No 2015 ACLS Guideline Changes For ACS Treatment.......Yet......

The AHA/ILCOR 2015 ACLS guidelines will be coming out by the end of this year(2015). So far, it appears most of the changes will be directed at the BLS level, with even more focus on high quality compressions, more efficient introduction of defibrillation through public access defibrillation programs, and more in-depth information on Return Of Spontaneous Circulation. Changes for AHA ACLS certification classes will probably be minimal.

The Meds for Acute Coronary Syndrome

It looks like ACLS meds for ACS treatment will not change:

• Oxygen
• Aspirin
• Nitroglycerin
• Morphine
• Fibrinolytic therapy
• Heparin
• Beta-Blockers

Acute Coronary Syndrome

What is acute coronary syndrome? 
Acute coronary syndrome is acute pain that results from a sudden decrease in the blood supply to the heart. The pain is so acute that it feels like the onset of a heart attack. In most cases, the patient feels as if the chest is being squeezed. In others the pain travels to the shoulders and arms and even the abdomen at times.


Causes of acute coronary syndrome
The cause of an acute coronary syndrome is not sudden. In fact, there is a slow and steady build up that can be detected in regular medical checkups. Plaque, made up of fatty deposits and calcium, accumulate in the coronary arteries over time. As the deposits increase the arteries narrow and the amount of blood that reaches the heart reduces. As the blockages increase there is a possibility of angina that results from reduced and inadequate blood that reaches the heart. When a piece of the plaque disengages or breaks off, clotting might create a complete blockage causing acute coronary syndrome.

Symptoms of acute coronary syndrome
Symptoms of acute coronary syndrome are similar to those of angina. However, they are generally more acute and severe in nature. A burning sensation in the chest and a tightening feeling that may occur immediately after exercise or consumption of a large meal are common symptoms. The pain may sometimes also occur in other parts of the body like the upper arm, shoulders or jaws. It is also not uncommon to experience nausea, vomiting, dyspnea or breathlessness, diaphoresis or excessive sweating and a feeling of lightheadedness.

Management of acute coronary syndromes 
Confirmation of acute coronary syndrome can be done by an ECG or Electrocardigram. This test records the electrical impulses of the heart with the use of electrodes. This is displayed on a monitor in the form of waves. Some blood tests can also detect a damaged heart due to the heart enzymes that leak into the blood stream. Other tests that are also done for further confirmation are Echocardiogram, chest x-ray, nuclear scan, Computerized tomography (CT) angiogram and Coronary angiogram (cardiac catheterization).

Immediate treatment includes blood thinners like aspirin and heparin to remove the blood clotting that is suspected. ACE inhibitors are used to reduce blood pressure and beta blockers are used to relax heart muscles. Surgical procedures become necessary when medicines are ineffective. Angioplasty is the most common surgical procedure that is recommended. It involves insertion of a wire with a deflated balloon into the tube. As the balloon is inflated, it squeezes the plaque against the arterial walls.

Acute coronary syndrome guidelines 

Prevention and management of acute coronary syndrome include various lifestyle management guidelines. Some of these are:

• Quitting smoking 
• Consuming a heart healthy diet that is low on saturated fat, red meat and salt and high on high fiber food like wheat, fruits, vegetables, fish and lean meat. Consider asking your primary care physician for a referral to a Registered Dietitian for this. 
• Regular cholesterol and blood pressure check-ups to ensure levels are under control
• Maintenance of health weight with regular exercise
• Taking significant steps to reduce stress levels
• Limiting consumption of alcohol

How To Become A Nutritionist | Nutritional Therapy

**Another post by Jason Goodwin**


Everything you put in your mouth has a benefit or a consequence. When we eat nutrient-dense, properly prepared whole foods our bodies thrive. When we eat processed, chemically concocted foods, our bodies suffer. Our bodies get confused by all of the weird, unnatural, hard to pronounce “ingredients” we eat on a daily basis. Your body does its best to adapt, but eventually it will protest by giving you all sorts of problems and symptoms.

