RVR is a non-profit Christian youth camp, outdoor education center, and retreat facility in Maryland. Since 1952 we've been offering unique experiences, quality caring staff, and meaningful life impact for our guests!
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Hasan colak Cover art photo provided by Joshua Rivera on Unsplash: https://unsplash.com/@jsh_rvr
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Hear my 5 cents worth! Follow me on Instagram @d.n.y.k Cover art photo provided by Joshua Rivera on Unsplash: https://unsplash.com/@jsh_rvr
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River Valley Roundtable provides monthly lunch-hour learning opportunities. Experienced business professionals share the successful principles and processes that have helped them advance in their personal and business endeavors.
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AAA Ask Andre Anything from Art, Design, Fashion, Cigars, and Grooming! Cover art photo provided by Joshua Rivera on Unsplash: https://unsplash.com/@jsh_rvr
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What is up I will do weekly podcasts and might go daily if this keeps up and I'll talk about anything you guys want to talk about, as well as the latest news and sports, gaming, music etc.. Stick around Cover art photo provided by Joshua Rivera on Unsplash: https://unsplash.com/@jsh_rvr
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PokéCouple Mack and Jaylee talk about their experiences playing through the Pokémon games. Updated Fridays!
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Hello,and welcome to STB's TalkCast where I (unironically) talk about stuff. Whether I'm just going through Reddit or talking with friends I usually end up having a good time. The question is... how about you? Cover art photo provided by Joshua Rivera on Unsplash: https://unsplash.com/@jsh_rvr
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The undefined relationship between twitter and the presidency. Cover art photo provided by Joshua Rivera on Unsplash: https://unsplash.com/@jsh_rvr
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Weekly radio show hosted on TranceWorld.Net The latest in Trance & Uplift Music
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The EMS Lighthouse Project Podcast exists to foster knowledge translation from peer-reviewed scientific journals to the street. Join Mike Verkest and Dr. Jeff Jarvis as they shine the bright light of science on EMS practice in an informative and fun way.
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I'm Paul from PassACLS.com and I'm here to help you pass ACLS. Like an audio flash card, this podcast is intended to aid any medical professional preparing for an Advanced Cardiovascular Life Support (ACLS) class. Each one-to-nine minute episode covers one of the skills needed to recognize a stroke or cardiac emergency and work as a high performing team to deliver safe, quality patient care. Listening to a tip a day for 14-30 days prior to your ACLS class will help cement the core concepts t ...
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Podcast by Dan Kent & Co.
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In atrial fibrillation (A-Fib) and atrial flutter (A-Flutter) the electrical impulse for cardiac contraction is in the atria but isn't the normal pacemaker of the heart, the SA node. The ECG characteristics of A-Fib and A-Flutter. Recognition and treatment of unstable patients in A-Fib/Flutter with rapid ventricular response (RVR). Suggested energy…
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RVR Level 67 - S5E6 - B&W Ep. 6: Route 6 to Mistralton City Gym
1:07:02
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Send us a text Through the cave and into the air field! We take on the High Flying Girl this week and put some spirit Pokémon to rest as we travel to the North Eastern town of scattered flowers. Breeze on through the city with us! Support the showVon MackseatGaming & Jayleebeans_
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Providing good, high-quality CPR with minimal interruptions and early defibrillation are two key interventions shown to improved cardiac arrest outcomes. A training tool used in many CPR and ACLS classes is to use a song (or a song list) with a tempo of 100 to 120 beats per minute to help the person doing chest compressions maintain an adequate rat…
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A patient’s medical history will help us identify things that may be causing (or contributing) to their current condition as well as guide our decisions so we provide the safest evidence-based care possible. Examples of information obtained in a medical history that will impact the treatment we provide. There are several mnemonics and memory aids t…
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Although magnesium can be used in the treatment of other medical conditions such as eclampsia, asthma, & digitalis toxicity; for ACLS, magnesium is primarily used to treat Torsades de Pointes. Identification of Torsades on the ECG. Administration of a magnesium infusion for stable patients vs slow IV push for patients in cardiac arrest. Procainamid…
