It is hard to believe we have moved through so much of our program. One of the goals of our service learning project was to develop a long term, strong relationship as a volunteer. My work with the American Heart Association certainly meets any of those goals! I must have triple the needed hours dedicated during this semester and foresee a very long future relationship with AHA and its volunteer teams.
We have designed the order sets for rural facilities sending patients having heart attacks to the tertiary care facility. It is all evidenced based. except for the (funny, odd) situation:
The use of oxygen with acute myocardial infarction can not be "proven". When studied, it did not change oxygen saturation or outcomes. Can you even imagine if we sent out our policies without oxygen application? Those who have Advanced Cardiac Life Support know MONA (Morphine-Oxygen-Nitroglycerin-Aspirin). It is so traditional!! We vote next week to decide whether or not to keep this non-EBP intervention. What do you think we should do???
My work with the AHA has been a bit of a roller-coaster ride this term. There are some national policies which if activated would eliminate most facilities from participation. I was a strong voice against these very high membership fees. The national office of AHA met by phone with me and several of my team members. That result is not known. I was very proud of the cardiologists who joined me in confronting the AHA. I believe they temporarily lost their mission/vision and will drop the fees ($21,000) for inclusion in the heart attack network. we will see.
All said and done, I am dedicated to this volunteer relationship. I've had to drop other volunteer relationships while in school (flying veteran to Washington DC and horse rescue) and enjoy knowing I'll be back into those situations in just one year.
Thanks for reading my blog! Best wishes to all my fellow students as we come down the home stretch.
Julie Benz
Hi Julie!
ReplyDeleteI have enjoyed following your service learning blog this semester. Your passion for improved cardiac care truly shows through your service learning efforts. In regards to your question regarding use of Oxygen in the patient with AMI, I wonder what the study measures were in the research that was done in order to determine the outcome of oxygen use in the treatment of AMI? It seems to me that unless the client had adequate coronary perfusion, the application of oxygen may not make a difference if the blood flow is blocked and the oxygen is unable to reach the heart and lungs. However, I am unaware of any studies that demonstrate that oxygen is harmful to clients with AMI. Another thought I have regarding the use of pulse oximetry readings for oxygen saturations, several instances have occured during my clinical experiences where the readings were not reliable. Also many times there are problems with arterial blood gases being reliable to measure improvement in oxygen saturation especially when obtained from clients with existing pulmonary disease. These clients "survive" with lower oxygen saturations and therefore may not demonstrate improvement when being treated for AMI. Just my thoughts on the subject...
Take care and God Bless!
Felicia P.
Hi Julie,
ReplyDeleteI enjoy reading your Blog. You show such passion and dedication in the service work that you do. Being an advocate for the right action is not always easy when others may follow another path. But staying true to your self and your profession is evident in your account of this semester. I admire your resolve and leadership to ralley others in these endevors. A gerat project. Best wishes an all you are doing in service and in practice as well. Nice job.
Janet W
Hey Julie!
ReplyDeleteGreat post and it’s such a worthy group you are helping with! Considering your areas of expertise, the American Heart Association is fortunate to have you but I’m sure you are the one who feels blessed by the relationship!
Wow, no oxygen! What a thought…as hard as it is for me to admit, I guess if there is no proof of benefit then it must go! But for the psychological well-being of everyone involved, maybe just send a bottle with the patient! (just in case!) Seriously though, if EBP is what we are after then we must use those interventions that are shown to work and discontinue those that have no proven value. With that being said, I would like to know more details about the studies and outcomes before making a vote one way are the other.
Great job in facing the giant too! Even in medicine we can sometimes be “forced” to pay for the brand name too! I hope your conversations help to get the AHA back on course in terms of the fees.
Great job as usual!
Troy