ACLS, PALS, etc.

[ArkansasRanger]

I'm doing a little reading, and I'm curious what roles a pharmacist would serve on code teams. I type in some phrases in Yahoo, but I don't see a lot that explains what I'm thinking about.

I'm curious. Having been a paramedic and well versed in ACLS and PALS I find the idea of pharmacists working with code teams interesting. I'm looking at pharmacy as a career choice, other than medicine, and it'd be interesting if I could remain attached to emergency care at least loosely.

What information I've seen is mostly on emergencypharmacist.org which suggests an emergency pharmacist should even take ATLS which I thought requires some knowledge of x-ray. That said, does pharmacy school provide students with exposure to electrocardiograms and related skills/knowledge, or even IVs for that matter?

Anyone with information is welcomed to reply.

---

Members don't see this ad.

 

[xiphoid2010]

I'm doing a little reading, and I'm curious what roles a pharmacist would serve on code teams. I type in some phrases in Yahoo, but I don't see a lot that explains what I'm thinking about.

I'm curious. Having been a paramedic and well versed in ACLS and PALS I find the idea of pharmacists working with code teams interesting. I'm looking at pharmacy as a career choice, other than medicine, and it'd be interesting if I could remain attached to emergency care at least loosely.

What information I've seen is mostly on emergencypharmacist.org which suggests an emergency pharmacist should even take ATLS which I thought requires some knowledge of x-ray. That said, does pharmacy school provide students with exposure to electrocardiograms and related skills/knowledge, or even IVs for that matter?

Anyone with information is welcomed to reply.

Well, I'm a pharmacy intern in ED. I am ACLS certified. My experience is that ED clinical pharmacist's job during a code or trauma is really more of a immediate drug reference and an extra pair of helping hand. She is the one by the code cart anticipating what will be used next.

For example, if the patient looks like needs intubation, she draws up sux and propofol or etomidate. During a PEA, she will have epi and atropine already ready for use before it's even said. Amiodarone would be anticipated ready during a v.fib. When the nurse asking what rate to run the amio, she shouts back 1 mg/min. If the resident want to know which non-depolarizing neuromuscular blocker to go for in a hypotensive patient, she reminds them that histamine release from atracurium can worsen hypotension, so go for vecuronium instead. The same kind of random Q&A goes for all the other drugs.

She always knows where everything is in the code cart, and is the ones handing out c-collars, ambu bags, CO2 detectors etc out of it (instead of having 10 different people trying to swamp the cart all at once).

She is also good at reading the rhythem strips, although she doesn't usually say it unless the resident gets it wrong. It's part ACLS training, part experience.

But she doesn't know much about what to look for on chest x-rays or CT or MRI (besides than obvious things like a huge heart heart probably means this patient's SOB is probably due to CHF exacerbation).

 

[njac]

I took ACLS and PALS as a 4th year pharmacy student, and again as a resident. Didn't learn how to read EKGs in class but did through interning at the hospital and spending a lot of time in the ED and ICUs.

 

[ArkansasRanger]

Thanks for the answers. The whole process of it all is neat, and it's interesting to be around. Having gone through the whole process many times by myself (only one guy in back of an ambulance) I'm ok with never putting my hands on the paddles or laryngoscope again, lol.

It'd definitely be handy to have a pharmacist around. That'd be at least one level headed person not trying to manage countless other elements of the patient. I can think of codes I've been involved in where I use a drug because it's in the algorithm and not because, at the moment, I could remember it's MOA, etc, but afterwards I could sit back and think "oh, duh, that's why!"

Thanks again.

 

[njac]

definitely, part of my job at codes and traumas is to be an objective perspective outside of the "bustle".

I can and have done compressions, stabilized a c-spine, etc but my job is really to go "hey don't you think some Bicarb would be good" or "last epi 2 minutes ago, do you want your amio bolus?"

