a code in a hospital or elsewhere?
enjoy..

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[UConn_SDM]

(very intimidating, seeing as most of us have never read EKGs before or heard of those drugs)

You should have. I'm not proficient in reading EKGs but besides the basics like tachycardia, bradycardia, etc. I can still look at an EKG and tell you if the patient has A-fib, right bundle branch block, left bundle branch block, WPW, or Torsade de pointes. Probably a few more if I sat for 5 mins to really think about it.

We spent so much time on this in the basic medical sciences and if every GPR program requires ACLS, and ACLS requires you to know how to read basic EKGs, then this should be part of every dental school curriculum.

 

[shammah98]

We spent so much time on this in the basic medical sciences and if every GPR program requires ACLS, and ACLS requires you to know how to read basic EKGs, then this should be part of every dental school curriculum.[/QUOTE]

I agree, it should be part of the curriculum. unfortunately its not. dont u guys spend ur first 2 years at Conn with the med stduents? if u did then it pays off. thats why i decided to do a GPR, to get more medical/hospital exposure. seeing as, after physicians, we're probably next in line in terms of chances of having to manage a medical emergency, i think its a good thing. mo st dental schools dont see it this way though, i think

 

[UConn_SDM]

dont u guys spend ur first 2 years at Conn with the med stduents?

Yep, and that where I really learned a lot of it but we also covered it at various times in our oral medicine classes. I know we do more than most schools on some topics but I thought this would've been something covered at least a little.

Light bulb moment Maybe the last 4 years haven't solely been torture for tortures sake. Maybe they actually abused us like that for our own good.

Suddenly I feel much better about my ulcer and hypertension.

 

[UConn_SDM]

u know of any dentists who've actually run a code in a hospital or elsewhere?

Hey can happen anytime and anywhere and until someone else gets there you're calling the shots. I'm sure it happens in offices and in clinics.

I personally know of at least 5 stories (told to me by people who directly now these dentists) of dentists having patients die in their offices - everything from MI in an otherwise healthy appearing 41 year old to anaphylactic shock in a patient who had been given Penicillin routinely her entire life - died at 43.

Point is sometimes it just happens - all you can do is be as prepared as possible and give your patient the best shot at survival.

 

[shammah98]

Hey can happen anytime and anywhere and until someone else gets there you're calling the shots. I'm sure it happens in offices and in clinics.

I personally know of at least 5 stories (told to me by people who directly now these dentists) of dentists having patients die in their offices - everything from MI in an otherwise healthy appearing 41 year old to anaphylactic shock in a patient who had been given Penicillin routinely her entire life - died at 43.

Point is sometimes it just happens - all you can do is be as prepared as possible and give your patient the best shot at survival.

true dat

 

[TucsonDDS]

I took care of (I am currently an RN but only 9 shifts to go before dental school) an elderly man who passed out in his dentists office. He had a nasty lac on his head that needed about 10 staples, apparently he bleed all over the place. The dentist even came in to see him while he was in the hospital.

As far as manageing a code and ACLS training, all you will need to know when it comes to ECG rhythms is a basic 3 lead, and then you only need to know 4 things, is it too fast, too slow, sustainable with life and do they have a pulse. You will never need to know what a bundle branch looks like or WPW. If you have time to get a 12 lead then the patient obviously isn't dead yet and therefore you would have plenty of time to get a medical doctor in there. I feel that having ACLS is very important because although you most likely won't be the most experienced person there you at least might have some clue as to is happening and you might not get in the way.

 

[USC2003]

Those who will most likely see the most codes are the OMFS residents. I have personally been in on numerous codes on each of my rotations (Medicine, Cardiology, Anesthesia, ICU, Gen Sx, Neuro Sx). Knowing what to do is the first step and that is where ACLS is important. Actually running a code on a patient comes with experience. The more you see the more comfortable you become. In the hospital setting there are plenty of people who show up for codes. If you're by yourself in an office setting your goal is to keep them alive until EMS arrives and they can be taken to the hospital. Besides being involved in codes, OMFS residents learn how to manage surgical patients. This means knowing what to do and how to properly work up a patient when the nurse calls you and says the patient has one of the following,chest pain, is in SVT, has numerous PVC's, went into A-fib, has a change in mental status, lost a pulse in an extremity, has a drop in their O2 sat, drop in their urine output, continued bleeding from their surgical site...ect. Oh and my absolute favorite calls had to be urology calles in the middle of the night. Yes the one where the patient is morbidly obese and the nurse can't get the foley in so they call you because you're on for urology call. Or when the patient has pulled their foley and they're now bleeding from their meatus. Or when you get a call from the ED because they can't get a suprapubic catheter to work on a 103 year old (my favorite). These are just some of the good times of residency. I thought I would just end by saying I do attend a 4 year program. I say this because I have read on previous posts elsewhere that a few people believe that 4 yr programs don't know how to manage "sick" patients.

 

[toofache32]

I say this because I have read on previous posts elsewhere that a few people believe that 4 yr programs don't know how to manage "sick" patients.

I'm a 6-year guy in a program with both 4- and 6-year guys. We have both 4-year and 6-year chiefs right now. I will say from my observation that there is no difference in the management or skills. They both do the same procedures, work with the same faculty, and make very similar decisions. Most people don't realize that the medical degree is peripheral to our specialty and basically optional.

 

[Mayo Ortho]

I have but I was in the Air Force at the Time. You were just a likely to run the code as the MD's. But we were doing IV sedations so we had to know the stuff inside and out anyway.