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I’m surprised this is an issue in anesthesiology. Y’all should know how to run a code. BLS/ACLS isn’t meant for y’all - it’s meant for novices and/or non medical folks.
I’m EM/CCM. I know the EM governing bodies have come out strongly against the need for merit badges in board certified EPs - it’s a core competency and doing classes with life guards and baby sitter isn’t the best use of our time.
I mean, if all you did was eyes all day every day or something like that then maybe, but a legit anesthesiologist shouldn’t need to do this.
This came up at my hospital because a code went poorly. Nursing wanted to force all of anesthesia to get acls instead of just addressing the issues that led to the code going poorly. It got discussed for a bit in committee (anesthesia falls under surgery supervisory committee for whatever reason) and eventually we went with the policy that mirrored what EM has that exempts them since it is considered core to the specialty.I’m surprised this is an issue in anesthesiology. Y’all should know how to run a code. BLS/ACLS isn’t meant for y’all - it’s meant for novices and/or non medical folks.
I’m EM/CCM. I know the EM governing bodies have come out strongly against the need for merit badges in board certified EPs - it’s a core competency and doing classes with life guards and baby sitter isn’t the best use of our time.
I mean, if all you did was eyes all day every day or something like that then maybe, but a legit anesthesiologist shouldn’t need to do this.
I’ve always wondered why this was required of us. I’m Cards/EP and everywhere I’ve been/trained has required us to be certified and renew.
Cardiologists should be excellent at running codes - if a patient makes it to your service, it’s an arrest from a cardiac issue and you should be able to manage it expertly. I will say that some of the worst run codes I’ve seen have been by cardiologists - that being said, they may have been “ACLS certified.”
I mean, for goodness sakes, it’s not that hard. Pump on the chest, bag and shock early and often. I don’t know why we should have to go through all this.
Ask your credentialing folks what is actually required. If it's just "ACLS" then you're good with the online course. If it's AHA-recognized ACLS, then you'll have to do the "real one". Our hospital doesn't care.How does everyone recertify for these? Quick online courses (based on AHA guidelines, but not specifically from the AHA), or actually do the whole class and skills test? Much more time consuming, but the only option AHA has to my knowledge.
you'd think the cardiologists would be good at it.
but how often do they actually come and direct codes?
when a patient codes in cath lab, they call anesthesia and we usually run it
It may be a matter of different people thinking they are running things. Anesthesia might feel they are because they got the airway, and nursing might think they are running it because they are keeping time and offering the next epi.well do you think patients in the CCU not code (cardiogenic shock, CHB, idiopathic refractory ventricular arrhythmias, STEMIs, complex congenital patients etc)? or the patients who get cardioverted? or during EP/cath procedures (especially the former) with complications? All VT/VF arrests with ROSC come to our service, and its not uncommon for them to arrest again once they arrive upstairs. Your experience is hard to fathom because I have NEVER been in a situation either in residency, fellowship or out in practice where we felt the need to call anesthesia to run our code (intubate yes). I mean asking anesthesia for what to do with ventricular arrhythmias? lol
Now to be fair, I can imagine a situation where a cardiologist is mostly outpatient based and only sometimes covers inpatient consults (in a hospital with no CCU). In that situation, he/she probably hasnt been directly involved in a code in a long time.
well do you think patients in the CCU not code (cardiogenic shock, CHB, idiopathic refractory ventricular arrhythmias, STEMIs, complex congenital patients etc)? or the patients who get cardioverted? or during EP/cath procedures (especially the former) with complications? All VT/VF arrests with ROSC come to our service, and its not uncommon for them to arrest again once they arrive upstairs. Your experience is hard to fathom because I have NEVER been in a situation either in residency, fellowship or out in practice where we felt the need to call anesthesia to run our code (intubate yes). I mean asking anesthesia for what to do with ventricular arrhythmias? lol
Now to be fair, I can imagine a situation where a cardiologist is mostly outpatient based and only sometimes covers inpatient consults (in a hospital with no CCU). In that situation, he/she probably hasnt been directly involved in a code in a long time.
interesting. is it usually PEA? are they not putting the probe on the patient? or ECMO + PCI if warranted? gotta say, stepping back and letting others (who are uninvolved in the case) run the show is lame. I've seen GI docs do it but come on.Yes my experience in perioperatively. The cardioloigts usually step back while we do it.