Separate names with a comma.
Discussion in 'Anesthesiology' started by urge, Sep 6, 2014.
Hmm. The pic quality is not very clear, but I don't see any gloves.
In the drawing itself. Interesting choice of lights and shadows.
The kid doesn't have an aorta, so that precludes PALS? I mean it's a surgical emergency, not a medical emergency.
Yeah, it says "Provider Manual".
It's just PALS training
There is a huge weird orange glow emanating from the child's chest. Wow...can't believe I missed that.
Are you thinking that the artist is missing pulmonary veins that drain into the LA?
Can't stand that word. Provider. Worse than "reimbursement."
Last I checked, providerology wasn't a recognized medical speciality. I'll eat my sneakers if I ever see a non-MD code a kid by themselves without going ballistic and waiting for the doctor first.
Like a paramedic? And should midlevels in the hospital not be aware of pals protocol to anticipate what's needed?
Paramedics are the exception. Otherwise have you ever been to a pediatric code? By the way they act, it seems like the physicians are the only ones who have ever seen a code.
No, no peds codes yet. And for reference, I'm not intending to make broad strokes about mid levels or even the use of the term providers (which personally doesn't happen to irritate me, but I understand how it may to others). I just think it's kind of silly to make an issue of providers being on a PALS training book like the book is solely targeted at physicians. How should they phrase it? "For healthcare professionals?" "For physicians and nonphysicians"?
That really depends on where you are in a given hospital. On the floors (adult and peds), everyone seems to get all slackjawed and ******ed when a code goes off until the code team shows up. In a the intensive care units, this is almost never the case.
In any case, there's no logical reason to argue that nurses, midlevels, and RTs should not be trained in PALS if you're working in a pediatric hospital or in a hospital that cares for pediatric patients.
I must be the only one who sees a phallus on the drawing.
Yes, no kidding they should all be trained in PALS. Point being, they all flip out (except paramedics) when a code does occur, and wait for the doctors to show up. Note the scene if you're the first one to show up at a code. Usually.
Can't blame them for flipping out. Unless you're in the ICU or ER, you don't experience many codes, hence fear of the unknown. And a dying kid freaks most people out. Providers is the best word here. I've been to and/or run at least a hundred peds codes. My job is to calm the room and focus on the algorithm/dx/next steps (i.e. ECMO? OR? etc) and direct when hopefully compressions have already begun and are of high quality. The whole point of PALS is that any "provider"-- paramedic, nurse, RT, nurse practitioner, med stud, resident, fellow, attending-- knows that you need to get on the chest stat and compress effectively, get the pads on and keep your no-flow fraction minimal--it's not rocket science, but it's amazing how good even a floor nurse can get at codes with repeated drilling of these basic conventions in simulation. When I show up to floor codes these days, the PALS algorithm is in full swing, with a line of people waiting to compress at switch times, pads on. Same goes for anesthesia trainees and attendings who fortunately don't see many OR codes but man can an OR code be ugly if folks don't have comfort with the PALS or ACLS algorithm. Get on the chest immediately, Compress fast (but not too fast!) deep and hard-- shocks and epi are important too, of course, but we need all these "providers'' who may be the first to the patient to get the compressions piece in their heads so that the kid has a chance. That's the main take home of what they learn in these courses. So providers/health care professionals-- right terms. It would be very wrong to limit this to the MD/DO.
Kid has no left lung.
Also, the number of ribs is unusual.
(Along with the pulmonary artery and veins, which have been mentioned above)
Did you see it?