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When a patient loses excessive amounts of fluids, we say that they are in a state of hypovolemia. The most obvious cause of hypovolemia is from bleeding. Bleeding can be internal or external and caused by trauma, pathology, or iatrogenic. Classic signs & symptoms of hypovolemic shock. Volume replacement with crystalloids vs blood. Connect with me: …
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MONA is the acronym sometimes used to help us remember the interventions to consider for patients with Acute Coronary Syndrome or ACS. Morphine's use in the Acute Coronary Syndrome (ACS) algorithm. Why Morphine is helpful for patients with ACS. Contraindications and considerations for the safe administration of Morphine. Morphine as an alternative …
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Even good CPR is far less efficient at circulating blood than a functioning heart. The indicators of high-quality CPR that were identified at the 2012 AHA CPR Quality Summit in order of importance include: Chest compression fraction (CCF); Chest compression rate; Chest compression depth; Allowing for full recoil; and Adequate ventilations. Using re…
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Epinephrine and Dopamine are adrenergic agonist used in several ACLS algorithms. The use of epinephrine for severe anaphylaxis and unstable bradycardia. Review epinephrine’s effects on blood vessels and bronchioles. Why epinephrine is helpful for patients with anaphylaxis. Using an epi drip for unstable bradycardia. Epinephrine administration durin…
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Providing rescue breathing to apneic patients with a palpable pulse. Normal end tidal CO2 for patients with a pulse. Identification of cardiac arrest and our immediate actions. Providing artificial ventilations during CPR without an advanced airway vs with an advanced airway in place. Using quantitative waveform capnography to confirm placement of …
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Hypothermic patients aren't dead until they are warm and dead. When a patient’s core body temperature drops below 96.8 F (36 C), they are hypothermic. As the body’s temperature drops below 36 C, hypothermia may further be classified as moderate or severe: Moderate if the patient’s body core temp is between 30-34 C; and Severe if it's below 30 C. Mo…
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Calcium is one of the ions that move across the cellular membrane during cardiac contraction and relaxation. The primary use of calcium channel blockers in ACLS is for the treatment of stable, narrow complex tachycardias refractory to Adenosine and to lower the blood pressure of ischemic stroke patients with severe hypertension. Use of calcium chan…
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The goal of CPR is to keep the brain and vital organs perfused until return of spontaneous circulation (ROSC) is achieved. Post-arrest care and recovery are the final two links in the chain of survival. Identification of ROSC during CPR. Initial patient management goals after identifying ROSC. The patient’s GCS/LOC should be evaluated to determine …
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Nitroglycerine is vasodilator that affects peripheral blood vessels and coronary arteries. Because of its widespread dilation effects on blood vessels, nitro can quickly lower a patient’s blood pressure, sometimes to the point of making a patient hypotensive. Assessment of vital signs prior to administering nitro is necessary to ensure patient safe…
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Ep 89 - IM Epi in OHCA, Part II
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Back in episode 80 we discussed a feasibility study out of Salt Lake City that showed IM epi resulted in 3-minute faster administration in cardiac arrest. It was underpowered to show survival, however. Fortunately, the great folks in Salt Lake City is back with a larger bite at the statistical apple. Dr Jarvis discusses the background around what w…
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As an ACLS provider you do not need to be familiar with all of the different signs of various types of poisoning. You should be able to obtain a history and know to order toxicology. The majority of toxins don’t have a specific antidote. There are a few toxins for which we have emergency interventions and ACLS providers should be familiar with. Rev…
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The ACLS algorithms are designed to make it easier to remember the key interventions we should deliver, and the order in which they should be delivered, to provide the best evidence-based care possible. Generally speaking, if there’s a change in a patient’s condition, we should ensure we’re using the correct algorithm. Three key points to remember …
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Beta blocking medications attach to Beta receptors to inhibit or “block” the effects of epinephrine (adrenaline)and norepinephrine in the body. The primary locations of Beta I, II, and III receptors. Effects of epinephrine & norepinephrine’s stimulation of beta receptors on the heart. Beta blockers effects on the heart. When we should consider the …
