Updated: Sep 24, 2020
Our introduction to BLS occurred early D1 year. Needless to say, I had forgotten most of the content. During D1 year it felt like a random insertion into our already exhausting course load and there was just no practical setting to ingrain the content.
Things were much different this time around. I feel like I can safely and confidently perform the techniques we learned. Having our basic life support class followed by our medical emergency simulation seminar drove the points home. I felt more focused and in tune with the class and able to understand the causes and outcomes of emergencies because I had the background knowledge needed to understand body systems.
We were socially distanced and could not simulate team activities, however my friend down below proved to be an ideal patient patient. The patient-est.
Key Learning Points BLS
This is by no means comprehensive, but some of my reflections after the class. Active recall is the pragmatic approach to solidify knowledge; this is just one of the ways I retain content.
BLS varies slightly depending on single or team efforts. For a single respondent, perform compression at a 30-chest pump plus 2-breathe cycle in adults, infants and children. When multiple respondents are present, the cycles for children and infants and 15 chest pumps followed by 2 breathes. The pace of the chest compressions is 100-120 bpm, which is the musical equivalent of the “Staying Alive” song as our instructor pointed out. Dark humour. Chest compressions need to go about 1/3 of the way into the chest. For a child less than 1 year of age, tap on the back of the foot to access responsiveness. Be sure to manage your surroundings, have clear communication and designate roles if needed.
The Heimlich manoeuvre (btw I had NO idea how to spell that until 5 seconds ago) is used in cases of choking. If the individual passes out, follow with 30 compressions and assess the airway for the object.
If they can speak or breathe, you do not need CPR.
The point of CPR is to build up blood pressure to get oxygenated blood to the brain (super important) and other tissues.
Don’t check an infant’s blood pressure on their neck, use the arm.
AED during ventricular tachycardia or fibrillation. Doesn’t work for a flat line situation like in movies. Remember to pay attention to instructions. Most machines can guide you during the CPR process. Make sure you know how the AED machine in your work facility works.
Key Learning Points Medical Emergency
We faced three scenarios in this seminar. We used dummy models, but the technology on these things was quite realistic. They blink. Yeah, they blinked! There are fancier models where you can even give IV injections.
In scenario 1, the patient suffered an allergic reaction. Their body broke out into hives, the heart rate went up. We called emergency services (simulation called that is), utilized an epi-pen (I finally learned how to operate one).
In scenario 2, our patient suffered a seizure. They began to lose memory and understanding of the location. They seemed to be foggy in memory (which could also indicate fainting). The patient also began to throw up (made hurling sounds). In this case, we just stabilized the airway and simulated a call to emergency services. Back in the day, they suggested to hold the tongue, but that is not part of the protocol now a days.
In scenario 3, the simulated patient had a heart attack. They had pain in the chest that radiated up into the neck. You could give aspirin in this case or nitroglycerin, but need to be sure the patient is allowed to take either/both first. If their heart stops, its time to perform CPR. We performed CPR, which helped me actively recall my early morning BLS class.
Today was basically a dream come true for a kinaesthetic learner.
Something that came up a couple of times during the medical emergency situation was that the simulated patient asked to leave. This was either when symptoms were progressing or had just reduced after the main episode. Of course, you can’t force someone to stay in the dental office, but you need to advise them that it could be injurious to their health or someone else’s if they leave. They shouldn't be driving. For example, if a patient drives away and ends up hurting someone due to symptoms re-appearing, the dental office needs to be sure it did everything ethically and legally necessary to prevent harm. Regardless of severity, its best practice to call emergency services and ensure the patient is not driving. I need to look further into this topic.
I also wish dental school went more into medical law and business. Until they do, self-study is king. Sorry, queen.
Overall, just another amazing day in dental school.