Is it time for you to renew your BLS certification? Follow these three easy steps to ensure a seamless and easy renewal process.

1. Find the renewal course that works best for you.
Find the renewal course that works best with your schedule. The American Heart Association BLS blended recertification courses requires online coursework and final exam online, followed by a brief in-person skills testing session. This format may offer more flexibility with less stress for busy healthcare professionals. 
​2. Complete the online coursework.
An AHA BLS renewal online course consists of instructional modules on the following topics:
A. Automated external defibrillator (AED) use
B. CPR for adults, children and infants
C. Care for choking victims 
D. 2-rescuer CPR techniques 
E. Cardiopulmonary emergencies and special situations
The online modules can be completed at the time and location you choose, allowing you to finish your training on your own schedule.
3. Schedule your in-person skills testing.
Once you have completed the online coursework and passed the online final examination, you may schedule a brief skills check with one of our exceptional American Heart Association BLS Instructors here at Help-A-Heart CPR, LLC. Your instructor is also available to answer questions and clarify information. 

Preparation is the key to ensure the successful completion of the AHA BLS Online Course. In addition, take a few moments before your course begins to review basic BLS information. A quick review will make it easier to understand and retain the information during your coursework. In addition, make a list of questions to ask your instructor during the skills testing session.
​Don’t put off BLS renewal any longer. Sign up for one of our classes today and keep your certification and BLS Provider skills up to date. 

The ECG or ECG is a tool used in a healthcare setting to both diagnose and monitor the electrical impulses of the heart. The ECG is used by healthcare providers to specifically monitor heart rhythms, detect and heart abnormalities and diagnose various cardiovascular diseases.

An ECG records the heart’s electrical signals in the form of waves and intervals, providing valuable information that allows healthcare providers to better understand the health of the heart muscle and its rhythm. Natural electrical impulses coordinate contractions of the different parts of the heart to allow and ensure that blood circulates in a normal manner. An ECG records these impulses to show how fast the heart is beating, the rhythm of the heart beats and whether it is steady or irregular, and the timing of the electrical impulses as they progress through the various parts of the heart. Subsequently, any modifications in an ECG can be a manifestation of many different heart-related conditions.

1. A wave is a positive or negative stroke that represents a single electrical event in the heart. There are five primary waves in a standard ECG:

P Wave: Represents the electrical activity in the the upper chambers of the heart otherwise known as the atria.
Q Wave: A downward deflection of the wave.
R Wave: The first upward deflection of the wave.
S Wave: A downward deflection following the R wave.
T Wave: Represents the repolarization or recovery of the ventricles within the lower chambers of the heart.

2. An interval measures the time between two waves on an ECG. The common intervals include the following:

PR Interval: Time taken for the electrical impulse to travel from the atria to the ventricles.
QRS Interval: Time it takes for the electrical impulse to travel through the ventricles.
QT Interval: Time from the start of ventricular depolarization to the end of ventricular repolarization.
RR Interval: Time between two successive R waves (measuring heart rate).

3. A segment is the region between two waves and is measured based on its elevation or depression from the baseline. Segments give information on how well the heart muscle is conducting electricity.

4. A complex is a group of multiple waves that form a single unit. The QRS Complex is the most significant complex in an ECG. It represents the electrical activity during ventricular depolarization.
​
Developing an understanding of an ECG may seem difficult at first, but with a basic foundation an ECG you can also gain an increased understanding of the electrical activity occurring within the heart. Whether you’re a healthcare provider or simply someone interested in learning about the mechanisms of the human body, understanding the core components of an ECG is a vital skill. Give us a call or view our class schedule to enroll in one of our upcoming ECG and Pharmacology classes.

​Both V-tach and V-fib are considered medical emergencies. Thus, the ability to distinguish between the two rhythms is necessary to ensure an appropriate intervention and treatment. For example, non-sustained V-tach may be addressed with medication in some cases, while V-fib and pulseless V-tach require immediate cardiopulmonary resuscitation (CPR) and defibrillation.

Ventricular fibrillation (V-fib) is most often characterized by a fast, abnormal heart rhythm caused by ventricle walls quivering or twitching instead of pumping blood. It can lead to sudden cardiac arrest and sudden cardiac death. Prior to experiencing V-fib, a patient may manifest shortness of breath, gasping for air, chest pain, lightheadedness, and nausea.

