For pharmacists who participate on code teams (or who attend codes, if not on the code team), are you ACLS certified? Do you find it useful or do you know of a legal liability if you aren't? My malpractice insurance seems to think that if such training could be reasonably considered necessary, whatever that means, not having it would be acting beyond the scope of practice. What do other hospitals do?
ACLS Certifcation
- Thread starter A101Dal
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The hospitals where I've worked won't allow anyone who does not have ACLS certification anywhere near a code. Somebody's trying to die on you and you come in trying to help but don't know WTF you're doing? Of course that's a legal liability! Either get ACLS or stay the hell away from codes.
For what it's worth, I agree with you (and I have mine), but my facility doesn't. I'm mostly fishing for evidence (my board says you only need it if you'll be actively administering medications). TBH, my reaction was similar to yours, "Why the **** wouldn't we need it?"
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Not sure about any legal ramifications but we all participate in codes at my workplace, and I am the only one who is ACLS certified (by choice).
I do think it is helpful to have so you can anticipate what drug the physician might want next.
I do think it is helpful to have so you can anticipate what drug the physician might want next.
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Ask yourself this question. If you were the patient in a code blue, would you want the team members to all have acls?
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The pharmacists that attend codes at my hospital are all ACLS and PALS certified and it is a requirement from our management.
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We require it for code attendance- as a pharmacist I'm thinking what medication the physician SHOULD want next.
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I am surprised that your hospital wouldn't require it, but from what I'm reading, you are saying they don't even want to pay for you to voluntarily get it? That's crazy. There are no drawbacks, and only benefits to being ACLS (other than the cost.) It sounds like your hospital is trying to save nickels and dimes and not thinking about the real cost of massive lawsuits.
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all of our RPh's are ACLS certified and we attend all codes - acls is beneficial - and yes - you should get certified to be a team member- but there is a lot that RPh's do that isn't covered in ACLS (it has been uber simplified over the years)
They are actively discouraging scoffing, “what does a pharmacist need to be certified for? All we want you to do is hand us drugs.”
I think the impression is that we will try to come in there and run the code. During codes, the last thing I want to do is take over.
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this is probably 80% of our hospital rph's - and I get it - but due to the set up of our department - we don't always have a icu or ed person who goes to codes around 24/7 -
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On the flip side, do you guys have any suggestions for pharmacists who are required to attend code blues who don't feel quite confident yet? I took ACLS but don't have meds memorized by heart (still working on that).
I want to be useful to the team if I'm required to attend. By the time I respond, the first dose of med is already given and the nurses are in change of med trays. I try to do my part with bringing up extra meds and following up on any new meds to be started e.g. pressors, but am not so confident in actively recommending which meds to give. Do you think that eventually, we'll need to know how to tell a rhythm from the ekg or is asking RNs by bedside is sufficient?
I want to be useful to the team if I'm required to attend. By the time I respond, the first dose of med is already given and the nurses are in change of med trays. I try to do my part with bringing up extra meds and following up on any new meds to be started e.g. pressors, but am not so confident in actively recommending which meds to give. Do you think that eventually, we'll need to know how to tell a rhythm from the ekg or is asking RNs by bedside is sufficient?
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We have this same issue. I do numerous code blue refresher classes every quarter. I personally trained every RPh at my hospital in code blue situations - specifically focusing on things that a pharmacist will be asked to do based on situations that I have found myself into. The actually ACLS algorithm is pretty basic - but the real world situations are much different
What I would focus on for you 1. RSI meds and when to recommend specific agents 2. When to use what pressors (epi vs norepi vs vasopressin) 3. make sure you can actually make a IVPB and assemble an abboject (many rphs sadly don't know how to do this) 4. If you have peds patients - make sure you know how to use broslow tape and can quickly dose and prepare pediatric doses 5. Something simple, but if you are in a prolonged code, make sure you re-supply BEFORE the cart is run empty (via pyxis, calling pharmacy and tubing, etc) 6. Think about H&T's and appropriate treatment of each - especially overdose/other toxicology. 7. As far as EKG - I know how to read them pretty good (compared to most RPh's) but I will never be as good as a MD or a well experienced RN - so that is low on your list of things to know 8. Learn how to run the defibrillator - you can impress a RN by jumping in when needed - especially if you are in a situation where help is limited or you find yourself cornered in a room and you happen to be the one next to it. 9 Learn to prime IV lines - if you hand a RN a bag of norepi - it saves them a lot of time if you have it ready to go 10. learn to program the IV pump 11. know where stuff is - supplies, extra bags of saline, etc - again - great customer service garners you respect
Also - simply learn by experience.
lololol. I love it when I get attitudes like this.
I went to a code in ENDO when they exclaimed "I don't need a Pharmacist!" Fair enough. So I waited outside for a bit. Next thing an RN is rushing out. "Did they tube that Levophed drip yet?" I told them why wait when I can make it now. So I made it. Gave to doc who looked at me with deer-in-headlight look. So I primed the tubing, set the pump and gave the line to the MD
Funniest part of that story is years later the same RN who yelled me out of the room called me to the OR to help out with a code with ROSC patient.
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I had a cath lab nurse say this to me during ACLS - "why do you need ACLS" - I was there with my ED peeps - I simply responded I attended 4 codes in the last week - I figure it can help me out. Then my ED nurses actually stood up and said how much they love a Rph and how much we add, can't do it without us, blah blah blah - they might have exaggerated a big (but see my previous post) - when you build up good will - we have each others back 🙂
She shut up pretty quick, funny thing is that she ended up in my mega code group (who was taught by one of my best friends) who said that the pharmacists always do the best in class (completely unprompted) and the day ended with said cath lab nurse requiring remidiation because she failed.
#karma
ED pharmacist here. ACLS is a job requirement for all pharmacists in my hospital, even central shifts (although they're not expected to attend codes). ICU/ED pharmacists here are pretty involved and very hands-on. Multiple times I've had to give meds because the nurses are busy, and other times I clear and shock the patient (it's on top of the crash cart, where my meds are, so...get familiar with the defibrillator too). I'm also PALS certified, but it isn't listed as a job requirement; I keep it because of the environment I work in. If you work in a hospital and are expected to attend codes, I would definitely get ACLS certification at the very least.