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This episode we are reviewing the use of advanced airways in the adult cardiac arrest algorithm. When we should consider insertion of an advanced airway for patients in a shockable vs non-shockable rhythm. In addition to an endotracheal tube (ETT), other ACLS advanced airways include the Laryngeal Mask Airway (LMA) and the Laryngeal Tube airway. Th…
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Our primary focus immediately following return of spontaneous circulation (ROSC) is aimed at ensuring adequate perfusion of the patient’s vital organs and decreasing cerebral damage. Post-arrest goals for O2 saturation, ETCO2, and BP/MAP. Indications for use of an antiarrhythmic after ROSC. Determining which antiarrhythmic to use post cardiac arres…
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Hydrogen ions is on one of the Hs in ACLS's H&T reversible causes of cardiac arrest. When considering hydrogen ions as a cause, what we’re looking at is the patient’s pH, or acid/base balance, and conditions that affect it. The body's normal pH. Using patient history, ABGs, & labs to determine acidosis or alkalosis. Common conditions/causes that ma…
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Being the team leader during a cardiac arrest is challenging. Using an algorithm helps by standardizing & prioritizing our interventions using an If/Then methodology. Review of BLS steps for determining if rescue breathing or CPR is needed and use of an AED for patients in cardiac arrest. If the patient is in a non-shockable rhythm on the ECG such …
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For patients exhibiting symptoms consistent with myocardial ischemia, Aspirin is the first medications we should consider along with morphine, oxygen, and nitroglycerine; if indicated & safe. Aspirin's mechanism of action & benefits for Acute Coronary Syndrome (ACS) patients. Contraindications and considerations for aspirin’s use. The dose and rout…
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To pass ACLS, you will need to be able to identify common rhythms on a monitor during your mega code and ECG strips on your written exam. If you don't normally monitor patients as part of your job, I suggest two things: 1. Find a system for ECG interpretation that works well for you; and 2. Practice reading ECGs every day for a few weeks before you…
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In the Adult Cardiac Arrest algorithm, we should administer an antiarrhythmic medication to patients in V-Fib or pulseless ventricular tachycardia approximately two minutes after the first dose of epinephrine. The two first-line ACLS antiarrhythmics that are generally used are Amiodarone and Lidocaine. Review of Lidocaine dosing and administration …
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The tongue is the most common airway obstruction in an unconscious patient. For patients with a decreased level of consciousness that can't control their airway, yet have an intact gag reflex, the nasopharyngeal airway (NPA) should be used as an alternative to the oropharyngeal airway (OPA). Examples of when a NPA should be considered. Contraindica…
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When blood, or other fluids, accumulate in the sac around the heart it’s called a cardiac tamponade or pericardial tamponade. The effects of tamponade on the electrical system and chambers of the heart. Cardiac tamponade can be acute or chronic and caused by traumatic, iatrogenic, or pathological etiologies. Common traumatic events, medical procedu…
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Two things have changed in recent years to aid students that don't use ACLS in their daily practice. 1. The role of the team leader; and 2. The ability to use your quick reference cards. The team leader is responsible for assigning tasks and overall direction of the team but can & should ask team members for help. Using closed-loop communication to…
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Two factors to cardiac arrest survivability that have been clearly shown to make the biggest difference is continuous, high-quality CPR and early defibrillation. The most common dysrhythmia present during the first few minutes of cardiac arrest is ventricular fibrillation (VF). The chance of successful defibrillation decreases every minute that pas…
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Quantitative waveform capnography is used in ACLS as a way to confirm good CPR and placement of an endotracheal tube; identify return of spontaneous circulation; and during post-cardiac arrest care. We can use waveform capnography with, and without, an advanced airway in place. Monitoring end tidal CO2 during rescue breathing. Use of capnography to…
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RVR Level 66 - S5E5 - B&W Ep. 5: Route 5 to Driftveil City Gym
1:04:06
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Send us a text We plumb the depths of the Driftveil Cold Storage for answers about why Team Plasma wants to end the world. Clay the hick gets in the way, and then we bury him in his favourite place. Throw on your mud stompers, it's time to get dirty and down to business. Also, a lot of 5s in the title of this one. Support the show…
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Ep88 - Naloxone in Cardiac Arrest?