​1. No clear QRS complexes, P waves, or T waves
2. Electrical activity is disorganized
3. The rate appears very rapid – up to 600 beats per minute
4. Coarse Vfib resembles a squiggly line, waves are 3 mm or larger
5. Fine Vfib features an almost straight line, waves are less than 3 mm

Ventricular tachycardia occurs when one of the heart’s ventricles takes over the pacemaker duty and causes the heartbeat to speed up. In addition to a sensation that the heart is beating too fast, a patient might experience a shortness of breath, light-headedness or fainting, and/or chest pain. However, some individuals do not experience any symptoms with V-tach, particularly if the episode is brief and/or lasting under 30 seconds which is known as non-sustained V-tach. Non-sustained V-tach with symptoms may be treated with medication to control the heart rate.

​1. Wide QRS complexes greater than 0.14 seconds
2. QRS complexes are not preceded by the usual P waves
3. Occasional R intervals that are not typically regular.
4. Ventricular rate is usually between 150 and 250 beats per minute
5. No atrial rate can be determined.

When every second counts, your ability to quickly distinguish the difference between V-fib and V-tach can essentially mean the difference between life and death. Getting training and certification now can prepare you for cardiac arrest emergencies in the future. Make sure you are equipped with the knowledge and practice you need to give your patients the highest level of care.

With instructors at Help-A-Heart CPR that are committed to making classes interactive and engaging you will find it easy to learn and become empowered with lifesaving skills and new information. With classes offered 100% online, in-person and on-site, we have a training schedule that can accommodate even the busiest professional. Check out our class schedule today to find the course that suits your schedule and accommodates your training needs.

​The following are five key statistics about cardiopulmonary resuscitation (CPR) and cardiac arrest which may help you save a life!

1. If you perform CPR, you can triple the person’s chance of survival.
According to the National Institutes of Health, early bystander CPR can double or triple a victim’s chance of survival after cardiac arrest. Research has continued to show that the average time between a call to first responders and their arrival on the scene is approximately 7-8 minutes. During those critical minutes, survival rates after cardiac arrest rapidly decrease.
Individuals who suffer cardiac arrest in a public setting have the event witnessed by bystanders. If one of those bystanders initiates CPR in the moments following the collapse, they increase the odds that the victim will survive the event and have a better quality of life afterward.

2. 356,000 people suffer from cardiac arrest each year.
According to CPR statistics from the American Heart Association, more than 356,000 cardiac arrests occur outside of hospitals in the United States on an annual basis. Nearly 90% of these events are fatal. Sudden cardiac arrest continues to be a national public health crisis, affecting up to 1,000 people every day and striking victims of all ages.

3. The compression to ventilation ratio is 30 compressions to 2 breaths.
If you encounter an adult who is not breathing and does not appear to have a pulse, combining chest compressions with rescue breaths is proven as the most effective intervention. The ratio is 30 compressions to every 2 rescue breaths for this situation.
If the victim is a child or infant, the ratio of 30 compressions to 2 breaths is the same if there is only one responder. If two responders are available, you can increase the ratio to 15 compressions to 2 breaths in younger victims.

4. For every minute that someone is unconscious and not breathing without CPR, they have a 10% less chance of survival.
During a cardiac arrest event, every second counts. One study found that for every minute a victim does not receive CPR, survival decreases by 7-10%. When CPR is administered by a bystander, the survival rate decreases by only 3-4% per minute from the time the victim collapses until defibrillation is provided.
Brain damage is another potential result after cardiac arrest. To increase the odds of survival without brain damage due to oxygen deprivation, CPR must be started within two minutes. After three minutes without CPR, lack of blood flow to the brain can lead to a brain injury that will progressively worsen in the minutes following.

