ACLS books

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blachatch

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About to start cardiology in January and was wondering what are some good ACLS and cardiology books that people helped used to get them through that section of medic school.
Thanks
 
The only ACLS book in existence is the AHA text that goes with the course...

ACLS is very easy. It's meant to be a practice/review course for what you should already know and understand.
 
high yield heart
 
Tom, I get the impression that when you say an expert in advance cardiac life support, you aren't talking about the AHA ACLS algorithms. If that's true, what steps would you recommend towards becoming an expert?
 
Aprz said:
Tom, I get the impression that when you say an expert in advance cardiac life support, you aren't talking about the AHA ACLS algorithms. If that's true, what steps would you recommend towards becoming an expert?
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You might as well ask Leonardo how to paint.
 
Ken Grauer's ACLS references are excellent and well-regarded. He's also a gentleman and a scholar who contributes a lot to the community, so support the man.
 
blachatch said:
About to start cardiology in January and was wondering what are some good ACLS and cardiology books that people helped used to get them through that section of medic school.
Thanks
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(I was going to leave this post be as others have covered it, but you're from Hudson and I lived there for a stretch, so here goes.)

Cardiology as taught in 'medic school is based around four key areas.

(0) Blood goes round and round
(1) Rhythm interpretation
(2) What antiarrhythmics to give when you have bunny ears that are up in 2 leads
(3) What to do if the ST-segments are frowny faced

This will get you through ACLS and PALS most assuredly. However, I'd suggest taking a more holistic approach.

First, double back on your A&P. Understand the mechanics of the heart on both a macro level (e.g. low pressure right sided circuit vs high pressure left sided circuit) and on a micro level (e.g. the role sodium, potassium, and calcium play in the myocardial cells). A college level A&P review book may help fill in these gaps, especially if you can find one geared towards the heart/lungs (as a pair). Don't forget to abuse the Khan Academy videos too.

Next stop in cardiac A&P is electrophysiology. I'll warn you now, but I'm a robot who only plays broken records. This is where you'll want Garcia and Miller for Arrhythmia/Rhythm interpretation and Garcia and Holtz for 12-Leads. These will get you thru school ahead of the pack. (insert plug for EMS 12-Lead Blog)

Now you need to double back on pharmacology and antiarrhythmics. Know and love the Vaughn-Williams classifications as they'll help you get a foot in the door when trying to determine what a drug will do. I'd grab Brady's Drug Guide (lil pocket sized book) for help with this as well.

Once you've tackled A&P, basic 3- and 12-Leads, and pharmacology you'll realize you probably haven't hit on the other big ticket item called Heart Failure. Hit up EMCrit for high pressure heart failure ("SCAPE"). A solid understanding of A&P of the renal system is your other saving grace in this area. Be sure to double back on heart failure when you go over shock too.

At this point you'll want to pass ACLS and PALS to the satisfaction of your instructors.

Good news: you probably have all of the knowledge necessary, you just need to put it all together. While I don't necessarily agree with every protocol from the AHA, they do at least have some system by which they arrived at it.

Better news: you can read all of this online and for free. Look up the guidelines and read them cover to cover. It is very accessible to paramedic students and you will certainly appreciate the what's and why's (later you'll go, "so wait, why are we giving these drugs? their own guidelines said they probably don't work...").

Just know that even programs which spend 100+ hours on cardiology don't adequately prepare you for everything you'll see in the field. But if you put in at least 1 additional hour on the topic for every hour in the classroom you will certainly be well suited to do the right thing. If you put in 2 hours for every 1 hour, you will certainly smoke the tests and your face will light up whenever your partner says, "man you take this, I hate cardiac patients".
 
Christopher said:
Good news: you probably have all of the knowledge necessary, you just need to put it all together. While I don't necessarily agree with every protocol from the AHA, they do at least have some system by which they arrived at it.
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Something I've learned over time is that while one can disagree with the major protocols and guidelines out there, if you don't understand why a large body of intelligent people would recommend something, there's some information you haven't considered.

Sort of a Chesterton's Fence notion. There's a reason for everything -- not necessarily a good one, but a reason.
 
Have you ever noticed how often the ACLS algorithms say, "consider expert consultation"? There are thousands upon thousands of health care providers walking around with an ACLS card that can barely distinguish VT from VF let alone distinguish between AF/WPW and Torsades. Knowing what the algorithms say and knowing when, where, how, and why you should give (or withhold or withdraw) a therapy are very different things. There's no algorithm in the world that can give you sound judgment.

Having performed QI on cardiac related calls for over a decade with a group of pretty smart medics (to say nothing of cases submitted to ems12lead.com over the past 4 years) I've seen it all -- the good, the bad, and the ugly. Contraindicated medications with harmful effects, false capture with transcutaneous pacing, peri-shock pauses over 30 seconds, VF not shocked for over 10 minutes, patient's side to first shock intervals of over 3 minutes, VT misinterpreted as SVT, adenosine given to sinus tachycardia (not once, not twice, but thrice), missed STEMIs, advanced airway misadventures, etc. The list could go on and on.

To me it's not enough to say, "You ought to know." That's just one lens of many through which you can view human error. If you subject any organization to rigid scrutiny you will find errors and system failures a plenty. How many organizations are dedicated to process improvement? Have meaningful surveillance with non-punitive feedback loops that improve quality? Measure outcomes? It's one thing to know the guidelines. It's another to operationalize them.

Forgive me if that sounds like soap-boxing. I don't feel emotional about it (at least not tonight). I just don't flatter my profession because I care about it too much.
 
Brandon Oto said:
Something I've learned over time is that while one can disagree with the major protocols and guidelines out there, if you don't understand why a large body of intelligent people would recommend something, there's some information you haven't considered.

Sort of a Chesterton's Fence notion. There's a reason for everything -- not necessarily a good one, but a reason.
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From a protocols perspective, usually it's because the even larger body of people following those protocols are predominantly complete morons.
 
NYMedic828 said:
From a protocols perspective, usually it's because the even larger body of people following those protocols are predominantly complete morons.
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Yes, maybe. But making it "us vs. them" masks the reality that a moron is just somebody who habitually does the dumb stuff you only do occasionally. The lessons are still there.
 
Brandon Oto said:
Yes, maybe. But making it "us vs. them" masks the reality that a moron is just somebody who habitually does the dumb stuff you only do occasionally. The lessons are still there.
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Not disagreeing at all. Just stating that the protocols exist how they do because we can only trust a few people on their own but we can't trust the other 90%.

In the end the doctor is still your governing body and has to answer for your actions to some extent whether he can be held liable or not.

People think they are an almighty paramedic they should be capable of free function, aka practicing medicine.

If I were a physician/medical director especially if I came from EMS, my protocols wouldn't be very lenient knowing the kind of people who will be following them.
 
Veneficus said:
high yield heart
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Is this a somewhat easy to understand book? I'm not the brightest cat out there but want to excel in cardiology above the rest of the class as I feel it is a very important topic.

Chistopher thanks so much for all of the sources I will look into some of those books!
 
blachatch said:
Is this a somewhat easy to understand book? I'm not the brightest cat out there but want to excel in cardiology above the rest of the class as I feel it is a very important topic.

Chistopher thanks so much for all of the sources I will look into some of those books!
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it is easy to read and has saved many of my students.
 
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