Can a rescuer with a pacemaker or ICD (Implantable Cardioverter Defibrillator) safely operate an AED?

And the answer is …. Yes!

When I’m short on time my go-to source for answers to questions I’m not 100% sure on is one of the online instructor forums I belong to. There are a lot of really smart and knowledgeable folks in the group. One member even did a bit of research for me and provided this great link to Daily Living with an Implantable Cardioverter Defibrillator. She even called Medtronic to ask. I’ll be updating this post when I have a chance to call them myself later today.

But AED’s are safe and easy to use, even if the rescuer has a pacemaker or ICD.

Online-only CPR and First Aid certification websites are scams. They promise “nationally accepted” certification that you take in your home and you can print your card on your own printer. Unfortunately most employers and licensing boards will not accept these cards. Why? Because there is no hands-on component to the course.

I did a quick search on my CPRMom blog and discovered over the past 4 years I’ve written on this topic a few times. Starting with Online CPR First Aid courses in 2009, I’ve written Be wary of some online BLS courses, False CPR certification, Video or computer based training versus learning it the old fashioned way, and I received this comment…. On this blog I’ve posted What is online certification. So yes, I guess you can say I’m a little passionate about the topic.

CPR AED and First Aid are practical skills. You learn by, well, practicing the skills. It’s kinda like learning how to drive. If you watch a video about how to drive a car, or take an online course on how to drive a car…. do you know how to drive a car?

When I teach a class I have a very specific goal. If I collapse in the parking lot after the class I want to know that I have trained the participants in my class well enough that they can help me. Whether it be with First Aid or CPR. If someone leaves my class and can’t do that then I have failed both them and myself.

However there is some confusion over some very good BLENDED courses, which contain an online component.

Blended courses have 2 or 3 parts. Part 1 is online. It is the cognitive portion and usually has a written exam you must pass. Part 2 and Part 3 are a classroom skills session with an instructor. This is where you learn the practical skills of CPR AED and First Aid.

What is confusing is some organizations like the American Heart Association use the term “online” in their blended course titles. Many people needing certification who have been told they cannot take an online course are hesitant to take a blended course because of the online portion.

Blended courses are valid courses. Just make sure the certification meets the requirements for your employer or licensing. Some organizations require certification from a specific organization like the American Heart Association or American Red Cross. A few of these online certification mills will try to mimic the name of a nationally recognized organization (AHA) or the name on their card (BLS for Healthcare Providers or CPR for the Professional Rescuer).

Be wary of courses that claim you can be certified without practicing any of the skills. Ask questions if the course time seems to short. You may be paying for a certification card that is worthless.

Check out the label on this AED cabinet

I was excited to see the AED as soon as I walked into the building. And then I saw the labeling on it. “Trained Responders Only”

Every state has different AED laws. New Hampshire’s are quite progressive. This label is in violation of NH RSA 153-A:30 which I’ve written about in my CPRMom Blog.

The NH Revised Statutes Annotated states:

Source. 2000, 302:4, eff. June 21, 2000. 2002, 156:5, eff. July 14, 2002. 2008, 207:2, eff. Aug. 15, 2008.

So simply put, if your organization purchases an AED they must provide CPR and AED training. However use of the AED is not limited to only those who have taken the training. That means ANYONE can use it, not just trained responders.

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I’ve been following an interesting discussion on an instructors forum I am on. It is one of those conversations that started out as one thing, and is slowly morphing into several different topics.

But one of the conversations that came out of it was the staff at one agency somewhat bashing the credentials of another … and that’s not cool.

There are many really good CPR and First Aid programs out there. While I teach for the American Heart Association (AHA) and the American Safety and Health Institute (ASHI); there is also the American Red Cross (ARC), Emergency Care & Safety Institute (ECSI), American CPR and probably a few I’m not familiar with.

There are also a lot of not so good programs out there, I’m not even going to try to look them up to list them here.

How do you tell a good program from a not-so-good program?
A good program has a hands-on skills component to the class. A good program can have traditional classroom courses as well as blended programs that encompass both online learning and skills sessions with an instructor. A good indication a program is in the not-so-good category is when the website promises the course is short and you can print off your card from their website once you pay them.