Make the connection between food and health.

A NUTRITIONAL THERAPIST evaluates your health profile to find what macro and micro nutrient deficiencies may be contributing to your health issues. The uniqueness or “bioindividuality” of each person means that there is no one-size-fits-all nutritional plan. A Nutritional Therapist will work with you to create a personal protocol to fit your particular needs and goals. Getting the appropriate nutrients transported effectively throughout your body means better health and overall wellness. To consider if Nutritional Therapy is a good fit for you, or if you're researching how to become a nutritionist, ACEND has tons of information on accredited nutritionist programs across the Country, as well as more in-depth nutritional therapy information.

Surgical Tech Programs In California

What Does a Surgical Technologist Do?

There are many important roles in the medical field that don’t get as much public attention as, say, surgeons or other major roles. One of these is the surgical technologist, who provides a valuable service in the health care industry but might not be familiar to many prospective students. The U.S. Department of Labor’s Bureau of Labor Statistics states simply that surgical technologists assist during surgical operations under the direct supervision of surgeons, registered nurses, or other personnel. Their role is largely a preparatory one, helping to organize the operating room and get the scene ready for the operating surgeon.

Before an operation begins, surgical techs set up the instruments the surgeon will need, assemble the sterile and non-sterile tools, and check to make sure everything is functioning correctly. A surgical technologist will also often work with the patient by cleaning and disinfecting their incision areas. The tech will transport the patient to the operating room, monitor their vital signs, and assist the surgical staff in donning gowns and gloves. Basically, a surgical technologist is a medically trained assistant who helps get things done in the operating room, allowing the surgical team to work together smoothly and perform operations with greater ease. But a surgical technologist isn’t just a pair of hands. The role requires training and education, as underscored by the Association of Surgical Technologists in their job description of surgical techs. They stress that surgical techs have learned and maintain expertise in both the theory & application of aseptic and sterile techniques, and therefore possess the skills needed to competently combine advanced knowledge of human anatomy, proper implementation of technologies and tools, and a solid understanding of surgical procedures to facilitate a surgeon's performance of invasive diagnostic and therapeutic procedures.

Surgical technologists often operate sterilizers or other light machines during the surgery, as well as pass instruments to the surgeon. Some surgical technologists with additional training and certification can also serve as surgical assistants, which involves controlling blood flow and other tasks under the surgeon’s supervision to help the surgery be executed safely. Enrolling in one of the surgical tech programs in Bakersfield Ca is a great way to become a vital part of the operating room process and the larger health care industry.

Training To Become A Surgical Tech In California

The decision to become a surgical technologist is a big one but one that will most likely lead to a rewarding career as a vital member of a hospital staff or assisting physicians in private practice. Pursuing a career as a surgical tech is easier than you’d think, especially if you do your research.

First things first: Find a good school. No matter what you’re studying, it’s imperative that you graduate from an accredited college or university. Accredited schools are those that have passed muster with regional or national accrediting agencies and have been judged as worthy institutions. They provide a quality education that’s respected by employers, and more importantly, only graduates from accredited universities are eligible to take certification exams in the surgical technologist field. Be VERY wary of surgical tech schools online. Properly accredited schools rarely accept prerequisite courses such as anatomy, physiology, and other science courses that are taken online.

The U.S. Department of Education maintains a searchable database of higher education institutions that have been accredited by legitimate agencies, and a pair of other organizations — the Commission on Accreditation of Allied Health Education Programs and the Accrediting Bureau of Health Education Schools — provide searchable lists of accredited programs that will allow you to sit for the exam to become a certified surgical technologist.