 

[WVUPharm2007]

When I did it I was usually Johnny on the spot with the atropine/epi/bicarb...handled the oddball pertinent drug q's that would come up...got **** for people (being the errand boy isn't beneath anyone on a code)...drew up drugs into syringes for nurses out of the pyxis (i.e. ativan)...etc.

Basically, I just got out of the damned way...did what I could to help...try to anticipate ****. If the dude is just seizing, obviously I leave the heart **** in the code box and mosey on over to the pyxis to get some benzos...

 

[Glycerin]

Ditto what other people have mentioned, but also at my institution, we actually administer the medications during traumas and sometimes codes as well. Not solely, but we can if other people are tied up. I can count beyond my fingers and toes the number of times on just my ED rotation alone during my residency that I started drips on patients or pushed drugs like mannitol, metoprolol, morphine, etc. Our physicians have a lot of trust in us, and our state is really progressive in pharmacy practice as it is.

 

[uicgrad]

Glycerin,

What state are you in that is so progressive in it's pharmacy practice? I am curious to know. Many states seem to restrict pharmacist's from drug administration. Except for vaccines and such. You are lucky to be in such a progressive state.

 

[Glycerin]

Glycerin,

What state are you in that is so progressive in it's pharmacy practice? I am curious to know. Many states seem to restrict pharmacist's from drug administration. Except for vaccines and such. You are lucky to be in such a progressive state.

I'm in Washington state.

 

[whatisayout]

As an ACLS/PALS instructor, I can say that I see TONS of pharmacists in classes. They always say they really enjoyed the class & found it useful.

 

[spacecowgirl]

I'm going through PALS training next month. Our departmental goal is to have all of us PALS and ACLS trained. I don't anticipate we will be administering meds, mostly drawing up meds, doing calculations, etc. The ED staff really wants us to attend codes; we'll see how it all shakes out.

 

[psychoandy]

does anyone else enjoy flipping the caps off of the abbojects? i <3 it

does pharmacy school provide students with exposure to electrocardiograms and related skills/knowledge, or even IVs for that matter?

As a pharmacist at a code, most of it is mixing drugs and possibly being "the scribe". Also can be called for mixing tPa, neo-synephrine, etc. However, not all hospitals assign pharmacists to go to codes, even big academic medical centers.

In terms of what you learn in pharmacy school:
learning EKGs: it was very superficial and looking at a bunch of rhythm strips and identifying common things like AFib and QTc.
x-ray/radiology: none really, maybe a description of a CXR. all of my rads knowledge has come from clinical rotations and seeing for myself what a pneumothorax or ground glass opacities look like.
IVs: sort of. we learn how to prepare IVs, but not physically administering them. hell, some pharmacists i know still struggle with figuring out which tubing to spike a bag with.

 

[dingerx]

does anyone else enjoy flipping the caps off of the abbojects? i <3 it



As a pharmacist at a code, most of it is mixing drugs and possibly being "the scribe". Also can be called for mixing tPa, neo-synephrine, etc. However, not all hospitals assign pharmacists to go to codes, even big academic medical centers.

In terms of what you learn in pharmacy school:
learning EKGs: it was very superficial and looking at a bunch of rhythm strips and identifying common things like AFib and QTc.
x-ray/radiology: none really, maybe a description of a CXR. all of my rads knowledge has come from clinical rotations and seeing for myself what a pneumothorax or ground glass opacities look like.
IVs: sort of. we learn how to prepare IVs, but not physically administering them. hell, some pharmacists i know still struggle with figuring out which tubing to spike a bag with.

HELL YES!!! ---> To flipping the tops off and watching them shoot across the room (I try to hit the nursing supervisors and they know I'm aiming for them and enjoy it!). Making IVs is big and conversing with the intensivist or hospitalists abouts what going on. Again, anything you can do to help is appreciated. I have rarely done chest compressions and it has been at my desire to stay "fresh" if you will. Again, nurses love it and the docs are happy when I'm there to help catch dose errors and such (it does happen, rarely).