5.  Many AEDs (Automated External Defibrillators) will talk you through how to perform CPR with the press of a button.
​An AED is a critical piece of equipment that may save a life during cardiac arrest. These devices are located in offices and public buildings and can be used by anyone on the scene of a cardiac event. While CPR classes usually include instruction on how to use an AED, many of the devices will also talk you through the CPR process based on analysis of the heart’s rhythm.
As soon as an AED is available, turn it on and begin following the voice prompts. Two pads are placed on the upper right side and lower left side of the chest. The pads will record the heart rhythm and the device will tell you whether the victim requires a shock. Before administering a shock, make sure no one is touching the victim, say, “clear” in a loud voice, and push the shock button.

We hope these facts about CPR have encouraged you to learn CPR and become a life-saver in your local community or workplace setting Help-A-Heart CPR, LLC a Central and South Texas leading CPR training provider, has various locations and flexible class schedules for your convenience. Our team of expert instructors makes learning fun and engaging. Register for a class today to become empowered with lifesaving CPR and First Aid skills.

Pulseless Electrical Activity (PEA) occurs when the patient has organized cardiac electrical activity, but doesn't have a palpable pulse. Pulseless Electrical Activity (PEA) is different from other irregular heart rhythms like ventricular tachycardia (Vtach) and ventricular fibrillation (Vfib). While both PEA and asystole are not shockable rhythms, asystole does not show any cardiac electrical activity. 

There are two different types of PEA which include Pseudo-PEA and True PEA. In Pseudo-PEA, the electrical activity within the heart may produce weak squeezing that could result in pulse detection through an arterial line, POCUS pulse check, or ETCO2. However, a palpable pulse will not be present. In True PEA, there is electrical activity but the heart does not respond to at all. In addition, a pulse can be detected through any means.

​There is not a specific pattern for determining the presence of PEA on an ECG. In some cases, there will be a P wave, PR wave, or QRS complex. In other situations, there might be a heart rate or no heart rate at all. The main noticeable component is that there will likely be some sort of organized or semi-organized rhythm with an unresponsive patient and no pulse.

Because PEA can present in different ways, it is important to integrate the ECG reading with an assessment of the patient, particularly pulse detection, in order to accurately diagnose this heart arrhythmia.

It is important to first identify the underlying cause of the cardiac arrest and treat it to bring the heart back to a shockable state as PEA is not a shockable rhythm. Diagnosing the cause of PEA involves a thorough knowledge of the H's and H's; otherwise known as the reversible causes. These include Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo-Hyperkalemia, Hypothermia, Tension Pneumothorax, Cardiac Tamponade, and Pulmonary and Coronary Thrombosis.

Get the certification you need with Help-A-Heart CPR. Our instructors are all healthcare training professionals who believe learning life-saving skills should be fast, effective, and easy. We offer ACLS, CPR/AED and EKG certification courses online, in-person, and on-site, Our aim is to make courses fun and easy to follow, so you retain the knowledge you learn long after you receive your certification.
Don’t wait to get the certification you need for your career and your patients. Contact Help-A-Heart CPR or check out our current class schedule today.

Understanding how to read an electrocardiogram (ECG) can often mean the difference between life and death for your patients. ECGs can reveal various serious conditions such as thickened heart muscles, electrolyte imbalances, ischemia, heart attacks, and heart arrhythmias. Understanding an ECG can also accelerate the diagnostic process so your patient gets the treatment and intervention needed within a timely manner. Lastly, an EKG and an ECG are the same procedure, but with different spelling (elektrokardiogramm vs. electrocardiogram). The procedure records changes in the heart muscle over time. The activity is typically printed on a strip of paper via a 6 second rhythm strip to make interpretation easier.

1. P-Wave – records electrical activity in the upper heart chambers and represents contractions
2. PR Interval – goes from the beginning of atrial polarization to beginning of ventricular depolarization
3. QRS Complex – records electrical activity in the lower heart chambers and includes the Q wave (first downstroke), R wave (first upward deflection), and S wave (first downward deflection)
4. T-Wave – also records upper heart activity, but represents relaxation

Learning how to read an echocardiogram involves understanding the components listed above and how to put them together to read a strip. There are small and large boxes on the strip that measure time and distance. The heart’s activity is translated into line tracings consisting of dips and spikes that constitute waves.
The various components above make up the waves and by understanding the various elements and learning to measure them correctly, you can accurately interpret your EKG findings.

The first step in understanding how to properly read an ECG is to determine whether a heart rhythm is normal, which requires your understanding of the acronym A-D-D.

