One Year: Thank You

One year has passed since I received my EMT-Paramedic, and I'd like to say thank you.

Firstly, to my friends and family. You have endured my absence well, or at least have hid your anger well. I'm sure this last year has been tough, but probably not as tough as paramedic school. I really could not do this job without your support, especially as a volunteer. I cannot say it enough, thank you.

To my colleagues and peers, you have surely challenged me to accomplish things I never knew I was capable of doing. You have mentored me, scolded me, and sat patiently while I fumbled with IVs. There is an entire network of you online which have been invaluable as a sounding board and a reference. I can only hope I will continue to take what you have given me and make myself a better Paramedic going forward. The fact that I feel like my feet are underneath me at all is a testament to you all, thank you.

Lastly, to my patients of whom I've met quite a few: you have taught me more than I could ever hope to tell you. Some of you were thrust into my arms, others I knelt and said goodbye. You have challenged me to better myself and I appreciate every experience. My life as a green Paramedic has been an odd mix of on-the-job training for emergencies I was never told about and connecting the dots for those I was told every day about. I thank you for your understanding. I hope that I can tell a story of that time I sat next to you on a flight, and heard about your trip to see your niece get married. That is why I am here, you are why I am here. I feel blessed to meet each and every one of you, thank you.

2010 AHA CPR/ECC Guidelines

If you haven't already heard, today the AHA released the 2010 edition of their CPR/ECC Guidelines which include updates for laypersons, BLS, ACLS, PALS, and neonatal resuscitation. If you've been following resuscitation research at all for the last few years, there are not many surprises.

1. Compressions trump ventilations in adult patients (C-A-B not A-B-C).
2. Minimize interruptions in the "flow" of a resuscitation, that is, continuous compressions are to be minimally interrupted.
3. ETCO2 is to be preferred over manual pulse checks: if you don't have a rise in ETCO2 to physiologic or near-physiologic levels, you probably do not have a perfusing rhythm.
4. AEDs are indicated for all ages, including infants and neonates, provided there are pads available which fit without overlap (>3cm gap).
5. Pharmacologic therapy has the same weight as TCP in certain bradyarrhythmias.
6. Procainamide is now first-line or at least recommended on par with Amiodarone, Lidocaine is almost off the list.
7. Atropine is no longer recommended during routine PEA/Asystole resuscitations.
8. Studies into neonatal resuscitation have shown that deep suctioning is not required in vigorously born neonates with meconium staining.
9. Routine use of naloxone in cardiac arrest secondary to opioid overdose is not recommended.

There were many other differences, including the addition of circular flowcharts documenting the new guidelines (linear flowcharts are still provided). I encourage everyone to read them.

Edit: here is a document (PDF) comparing the AHA 2005 CPR/ECC guidelines to the 2010 guidelines.