# ACLS - pretty disappointed.



## MedicPrincess (Mar 21, 2007)

My paramedic class did our ACLS course this past weekend.  We had spent the last 7 weeks preparing for it.  I had read and then re-read the book.  Taken the pre-test...and then took it again.  I found ACLS simulators online and practiced those.  I was ready.

You all know how it goes now.  Saturday we watched the video and practiced.  Then watched the video and practiced.  Did that a little bit more.  Then for the last 2 hours, they ran each of us through a practice mega code.

Sunday came and we were scheduled to practice during the morning and test after lunch.  Didn't matter, I was ready.  Went through my "practice" with no problems.  The instructor made me sweat for a minute when he wouldn't give me my next rhythm change (kept my patient in V-Fib for it seemed like an hour).  But when it was all done, he pulled me in the other room to let me know I was done.  We were being tested all day, and as soon as we showed competency we'd be signed off, however we had to stay with our group for the duration.  Thats fine.  Now we were not allowed to come out and tell the group leader when they had ordered something wrong, however we were able to verify and reverify that is what they really wanted.

Now this is where I my severe disappointment comes in.  There are 5 of us in my group for class.  I was the only on in the group that didn't make...not just any errors...but potential critical errors.  One person misidentified a rhythm and didn't recognize an unstable patient, 2 of them called for the wrong drug, and the 4th called for shocking at the wrong joules.  

Person 1 - given a 17 y/o pale, diaphoretic, shallow resps at 26, altered LOC, in V-Tach at 145, BP of 70 palp.  He called it SVT and began with vagal maneuvers.  I was like, "You want me to have him try to vagal?...Okay...I'm walking over to the patient.  I'm bending down.  I'm going to talk to him now and ask him to bear...." at that point he stopped me, told me to get the pads instead and went on with his scenerio.

Person 2 & 3 -  one of these guys ordered Amiodarone 150mg rapid IV push for Asystole.  The other one called for Atropine 1mg in pulseless V-Tach.  On both of them I repeated it back to them, said "Okay, Im drawing up the Ami/Atropine into a 10cc syringe.  Are you ready for me to push this Ami/Atro right now?"  Both of them got it and corrected their order and moved on.

Person 4 - called for Shocking V-Fib at 50joules.  Again, I verify what he wants and go one with.."Okay, I am charging the monitor to 50 (with emphasis) joules.  Okay, the monitor is charged to 50 joules, everyone stand clear while I shock at 50..."  No, no, no....he corrected and moved on.

The instructor in each of these stations passed them on their megacodes.  He wasn't the same on that I had tested for earlier, but either way...

I guess I was just disappointed that it seemed like I was the only one that took ACLS serious enough to be ready for whatever they through at me.  If I had made those same errors and then the instructor told me I passed, I would not feel good about it.  It's a quality of care issue for me.  I felt like if I couldn't perform there, in the classroom, what in the world would I ever do once I am on my own and am faced with my first unstable patient.  At least now I know the material, inside and out, and stand a decent chance of remembering it when the time comes.


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## Ridryder911 (Mar 21, 2007)

Now, this scares the hel* out of me. That your class was to be ready and prepared for ACLS and did not know the indications of the medications as well as identifying and safety of performing defibrillation. I have issues with your instructor then, apparently these students should had been either counseled or failed before the point of even taking an ACLS course. 

I just finished teaching a recert course, and it gets easier each remodification.

Technically, one cannot fail an ACLS course, rather it is recommended for remediation until pass or another class. Since there is no longer an ACLS certification, rather an continuing education in the recommendations from the ECC and the AHA. Since they corrected their mistakes, AHA will count that.

The errors you described are not the typical "jitters' of an ACLS course, rather just not possessing the knowledge of performing appropriate treatment. Actually, harmful and inappropriate treatment could had occurred. 

So yes, the AHA ACLS instructor could had not technically failed them, since they corrected their responses before actions were taken. Since this was associated with your program, I would hope your instructor will take notice of the poor outcome and take action before proceeding further into the course.

Congrat's on the ACLS and the remainder of your course. 

R/r 911


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## Flight-LP (Mar 21, 2007)

sigh................

Pathetic!

Great job Princess, fortunately you possess a level head with excellent thought processes (you're gonna be one hell of a medic!), sounds like the others don't. But oh well, as long as they aren't called ambulance drivers, I guess they will be just fine............


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