With a degree from one of the surgical tech programs in California, you will be ready to study for and take the certification exam. Becoming a certified surgical technologist will greatly improve your earning potential and job opportunities, though you’ll need to retake certification exams every few years in order to maintain your CST status. You can also choose to advance to the role of surgical first assistant, which requires more training and study. There are a variety of career resources available for surgical technologists, too. The Association of Surgical Technologists, a professional organization for the field, devotes a section of its website to job opportunities for qualified surgical techs.

It’s also a good idea to stay in touch with local hospitals and the surgeons you worked with during your schooling and internship period. Often, the best way to learn about available jobs is to know someone who needs a qualified tech and will think of you. Becoming a surgical technologist is an easier goal to achieve than you might think. With the right preparation before choosing a school, and taking the certification exam after graduation, you’ll be able to enter the medical field and become an integral part of a surgical team.

Acute Coronary Syndrome | Bakersfield ACLS Training

Acute Coronary Syndrome or ACS is a catch all term used to describe a set of symptoms consistent with acute myocardial ischemia when the symptoms are not pathognomonic. Myocardial ischemia is a condition in which insufficient blood flow is reaching the heart muscle. This is usually a result of atherosclerotic plaques building up in the coronary arteries. Symptoms The symptoms of ACS are typically tightness in the chest that radiates into the left arm, anxiety or a sense of impending doom, and shortness of breath. Other symptoms that might occur are nausea, vomiting, sweating and palpitations. In female patients, the elderly, and those with diabetes there is a higher occurrence of atypical presentation. This can translate to other, non-specific, symptoms such as feeling weak or lightheaded to a complete absence of symptoms, all of which are explored during Bakersfield ACLS Training.

There are three distinct subtypes of ACS:

• Unstable Angina
• non-ST segment elevation myocardial infarction
• ST segment elevation myocardial infarction

Diagnosis

Diagnosis of ACS usually involves an Electrocardiogram. Elevation in the ST segment indicates that damage has occurred to the muscle and that intervention is required immediately. In the absence of ST segment elevation, it is more difficult to distinguish between unstable angina and non-ST segment elevation myocardial infarction. Blood tests can be administered to look for increases in cardiac enzymes. The most accurate indicators for myocardial infarction are increased Troponin I and Troponin T. A second, common predictor is an increased Creatine Kinase level. Another diagnostic tool that can be employed is the ACI-TIPI. The ACI-TIPI is a rough algorithm that uses demographic information and EKG information to provide an estimate of the likelihood of myocardial infarction.

Treatment

In the event of ST segment elevation myocardial infarction, there are several treatment options. Aspirin is often administered on-site by paramedics to reduce clot size. Beta blockers are often administered to reduce the work load on the heart. Anticoagulants, such as heparin, may be administered to prevent further clots. ACE inhibitors are often administered to prevent some of the heart enlargement. Clearing the blockage as soon as possible is key to patient survival in the case of ST segment elevation myocardial infarction. In most cases an angioplasty and stent placement is performed within an hour or two when possible. Doctors can also use intravenous Thrombolytics to break up clots. For non-ST segment elevation myocardial infarction, the treatments tend to be the same, though without the same time constraints. If an angioplasty is not a viable option due to recent surgery, a bleeding disorder, or multiple blocked arteries, coronary artery bypass surgery can be used to restore blood flow.

Exercise and Nutrition – What’s More Important Than Breakfast?

***This post was written by friend and former coworker Jason Goodwin, an experienced personal trainer and current nutritionist student in California......I'll go ahead and assume he knows what the hell he's talking about.......***

A healthy diet and nutrition has been forever focused on breakfast being key to your daily performance and eating habits. You have hear it over and over again, read it everywhere, and been asked about it time and time again by trainers and nutritionists who work with you – Breakfast. What are you eating, when and why? They will tell you how breakfast is the single most important meal of the day.