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Do you give naloxone to patients who are in cardiac arrest? Should you? Can it possibly provide any benefit at all once you are already providing effective ventilations? Well, Dr. Jarvis certainly thought not. He might have even thought it out loud. Like, loudly out loud. Based on two recent papers looking directly at this question, perhaps he need…
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Patients with a narrow complex tachycardia with a rate over 150 BPM are in SVT. Unstable patients in SVT, or V-Tach with a pulse, should be cardioverted with a synchronized shock. Assessment & treatment of stable tachycardic patients. Commonly used vagal techniques. A less common technique to stimulate the vagus nerve is the dive reflex. Indication…
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Remembering all the different energy setting needed for synchronized cardioversion and defibrillation used to be confusing for a lot of people. Defibrillators can be broken down into three basic categories: 1. Automated External Defibrillator (AED); 2. Biphasic defibrillators; and 3. Monophasic defibrillators. Use of an AED to rapidly deliver a sho…
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RVR Level 65 - S5E4 - B&W Ep. 4: Route 4 to Nimbasa City Gym
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Send us a text The competition is electric and the sparks fly this week as our duo light up Team Plasma and their King is shockingly revealed. Get amped for the high voltage potential! Also, Elesa is there somewhere, too. Zap. Support the showVon MackseatGaming & Jayleebeans_
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Brandon Vieth pt2 | Summer Camp Wk9
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 9, 2024 with Pastor Brandon Vieth!Von River Valley Ranch
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Brandon Vieth pt1 | Summer Camp Wk9
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 9, 2024 with Pastor Brandon Vieth!Von River Valley Ranch
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Brandon Vieth pt3 | Summer Camp Wk9
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 9, 2024 with Pastor Brandon Vieth!Von River Valley Ranch
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Brandon Vieth pt4 | Summer Camp Wk9
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 9, 2024 with Pastor Brandon Vieth!Von River Valley Ranch
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Brandon Vieth pt5 | Summer Camp Wk9
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 9, 2024 with Pastor Brandon Vieth!Von River Valley Ranch
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Ep87 - Those CPR Pauses, Though...
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Remember when we learned interruptions in compressions take a long time to recover blood pressure from? And how, to avoid these, we should do continuous compressions to avoid them. And ventilations aren’t all that important. Right? Right? Well, about that. Maybe the stories of the importance of continuous compressions were greatly exaggerated. Join…
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Tim Trinkle pt2 | Summer Camp Wk8
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 8, 2024 with Pastor Tim Trinkle!Von River Valley Ranch
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Tim Trinkle pt5 | Summer Camp Wk8
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 8, 2024 with Pastor Tim Trinkle!Von River Valley Ranch
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Tim Trinkle pt1 | Summer Camp Wk8
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 8, 2024 with Pastor Tim Trinkle!Von River Valley Ranch
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Tim Trinkle pt4 | Summer Camp Wk8
38:46
38:46
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 8, 2024 with Pastor Tim Trinkle!Von River Valley Ranch
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Tim Trinkle pt3 | Summer Camp Wk8
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 8, 2024 with Pastor Tim Trinkle!Von River Valley Ranch
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RVR Level 64 - S5E3 - B&W Ep. 3: Pinwheel Forest to Castelia City Gym
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Send us a text We head across the Skyarrow Bridge into the big city to take on Burgh the "Premier Insect Artist". Getting lost in the streets and taking in the beats, we also unlock secrets long lost to the franchise. Support the showVon MackseatGaming & Jayleebeans_
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Elijah Ogden pt1 | Summer Camp Wk7
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 7, 2024 with speaker Elijah Ogden!Von River Valley Ranch
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Elijah Ogden pt4 | Summer Camp Wk7
38:17
38:17
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 7, 2024 with speaker Elijah Ogden!Von River Valley Ranch
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Elijah Ogden pt2 | Summer Camp Wk7
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32:45
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Evening speaker recordings at our Frontier Town teen summer camp services. Week 7, 2024 with speaker Elijah Ogden!Von River Valley Ranch
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