1. A is for Amplitude: Uncover the significance of wave height to measure the voltage of the beat
2. D is for Deflection: Decode the meaning of deflection and which lead it’s coming from
3. D is also for Duration: Grasp the importance of wave and interval duration (how long is it?)

​A. The first step in interpreting the meaning behind an ECG strip is to review the P-waves. The P-waves are located at the beginning of the ECG cycle and they should be present and upright. If the P-wave is inverted or absent, it indicates an abnormality.

B. The next step is to measure the PR interval. The PR interval can be assessed  by simply counting the small boxes between where the P-wave begins and the QRS complex peaks and multiplying that number by .04..

C. Step three is to then measure the QRS complex by counting the small boxes from the beginning to the end of the complex and dividing that number by .04.

D. Next, you will want to examine the rhythm to determine whether it is regular, regularly irregular but in a recurrent pattern, or irregularly irregular and completely disorganized with no pattern.

E. Lastly, you will then need to determine the heart rate by counting the large boxes between the R waves and dividing that number by 300.

​Learning how to understand an ECG report allows you to provide an even higher level of urgent care to your patients. Here at Help-A-Heart CPR we offer an in-person ECG and Pharmacology class to better prepare and train individuals for reading and interpreting ECG's. 
Now is the time to learn how to interpret an ECG and take your patient care to the next tier. To learn more about ECG training with Help-A-Heart CPR, contact us today.

Advanced cardiac life support (ACLs/ALS) classes prepare a healthcare provider for events relating to sudden cardiac arrest including basic life support (BLS) and airway management skills. However, once resuscitation events have proven successful it is also important to identify any reversible causes of the abnormal arrhythmia and cardiac arrest. This is the point where an in-depth understanding of the H's and T's is critical.

The H's and T's are a mnemonic device to help you remember the different contributing factors to sudden cardiac arrest due to pulseless electrical activity (PEA), asystole, ventricular tachycardia (Vtach), or ventricular fibrillation (Vfib). An increased understanding of these factors can help you find underlying causes  due to any of these events. 

​1. Hypovolemia: Hypovolemia occurs when the body loses a large amount of blood or fluid due to severe blood loss, vomiting or diarrhea, dehydration, and excessive sweating. 
2. Hypoxia: Hypoxia is a condition exhibited by decreased oxygen levels throughout the body or in a specific area. Hypoxia may be caused by various pre-existing medical conditions, drowning, trauma, or a brain or spinal cord injury.
3. Hydrogen Ion (Acidosis): Acidosis occurs when there is a buildup of hydrogen ions that impair the circulatory system and reduce oxygen into the lungs. Both metabolic and respiratory acidosis may lead to cardiac arrest. 
4. Hyper-/Hypokalemia: These are metabolic disorders which involve abnormal potassium levels which can lead to cardiac arrest. Hyperkalemia occurs when potassium levels get too high, while hypokalemia is characterized by low potassium.
5. Hypothermia: ​Hypothermia occurs when a person’s body temperature drops below 86°F. Although it is not a common cause of cardiac arrest, it should be considered in some circumstances, especially drowning.

1. ​Tension Pneumothorax: This condition occurs when air becomes trapped in the pleural space. The buildup of tension can lead to cardiovascular collapse, which is life-threatening. It can occur due to respiratory diseases, trauma, or other factors
2. Tamponade: Cardiac tamponade occurs when fluid accumulates in the pericardium, which prohibits the heart from pumping blood normally. It is often caused by trauma or inflammation of the pericardium. 
3. Toxins: This condition can be caused by an accidental overdose of any number of medications which can lead to cardiac arrest. Some of the most common include tricyclic antidepressants, beta-blockers, calcium channel blockers, benzodiazepines, opiates, and barbiturates. 
4. Thrombosis (Pulmonary): Pulmonary thrombosis occurs when there is a blockage in the primary lung artery. It often occurs due to deep venous thrombosis (DVT).
5. Thrombosis (Coronary):​ Coronary thrombosis is in the majority of cases caused by disruption or fissuring of an atherosclerotic plaque.

