Featured Free CME Courses

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Pulmonary Arterial Hypertension: Meeting the Challenge of Early Diagnosis and Intervention Free 1
Evaluating the Efficacy of Disease Modifying Therapies for Relapsing-Remitting Multiple Sclerosis Free 0.25
DIABETES VIRTUAL CME SYMPOSIUM SERIES - Stemming the Diabetes Epidemic: Strategies to Improve Prevention and Treatment Free 1
Diabetic Retinopathy: Strategies to Improve Prevention and Management Free 1
New Kids on the Block: Antimicrobial Advances in the Management of Gram-Positive Skin Infections Free 1.5
Invasive Mycoses: A High-Risk Battle in the High-Risk Patient Free 2
Preventing the Preventable with Immunizations Free 2
Clinical Insights on Multiple Sclerosis Management from AAN 2016 Free 1
Alzheimer’s Disease in 2015: Diagnosis and Management Across the Disease Spectrum Free 1
Global Perspectives in Multiple Sclerosis Management from ECTRIMS 2015 Free 2
Lennox-Gastaut Syndrome Across the Lifespan: Improving Diagnosis and Management Free 1
MIGRAINE INSTANT SYMPOSIUM: Treatment Choices in Acute Migraine Management: Selecting Appropriate Use for Individual Patient Free 1.0
Multiple Sclerosis: Exploring Treatment Options and Individualizing Therapy Free 2
Chronic Lymphocytic Leukemia Summit: Evolving Practices in Chronic Lymphocytic Leukemia Free 1
Nursing Perspectives for Optimizing Outcomes in Hemophilia Treatment Free 1
MELANOMA VIRTUAL EDUCATION SUMMIT: The Evolving Landscape of Advanced Melanoma Treatment Free 2
LIVE VIRTUAL LEARNING SERIES: Treating Chronic Pain While Managing Risk Free 4
Treatment Evolution for Patients with Idiopathic Pulmonary Fibrosis Free 1
Acute Lymphoblastic Leukemia in Adults Free 1
Renal cell carcinoma (RCC): Highlights from the 2015 American Society of Clinical Oncology Free 1
Acute Lymphoblastic Leukemia (ALL): Highlights from the ASH 2015: Take-Aways, Emerging Practice Changes, and Barriers to their Implementation Free 1.0
The Newest in Non-Small Cell Lung Cancer (NSCLC): Emerging Therapies, Novel Approaches, Therapeutic Updates, and Barriers to Care and Incorporating Best Practice Free 1.0
Psoriasis: Best Practices, Barriers to Care, and Emerging Therapies in Medication Management Free 1.0
ScientiaCME Cardiology Free CME Free 0 - 1.5 each
ScientiaCME Medical Safety Free CME Free 0.5 - 1 each
ScientiaCME Pharmacy Free CME Free 0 - 1.5 each
ScientiaCME Pulmonology Free CME Free 0.5 - 1.5 each
ScientiaCME Neuropsychiatry – Psychiatry Free CME Free 6.75
Critical Care - Hemodynamics Free 0.5 - 1 each
Critical Care - Pharmacotherapy Literature Updates Free .5 each
ScientiaCME Critical Care - ERAS Free CME Free 0.75 - 1 each
ScientiaCME Endocrinology / Diabetes Free CME Free 0.5 - 1.5 each
ScientiaCME Gastrointestinal Free CME Free 1 - 1.5 each
ScientiaCME Immunology - Allergy Free CME Free 1 each
ScientiaCME Immunology - Rheumatology Free CME Free 1 each
ScientiaCME Infectious Disease / Virology Free CME Free 0.5 - 1 each
ScientiaCME Neurology Free CME Free 1 - 7 each
ScientiaCME Hematology Free CME Free 0.75
ScientiaCME Oncology Free CME Free 0.5 - 1 each
ScientiaCME Pain - Neuropathic Free CME Free 1 each
Diabetes Full Circle: Digesting New Data on Combination Therapy and Cardiovascular Risk Free 0.75 (3 sections of 0.25 hour each)

New ACLS Guidelines

The American Heart Association evaluates research and reviews existing first aid and life support guidelines to determine what changes need to be made to improve the effectiveness of procedures such as Advanced Cardiac Life Support (ACLS), Pediatric Advanced Life Support (PALS), Basic Life Support (BLS), and Cardiopulmonary Resuscitation (CPR). This assessment of guidelines occurs every five years.