What’s the difference between the different good programs?
We all teach roughly the same skills. Good CPR programs follow ILCOR 2010 Guidelines. Good First Aid programs follow the 2010 consensus for First Aid co-written by the American Heart Association and the American Red Cross. The training materials, length of class and how the class is taught will vary between the different organizations. However if your class includes hands-on skills practice you can be comfortable know that you are taking a good course.

If you need certification for work or as a licensing requirement check what is required. Some employers or licensing agencies may require you to hold a card from a specific organization. You should check into that before registering for a course so that you make sure you are taking the correct course for your workplace or license.

In general if the public schools in Newington, Portsmouth & Dover cancel school I may need to reschedule the class.

I do not cancel classes due to weather, I reschedule. I will try to reschedule for the same time on a different day within the same week. The time might be slightly earlier or later as I rent space from other studios to hold the classes and I can only use the studio when someone else is not in there. If I can’t get a time in the same location at roughly the same time I will look for a different location, but at still the same time. I do this because I know if you signed up for a morning class, or an evening class, it’s because that time of day works best for your schedule.

Any changes to the class schedule will be posted on my Facebook page – www.facebook.com/coastalcpr – this is the fastest way for me to get the information posted.

If the public schools in Newington, Portsmouth & Dover are open classes will be held as scheduled.

If the public schools in the area cancel (they usually do before 6am) and there is already significant snow on the ground (3-4″ and still snowing) the class will be rescheduled.

If the public schools cancel, but we don’t have a lot of snow I’ll decide based on how much snow is at my house. I don’t know where everyone is driving to the class from, but I do not want anyone driving on unsafe roads. Myself included.

I will post any changes or updates on FB approximately 2 hours before the class start time and will follow up with emails & phone calls to everyone. If you are driving a distance and need to be notified earlier than that please email/call/text me and let me know when you need to know by and the best method to reach you by – email/text/phone – and the email or number to use. If I post that the class is on as scheduled then I won’t be calling/emailing/texting. You’ll only receive followup communication from me if I need to reschedule.

If I do need to reschedule, and you know you would not be able to attend on a different morning this week please email me. We’ll see what we can come up with to reschedule in a timely manner. I might be able to hold an additional smaller class in a different location.

“What will it take to get you to come here and provide a course for us?”

This is often the response I get when I tell someone they are too far away for me to come on-site and provide a course for their organization.

I limit where I teach to a 45 minute radius of the Portsmouth, NH area. Occasionally I’ll travel a little further… maybe an hour. But no further than that. It’s not because the cost of gasoline is getting more and more expensive (well, it is); or the wear and tear on my minivan. It’s the time involved in the drive.

If I drive 2 hours to provide a 3 hour class I’m in the minivan driving to and from more than I am actually teaching. If I drive 2 hours to offer a 6 hour class I am gone from my home for over 10 hours if you add in set up & clean up time. That’s an long time in the minivan and an awfully long time that I’m away from my family.

I started my business partly to have more time at home with my family. I run my business from my home so I can still be involved in my children’s activities and spend a lot of time in my minivan driving them to and from those activities. To offer an onsite course 2 hours away means I’m potentially not getting home until after dinner or possibly after my kids have gone to bed. Unfortunately long commutes do not match the personal and business goals I set up when I began teaching.

From a business perspective I’m probably losing a lot of business. But I’m okay with that. I’m happy to provide referrals to other instructors who may be closer or who are more willing to travel than I am. I’d just rather spend more time enjoying the class I’m teaching than driving to and from the class site. I also don’t think it’s fair to the folks attending the class to have to pay extra for the travel to get me there when there may be a really good instructor who is geographically closer.

I’m flattered, truly flattered, that I get calls for classes from folks who really want meet to make the drive, often based on recommendations. It lets me know that people are enjoying learning CPR and First Aid in my courses and are referring their friends to call me for courses. But sadly I cannot schedule on-site courses that require long drives. Feel free to ask me for a referral to another instructor, I’m happy to pass their info along.