Understanding the H's and T's of cardiac arrest and reversible causes is a vital part of any ACLS/ALS training. By knowing the aforementioned reversible causes allows the healthcare provider to respond quickly to the underlying problem and possibly prevent additional complications from occurring. The H and T mnemonic presented will allow you to quickly evaluate possible causes, while also ensuring you can respond to any additional patient needs and concerns. 

Would you like to take your knowledge and your patient care to the next level with ACLS/ALS certification with us here at Help-A-Heart CPR. With classes online, in-person, and on-site, you can find a course that fits your busy schedule. Contact us today to learn more about our class options or check out our current class schedule today.

Waveform capnography is one of the most important vital signs used to monitor a critically ill patient. The waveform capnography reading provides information regarding the tracking of ventilations, airway placement, and the measurement of carbon dioxide during exhalation.
Through the use of capnography, a patient’s ventilation status is monitored in real time. Health care providers are able to identify potential breathing complications (such as airway obstruction, hyperventilation, hypoventilation, or apnea) and respond accordingly with a change in clinical management.

Waveform capnography indicates how much CO₂ is present during each phase of the respiratory cycle, from inhalation to exhalation. It also displays respiratory rate. Capnography measures ventilation, rather than oxygenation. Ventilation encompasses the air movement both into and out of the lungs, while oxygenation lets you know how much oxygen is inhaled by the lungs and reaches the bloodstream.

​Capnography waveforms reflect the amount of CO₂ in exhaled air, known as the end-tidal carbon dioxide or EtCO₂. End-tidal carbon dioxide (EtCO₂) is the level of carbon dioxide that is released at the end of an exhaled breath. EtCO₂ levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled. 

​Different capnography waveforms can indicate conditions like cardiac arrest, shock, asthma, pulmonary embolism, and emphysema. An assessment of the waveform capnography allows the healthcare provider to detect occurrences of bronchospasm, hyperventilation, or respiratory failure. By understanding the PQRST of the waveform, you can rapidly assess possible causes for the respiratory distress and provide the appropriate treatment. The PQRST includes the following:
1. Proper: means that you should know the normal readings for quantity, rate, shape and trending of EtCO2. In this case, normal means what we find in a healthy person with no metabolism, ventilation or perfusion problems. 
2. Quantity: target EtCO2 value should be 35-45 mmHg.
3. Rate of ventilation: should be 12-20 breaths per minute (bpm) for adults if the patient is breathing on their own and 10-12 bpm if you’re ventilating them. Children should be ventilated at a rate of 15-30 bpm; 25-50 bpm for infants. Ventilating too quickly won’t let enough CO2 build up in the alveoli, resulting in lower EtCO2 readings. Ventilating too slowly will allow extra CO2 to build up, resulting in higher readings.
4. Shape: of the waveform should normally be a rectangle with rounded corners. Different waveform shapes can indicate different conditions.
5. Trending: of the quantity, rate and shape of EtCO2 should be stable or improving.

The waveform capnography reading can advise the healthcare provider on how effectively a specific treatment is working. If the treatment does not produce the desired effect or there are sudden changes to the waveform, this assessment of the reading can allow the healthcare provider to identify the issue quickly so a modification to treatment can be made a seamless and effective manner.

The waveform capnography reading can also provide information about the circulation throughout the body. A decreasing EtCO₂ may indicate the early stages of hypotensive shock related to reduced cardiac output, which is the most effective time to begin treatment. Capnography can also provide feedback on the effectiveness of chest compressions during cardiac arrest.

The assessment of the waveform capnography reading provides important data which allow healthcare providers to effectively diagnose and treat patients in cardiac arrest, as well as respiratory distress and shock. 
Would you like to learn more about certification training and our class schedule here at Help-A-Heart CPR? Or, would you like to learn more about waveform capnography and take your skills to the next level? We offer advanced training including ACLS/ALS certification and in-person ECG and pharmacology courses that will help you advance your career and optimize your personal skills and knowledge. 

​The LMA is a supraglottic airway device that was first designed for elective ventilation in the operating room. The use of the LMA is an often preferred alternative to bag-valve-mask ventilation allowing the healthcare provider to monitor the patient rather than holding the mask in place. ​The LMA is also minimally invasive and designed specifically for airway management in the unconscious patient. Subsequently, an inflatable mask is fitted with a tube that exits the mouth to permit ventilation of the lungs.