Late in 2010, new ACLS guidelines were announced. Health Education Solutions (HES) will implement new modules that adhere to those standards in their courses for ACLS Certification and ACLS Recertification.

A-B-C to C-A-B, ACLS guidelines change priority of response

The A-B-C approach (Airway-Breathing-Circulation) has been changed to the C-A-B approach (Circulation-Airway-Breathing). The purpose of this new approach is to quickly initiate chest compressions for individuals with life-threatening heart problems in order to restore and maintain blood pressure. It primarily applies to CPR performed by a single rescuer. In the hospital setting and with teams, management of circulation and respirations are achieved simultaneously.

ACLS Chest Compression Changes

The newly mandated ACLS changes to chest compressions require that:

  • Depress the adult sternum at least 2 inches
  • Complete recoil of the chest is required
  • Chest compressions should be performed at a rate of at least 100/minute
  • Checking for a pulse in an unresponsive individual now requires less than 10 seconds so chest compressions aren’t delayed.

Remember, mistakenly doing chest compression on someone with a pulse does little harm compared to not doing compressions on someone without a pulse.

Quantitative Waveform Capnography Recommendation

To confirm and monitor endotracheal tube placement, use quantitative waveform capnography. The continuous measurement provides the partial pressure of exhaled carbon dioxide in mm Hg and it also provides a monitor of effective chest compressions. The return of spontaneous circulation can be difficult to assess, however it’s clearly demonstrated on the capnography measure by a sudden increase in co2 readings. Individuals who require endotracheal intubation are at risk of tube displacement during transport and transfer. The continuous waveform capnography will reflect these changes.

New Medication Protocols in ACLS Course

Four new medication protocols are covered in HES’ ACLS Classes.

  1. Due to the lack of any observed therapeutic benefit, atropine is no longer recommended to manage Pulseless Electrical Activity (PEA) or asystole.
  2. Adenosine is recommended for the treatment of stable, undifferentiated wide-complex Tachycardia when the rhythm is regular and the QRS waveform is monomorphic.
  3. Intravenous chronotropic agents are recommended as an effective alternative to external pacing for individuals with symptomatic or unstable bradycardia.
  4. Oxygen supplementation for uncomplicated acute coronary syndrome is no longer routinely indicated and should only be applied only if the oxyhemoglobin saturation is less than or equal to 94 percent.

Emergency Care Priorities

In order to avoid interruptions to chest compressions or delays in use of defibrillators, the use of advanced airways, gaining vascular access, and administering drugs doesn't take priority over high quality CPR and access to immediate defibrillation.

Post-Cardiac Arrest Care

A new ALCS guideline was created for Post-Cardiac Arrest Care. This ALCS guideline emphasizes a structured interdisciplinary system of care following a cardiac arrest. Therapeutic hypothermia treatment and percutaneous coronary interventions, such as coronary angiography with revascularization should be provided when indicated after cardiac arrest.

New Stroke Care Recommendations

The window of time to use thrombolytics (rTPA) is still within three hours of onset of stroke symptoms. However, select patients can be treated with TPA within four and one-half hours. Stroke care through regional systems of care and organized stroke units are recommended.

The talented neurologist can pull a lot of information about acute ischemic strokes on head CT. Watershed infarcts are more difficult to identify on CT but the clinical setting is usually the most helpful in diagnosis.

Previous ACLS Study Remains Valid

If you've been trained under the old guidelines, you aren't required to immediately take new ACLS courses. The new ACLS guidelines don't suggest that the earlier guidelines were unsafe or ineffective, and individuals trained under earlier guidelines should continue to perform to these standards until they are trained under the new guidelines. Course completion cards will continue to be recognized as valid for two years, regardless of ACLS procedural changes.