The term “accreditation” is an often-misunderstood term in the CPR industry. No organization exists that provides a national endorsement or accreditation to any CPR course provider. The American Heart Association cannot approve, endorse, or give accreditation for CPR training for any other organization. Each first aid certification provider is free to construct their own curriculum, standards, and teaching methods based on the ECC/ILCOR guidelines. American Academy of CPR & First Aid, Inc, courses strictly follow the ECC/ILCOR guidelines.

So at first I’m irritated, but then again I get A LOT of spam on the blog. Since I moderate the blog I decided that in the interest of fairness I would post the comment, but added the following reply.

Thanks Gold Price, but consider this….

Any online program can follow ILCOR ECC Guidelines by just citing the 2010 Guidelines. Heck, I could post them on this website. But how well can you learn and provide a hands-on skill in an emergent situation if you’ve never practiced it?

The term “online course” can be misleading, the AHA, ASHI, and ARC all have online programs. They are “blended” courses, meaning part of the course is taken online, but the participant must meet with an instructor for a hands-on skills session before the earn the card.

Anyone can take an online course, I could take it right now and pass. My friends could ask me to take the course for them and put their name on it and they would have a card. Because the emphasis in nationally recognized programs is on a skills component to the class, these online ‘programs’ and their certification card the participant prints off on their own printer, are not usually accepted. Thus the participant has paid to take a brief online course and print off a worthless card.

Just posting on a website that the course is meets ILCOR or ECC Guidelines is not sufficient. Hands-on skills practice is still the best way to learn a practical skill.

You can find links to all the documents on the ILCOR website

Duck Itch

We’ve never had duck itch in our house. While the research I did said you can get it in salt water, I don’t think it is as common in the ocean. Since we live near the coast we’ve never had it. But I took that interesting picture of my niece’s knee since I ended up being the one to take her to the doctor’s office to have them look it. You can read all about our interesting visit to the doctors office on my CPRMom Blog.

What does duck itch look like?
The start as small bumps that look like mosquito bites. As they heal the bumps actually get bigger, to about the size of a dime or so. They will itch for about a week and then will fade away.

How do you prevent duck itch?
Move around in the water or go where it is a bit deeper where the water circulates a bit more. Take a nice shower or at least rinse off after swimming.

How do you treat duck itch?
Pretty much it needs to run its course. The research I did (see links at the bottom of the post) did have more definitive treatment plans. But I’m using the advice given by a good friend who lives near a large lake, and her kids have had this. Just let it run it’s course. That can take up to 3 weeks.

Good links of info:

Mayo Clinic Info
MedicineNet Info

Every now and then I get a call from someone who seems surprised by how long a class is. Today was no exception.

A CPR AED course is about 3 hours long. It can run shorter if everyone is renewing their card or if it is a small group. Since I teach both AHA and ASHI I find the full course is about 2.5-3 hours long. Renewal courses that I offer through the ASHI program can be as short as 2 hours.

A First Aid or Pediatric First Aid course is also about 3 hours long. Sometimes I plan on 3 1/2 hours for a class if I know the group is large or if it is a first class for most of the group. The AHA video has a lot of information on it and I just can’t make it play any faster than it is supposed to. With the ASHI program I do a mix of video, lecture and scenario-based practice. But still, it takes time. Even if everyone is renewing their cards there are key topics I am required to cover and have participants practice.

So you can guess that a First Aid CPR AED course, covering both First Aid AND CPR AED can be anywhere from 4-6 hours long. Shorter if it is a refresher or renewal course, longer if there are folks who have never taken a course before.

I guess I should not be amazed when someone calls and tells me that they need a course for their staff, the person who used to provide their courses is no longer teaching, and … they did the entire First Aid CPR AED course in 2 1/2 hours.

Part of me wants to say…. maybe that’s why they are not teaching anymore. But I don’t. It’s just not worth it. Instead I have to explain why the course is as long as it is. I give them lots of info, how much it will cost, how to schedule a class with me and sometimes some dates that I am available to teach. But I know they probably won’t call back. All I can think after the call ends is that you get from the course what you put into it and what is provided to you. What can you learn about adult, child, infant CPR AED, choking and first aid in just 2 1/2 hours? Is there time to practice any of the information provided? For the staff who needs this for work & state licensing I question how well prepared they will be to handle an emergency in the workplace when they’ve not been provided with enough instruction and practice to know what to do.