These exercise and nutrition professionals will tell you how you have to have it to get your metabolism jump-started after a 7-8 hour sleepy slow down, and that eating breakfast will assist you in potentially losing weight through the day. It is true that skipping breakfast is a bad idea, especially if it forces you to over-feed at lunch or dinner. Assuming a lunch at noon and dinner at 8:00 the night before, one will have gone up to 16 hours without a meal if they pass on breakfast. On a regular basis this is detrimental to your weight as well as your mental and behavioral functions. I do advocate starvation practices over the short term and on a planned and infrequent basis, but as a way of life well, we have to eat.

Breakfast Is A Must To Jump-Start Your Metabolism

While skipping breakfast can cause you to eat more than normal at your following meals and can lead to unhealthy snacking and craving, this does not make it the most important meal of your day. Being the intense, weight training, fit, fighting machine, that you are – the most important you eat each day is the first meal immediately after your vigorous workout! This is the key to exercise nutrition.

‘Post Workout Nutrition’ is an important practice that has to be done correctly to maximize all of your time and effort in the gym. Feeding those starving muscles the correct ingredients and at the right time can help trigger recovery and muscle growth to ensure you build the most muscle possible. And as we have hammered home in previous articles, more muscle burns more calories and fat!



Too many people spend too much time in the gym, training with intensity, yet failing to show much or any progress even after a year of training. Many times the culprit is not the exercise or effort, but rather it is the timing of nutrients and nutrition after your session. Immediately after training your body is still breaking down muscle (catabolic), not building new muscle fibers, and this process has to be halted and changed to an anabolic (muscle building) state as quickly as possible. Exercise depletes your carbohydrate reserves and protein structures at the muscular level, these must be replenished right away, as your body sends the message to “recover”. Recovery happens when the body is fed the right macronutrients at the right time, coupled with the required rest.

Proper Post Workout Nutrition Maximizes Your Ability to Build Muscle

In order to feed those starving muscles you want to use the hormone insulin to your advantage as it will hammer home all those valuable nutrients directly to your ripe and ready muscles. Eating sufficient carbohydrates is what triggers this insulin spike, so a post-workout meal full of carbohydrates and fast digesting protein is essential. Insulin will shuttle the protein and carbs to your muscles leading to replenished energy stores and moves the amino acids in protein to the muscles where recovery and muscle growth occurs.

A guideline to follow for healthy nutrition and exercise recovery is 1 gram of carbohydrates and roughly 0.4 gram of protein for every kilogram you weigh, again, use this as a guideline because finding your own way is the best approach. Post workout fat intake should be kept low because the insulin spike we purposely create with carb consumption is going to send most of these nutrients into storage (carbs for glycogen and protein for repair) and we need this to happen quickly. Fat slows absorption, which means the nutrients will take longer to get to their desired destination.

Finally, your first meal after your strenuous workout should be immediately after exercise when the muscles are primed for compensation. It has been proven that a meal within 1 hour (within 45 minutes is best) of exercise is far more beneficial than one consumed 3 hours after a workout. This is why a fast digesting whey protein shake with easily digested carbohydrates is so helpful.

Your post workout nutrition is the most important of the entire day, every day, it is the difference between muscles growing or muscles being broken down. More muscle burns more calories even at rest so more fat is burned daily. Yes, please eat your healthy breakfast every day, but missing your post workout meal can be damaging.

Pharmacy Tech Certification In Bakersfield - PTCB

PTCB certifications are issued by the PTCB (Pharmacy Technician Certification Board), this is the national organization that creates the board exam which you will sit for after training.

There are two parts to PTCB certifications and to being a Certified Pharmacy Technician (CPhT):

1. Pharmacy technicians must sit for and pass the national Pharmacy Technician Certification Examination (PTCE). Once a pharmacy technician has passed the exam, he or she may use the designation of CPhT.
2. To continue to hold certification, a CPhT is required to obtain twenty hours of continuing education for recertification within two years of original certification or previous recertification.

