Sunday, March 3, 2013

BLS and ACLS

I thought of writing about the two most important things for me right now, together, but then it didn't really make sense. Let's have two different posts then.
I managed to complete the Basic Life Support and Advanced Cardiac Life Support Courses. I am now a certified provider of both, and man, am I so confident and happy about the two!!
Day one was really good. One of my chief problems has been talking to people. Somehow, the two years higher secondary school and the four years of college taught me everything except communication. I haven't been the kind of a person who makes friends everywhere she goes, and these experiences just added to that trait more than ever. I haven't been doing a lot of out-of-college stuff, so the chance of trying to get out of this trait never came. I was worried about the experience of doing this alone. But, you know what, I'm not that bad after all. I did meet new people and definitely made a new friend :-)
Going back to the actual course- BLS was fantastic. Initially, the task of doing 5 cycles of 30 chest compressions with an interruption of <10secs :-="" :-p="" a="" after="" aha.="" aha="" an="" and="" anything="" arm="" as="" association="" at="" been="" between="" beyond="" bls="" but="" by="" can="" cardiopulmonary="" certified="" course="" day.="" designed="" do="" end="" examination="" got="" had="" has="" heart="" helps.="" hurt="" i="" if="" in="" into="" involves="" is="" it="" learning="" man="" merican="" method="" mode.="" more="" my="" nbsp="" now="" of="" on="" over="" p="" perceived="" period="" plus="" practical="" protocol="" providers="" really="" resuscitation="" s="" see-and-learn="" session="" step-by-step="" stupid="" superb.="" teaching="" technique="" than="" the="" there="" things="" this="" time="" to="" tough.="" under="" was="" we="" well="" were="" which="" wrist="" written="">

ACLS was more taxing. The whole process was beautifully organised. We were shown videos of teams managing cases...step-by-step videos....followed by putting-it-all-together videos, so the idea of an ACLS team was put through to us via visuals than mere didactic sessions. Those videos were a class apart. I have always admired the importance of protocols and organisation given in the Healthcare system in the US. This course provided perfect evidence to my previous heard-from-others respect.

From my point of view, the ACLS was more demanding. I haven't worked in a hospital before, haven't been a part of a team that needs to save a dying patient, haven't ever needed to think fast, act fast, be on my toes all the time, manage a whole team, think of what everyone is doing and ensuring that it done well. That is exactly what this course was about. I was the youngest person there, having just completed my final year of undergrad (and not even a doctor on the first day, our results were declared that evening). I was quite taken aback, when they said that we were going to be tested on our ability to be team leaders and guide a team to perform an ACLS service. Yeah, here I was, fresh out of medical school from India (where they don't teach you anything not-theoretical)....having my own doubts about calling myself a doctor and now, I was supposed to consider myself the most experienced out of the whole team and order them around as if I knew what it was exactly I have to do. I've always had my doubts about my own capabilities, but the second day of our course, those doubts stood out like tall pillars hiding me from what I knew was to be done. The instructors kept saying that when you know the algorithms by heart, there isn't much difference between a doctor and a non-medical person. All you have to do is follow the protocol and the algorithm.
Then came the task of identifying cardiac rhythms. Have I ever mentioned how stupid I am, when it comes to cardiac rhythms? Those ECGs were never taught to our batch (our bad, and only our bad. All my friends in other batches came to final year knowing how to read ECGs). They gave me nightmares during exams (and my final university examination, luck stood by me. I got an Inferior Wall MI to identify, the only rhythm I could identify). So, when they said you have to analyse rhythmns, yes, I threw up inside of me. I'd rather do something else. What added to my stress further was that everyone else already knew the rhythms (thanks to being doctors working for years, or doctors who'd completed their internship.). I was terrified. Let alone having ever seen a defibrillator or a TCP device before, I couldn't even identify rhythms. How was I to know whether to shock the patient or not?
Day two left me a little bruised inside. I was wondering how I'd fare in the examination the next day. I was wondering whether it had been a good decision to do this course now, at the start of my internship. A lot of questions swum around in my head, as I mugged up all those algorithms and tried out all sorts of permutations and combinations of them, thinking of patients weaving out of one rhythm and going into another.
I don't know whether it was the feel of a new day or just the fact that I'd studied hard enough to finally get hold of the idea, but next day (i.e. yesterday) when we practised again, I was understanding things, thinking for myself, looking at myself as a team leader, and gaining confidence as I did it all. It helped that our instructor was very pleasant and very nice about all the doubts I had, explaining every little thing to me. So as luck would have it, my practical went really well. So well that the examiner asked me where I worked :-p Lol!! When I told him that I was yet to start with internship, he gave me this surprised+satisfied look and said, "Very Good then. I thought you were working in some institution." Such a boost. The theory was a little tough, but I managed to get the required percentage. Yay!!
So now I am a certified BLS and ACLS Provider for two years....I have the confidence to know and do exactly what I need to save a dying patient in the casualty....and yes, I feel more like a doctor now than I felt immediately after our results were declared (when I officially became one :-p) 

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