The laryngeal mask airway (LMA) is a supraglottic airway device developed by British Anesthesiologist Dr. Archi Brain. It has been in use since 1988. 

The LMA comes in an assortment of sizes and styles. The different types of laryngeal mask airways include:
​
1. LMA Classic: the original, reusable device
2. LMA Unique: a disposable version that works well in the field
3. LMA Fastrach: an intubating LMA that easily precedes intubation
4. LMA Flexible: softer tubing, not appropriate for emergency situations
5. LMA ProSeal: used to suction gastric contents, not appropriate for emergency
6. LMA Supreme: similar to the ProSeal, but includes a built-in bite block
7. LMA CTrach: includes built-in fiber optics with a video screen

The LMA is used as temporary airway during anesthesia or as a life-saving measure when respiration is not present. The LMA is often useful in the operating room, intensive care unit, emergency room, and by paramedics and EMT's.

​The LMA consists of an endotracheal tube that connects to an elliptical mask on the distal end. The mask features a cuff that forms an airtight seal on the glottis once it is in place. The mask of the LMA is inserted first, with the mask covering the glottis and the tube extending out of the patient’s mouth.

LMA devices range in size from 0 for an infant to 6 for a large adult. The specific size is determined by the age and weight of the patient. When a patient is between mask sizes, the larger size is usually recommended to ensure a secure seal.

To insert an LMA, follow these steps:

1. Inflate and deflate the cuff to check its volume and ensure there are no leaks.
2. Apply the lubricant to the posterior surface of the mask.
3. Pre-oxygenate the patient with bag-valve-mask ventilation if possible.
4. Position the patient in the sniffing or "neutral" location.
5. Insert the LMA and manually guide it along the hard and soft palates and into the throat by pushing with the index or long finger in the v-shaped notch where the tube attaches to the mask.
6. Use minimal pressure to advance the LMA until you encounter resistance.
7. After the LMA is in place, then inflate the cuff.

Help-A-Heart CPR has the classes you need to stay current and advance your career. Check out our class schedule today to find the right training for you.

The return of spontaneous circulation (ROSC) is the primary goal of resuscitation of a cardiac arrest patient using basic and advanced life support measures.

​Cardiac arrest can occur when the heart’s electrical system stops working properly, which can lead to an abnormal heart rhythm. In addition, besides constant palpation of a carotid pulse, waveform capnography is the most reliable prehospital monitoring device to detect the immediate loss of circulation. Lastly, providing high quality CPR, sometimes combined with defibrillation, can be used to attempt resuscitation with the ultimate goal of achieving ROSC.

A few signs of ROSC might include:
1. Movement
2. Coughing
3. Breathing
4. Detectable pulse
5. Measurable blood pressure
​6. Increase in ETCO2
Although ROSC is a positive sign and the ultimate goal of CPR, post-resuscitation care must be tailored to the needs of the individual patient.

​The measurement for ROSC involves the assessment of noticeable signs like breathing or movement, as well a fluctuations in ETCO2. A sudden increase in ETCO2 is often the first sign of return of spontaneous circulation (ROSC), even before a carotid pulse can be detected .Some of these causes might become apparent during resuscitation of the patient, especially while evaluating the 5Hs and 5Ts of cardiac arrest.
​In order to achieve ROSC it is critical to focus on the advantages of high-quality CPR with adequate chest compressions and rescue breaths. The ability to achieve the proper compression depth, minimize compression interruptions, and the addition of antiarrhythmic drugs will often proven advantageous for the patient resulting in ROSC.

As a healthcare provider or caregiver, it is important to provide patients the best odds of ROSC by knowing and understanding high-quality resuscitative measures. A CPR and AED certification class gives you the chance to review your knowledge and practice your skills so you are prepared to provide lifesaving measures in a cardiac emergency. Help-A-Heart CPR offers training classes taught by experts in the field who are committed to making training informative and fun. With better focus during class and greater retention afterward, you will be equipped to give your patients the highest level of care possible.
Help-A-Heart CPR offers classes at our Texas locations, as well as online and on-site. Contact us today to get our current class schedule.