Some important points to note regarding PTCB certifications are:

• Exam schedules - PTCB certification-s exam is given 3 times a year in MARCH, JULY & NOVEMBER.
• Application fee – $120
• Continuing education – Must complete 20 hrs every 2 years before license renewal, make sure to keep a record of completed ce (continuing education) credits for each year.
• Eligibility – Candidate must have a HS diploma or GED and never have been convicted of a felony, however, there may be certain cases where the PTCB may make an exception, contact them for more information.
• Exam format – 140 multiple-choice questions. Fifteen of the 140 questions are pre-test questions and will not count toward your final score. However, there is no way to know which questions are pre-test questions and therefore you should answer every single question within the allotted time if you can.
• Exam questions - Questions may cover all aspects of pharmacy and if you recall I mentioned on the checklist that good pharmacy tech courses should cover most aspects of pharmacy.
• Reexamination – The PTCE (Pharmacy Technician Certification Examination) may be taken by eligible candidates as many times as needed to earn a passing score. A new application including appropriate documentation and $120 in fees must be submitted each time to the PES (Professional Examination Service). This is an agency that conducts testing on behalf of the PTCB.
• Passing score – if you receive a score of 650 or greater then you’ve passed the exam.

Once you pass the exam the board will issue a license in your name and you will then be able to use the credentials “Cpht” (Certified Pharmacy Technician), it is these credentials that employers want to see when they make their hiring decisions.

A point to note is that not all states require a pharmacy technician to be certified in order to work in a pharmacy BUT regardless of the state’s requirement most employers may only hire pharmacy technicians that are certified or are in the process of becoming certified or are in training to become certified.

Pharmacy Tech Programs Bakersfield Ca - Why Take The PTCE?

Uncertified techs may become a liability if they are not experienced and may not possess the necessary pharmaceutical knowledge in order to function efficiently within the pharmacy team. This could give rise to lawsuits towards the company if, for example, the wrong medication gets dispensed to patients. There can also be other medication errors of which the uncertified tech is a cause of.

Completion of one of the accredited Pharmacy Tech Programs Bakersfield Ca qualifies the student to sit for the PTCB certification exam. So, certification is essential and sooner or later states that do not have PTCB certifications requirement will adopt them.  Also, if you’re certified you may very well start at a higher salary than someone that isn’t.
The PTCB has created a candidates guidebook to certification that can be downloaded for free from their site HERE. This guide will cover the above points in detail and will also have contact info for the PTCB.

Bloodeborne Pathogen Training In Bakersfield Ca

Bloodborne pathogens are infectious micro-organisms that can cause disease and may be found in blood or other body fluids. Bakersfield-area healthcare workers can learn how to safeguard themselves and others against bloodborne pathogens as part of the American Heart Association's Bloodborne Pathogens course. Such training modules can address appropriate policies and procedures for safe dealing with bloodborne pathogens and other bio-hazardous materials.

Dangers of Bloodborne Pathogens

Exposure to bloodborne pathogens can cause a person to become infected with serious diseases, such as hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Medical professionals are at particular risk to exposure to bloodborne pathogens due to the nature of their work.

Risks to Healthcare Workers

Healthcare workers and Bakersfield nursing students on clinical rotation may be exposed to blood and other potentially infectious bio-hazard materials, such as human tissue and body fluids, on a daily basis. Blood should always be considered potentially infectious and handled accordingly. Bloodborne pathogens can be passed along via a prick or cut to a person’s skin or exposure to a mucous membrane. Such exposure can be the result of an accidental jab from a needle or cut from contaminated medical waste.

Prevention of Exposure

The health threats presented by bloodborne pathogens are very real. In fact, the Occupational Safety and Health Administration (OSHA) mandates that all workplaces develop a bloodborne pathogen exposure control plan. Such plans call for details on instituted employee protection measures and what to do if exposure occurs. For healthcare workers who may regularly come into contact with bloodborne pathogens, it is important to learn how to properly handle and dispose of medical waste. It is also important for employees to be aware of what personal protective equipment might be recommended to help safeguard against bloodborne pathogens.