ACLS Instructor Highlight: Jenny Chen, MD

As a Naval-trained physician, Dr. Chen has gained a global perspective through her extensive travels. Her passion for learning medicine, physician self-care, and training other healthcare professionals in critical life-saving skills sets her apart as a leader and mentor in the medical community. Learn more about Dr. Chen’s honorable and rewarding career in medicine and as a valuable instructor for ACLS Academy.

Medical Career Experience & Current Employment: 

Emergency Medicine Physician, Winchester Hospital, Winchester, MA, and Holy Family Hospital, Methuen, MA 

Veteran, US Navy Bureau of Medicine and Surgery

Education: 
Boston University

Bachelor of Arts (BA)

Medical School:

Boston University School of Medicine (MD)

Internship and Residency: 

Naval Medical Center, San Diego

What led you to join the Navy? During my undergraduate studies, I was looking for funding resources for my education, and I met a senior chief at the Armed Forces recruitment office. He had been in the military for 30 years and still had an amazing passion for his career. He talked about his experiences traveling worldwide with various deployments and opportunities. The idea of traveling while being a physician and serving in the Navy fascinated me and led me to choose this path. I thoroughly enjoyed the experience as it exposed me to new opportunities and challenges I could not have imagined. Ultimately, I left the military to return to Boston and be closer to family.

What were some of the highlights during your eight years of service?  From a travel perspective, I spent three years stationed at the United States Naval Hospital Okinawa (USNHO) in Japan. As the largest U.S. Naval Hospital outside the United States, USNHO hosts many physicians and nurses providing comprehensive medical services. It also serves as the referral center for U.S. military personnel in the Western Pacific. While at USNHO, I had the rewarding experience of serving as the Program Director for Japanese interns. This role allowed me to connect with the local Japanese medical community and combine my teaching and clinical practice interests. Another highlight was completing a medical rotation in Guam. I thoroughly enjoyed living in and experiencing the diverse cultures of these WestPac countries. 

How has your military background impacted your approach as an Emergency Room doctor?

A military saying called the “Six Ps” is “Prior Proper Planning Prevents Poor Performance.” My training in the Navy ingrained in me the necessity of preparing ahead of time and anticipating what you can plan for while recognizing there will be situations where you cannot. Consistently practicing in advance is beneficial when those unexpected situations arise. Granted, some scenarios can't be anticipated, but knowing you've done your best to prepare provides peace of mind and confidence.

You are a Member of the Physician Coaching Alliance and Physician Coach Support, which helps physicians and medical professionals overcome burnout and find more joy and fulfillment at work and at home. Tell us more about your involvement with this organization.  

I've sought support in my career from physician coaching organizations, and I found the experience so beneficial that I became a certified life coach in 2022. These organizations allow physicians and healthcare professionals to connect with fellow coaches, focusing on career fulfillment and combating burnout. My interest in research on chronic workplace stress, particularly in healthcare, centers around Dr. Christina Maslach’s work on burnout. This condition, marked by emotional exhaustion, depersonalization, and reduced personal accomplishment, arises from systemic issues within healthcare settings akin to the inherent dangers in a coal mine. The pandemic has only exacerbated these stressors, making coaching an invaluable resource for helping healthcare professionals navigate this challenging environment. These coaching organizations play an incredible role in supporting medical professionals, ensuring they can maintain their well-being and sustain a fulfilling 30-year career.

Why ACLS Academy?  During my medical training, I became an ACLS, PALS, and ATLS instructor early in my career. As I was exiting the military and relocating to Boston, I knew I wanted to continue teaching. I connected with Shelley and became an instructor at ACLS Academy in 2016. Chad and Shelley are special people who contribute so much to their local community. Our values were aligned, and working with ACLS Academy as an instructor is a great way to continue teaching while being clinical. I love Shelley’s story behind the founding of the ACLS Academy and its desire to train more people in life-saving skills. Empowering all healthcare workers to upgrade their critical care skills is a great mission.

What courses do you teach at ACLS Academy?  I teach PALS and ACLS certification skills training, including the associated adult and pediatric codes. In the Emergency Room, I specialize in high-risk, low-volume codes that are infrequently practiced but carry significant risk due to their complexity. Successfully handling these situations requires thorough preparation and regularly refreshed skills. Our training sessions provide a safe environment to break down critical steps, ensuring students feel confident in their competency, even for infrequent ACLS scenarios.

Training Secret Sauce: I genuinely want the students to succeed, driven both by my passion for patient care and the importance of them mastering these skills for their future work. I believe in actively listening to understand their thought process, identifying any hurdles they face, and then course-correcting to ensure they master the skills. 

My experience as a physician coach also adds another dimension to my abilities as an instructor. There is the knowledge and skills you obtain from a textbook perspective, yet the mindset component as a team member, getting out of the fight-or-flight response and taking action in a critical situation, is so important. It’s not just having the “right” answer but leading the team through a challenging high–stress event.

What advice would you give aspiring healthcare professionals beginning their careers? Working in healthcare is incredibly rewarding and challenging—emotionally, mentally, and physically. The hours are long, and breaks are infrequent, so it's essential to understand the reality of this profession. It's crucial to consider the sustainability and longevity of your career. Regularly check in with yourself to mitigate burnout. Be aware of the signs, ensure you get adequate rest, find ways to recharge, and don't hesitate to ask for support. Ironically, healthcare workers often neglect their well-being. There’s a reason airlines remind us on every flight to put on our oxygen masks first before helping others. Staying healthy is key to effectively caring for others. Keep reconnecting with why you chose to go into healthcare in the first place. A big thank you to all healthcare workers—you make a huge impact and save lives every day.

Family Life: I am a married mom with two children in the 3rd and 5th grades.

Favorite things outside of work? Family, travel, reading, running, getting outside for physical activity.

What's one destination you've visited that left a lasting impact on you, and why? The Peace Memorial Museum in Okinawa. Situated on the coast, it was established as a tribute to the Battle of Okinawa in WWII, commemorating the military and civilian lives lost.  It brings perspective on why we are here and what we can learn from this tragedy. The seriousness behind the memorial’s establishment, contrasted by the breathtaking, serene location, illustrates the balancing of the bittersweetness of life and death and the beauty of this world.

My favorite book genre? Growing up, I always enjoyed novels and good mystery stories. Now, my interests lie in nonfiction. I enjoy learning, so these days, I can usually be found reading psychology, finance, or an uplifting social scientist like Brene Brown.

Digital books or hard copy? I prefer hard copy. It’s nice to curl up with a good physical book after a long day.

Your happy place? Home. I love being home with my family, enjoying good times and laughs.

Queue the Balloons! Join Us in Celebrating the AHA’s 100 Anniversary on June 10th

On June 10th, the American Historical Association (AHA) is set to celebrate a milestone of monumental proportions—its 100th anniversary. This centennial event promises to be a spectacular tribute to a century of dedication to studying and promoting history. In 1924, the founders of the American Heart Association (AHA) envisioned an international society focused on the heart and aimed at facilitating research, disseminating information, increasing public awareness, and developing public health policy related to heart disease. Remarkable progress has been demonstrated in all these areas. Among the many ways to measure AHA’s progress from 1924 to 2024, one of the most compelling is the reduction in the death rate from cardiovascular diseases. This rate has been effectively cut in half, representing a staggering improvement. This achievement translates to millions of lives saved and significantly improved each year.

Pioneering Hope: The Fight Against Heart Disease

Before the establishment of the American Heart Association (AHA), a diagnosis of heart disease was often seen as a death sentence, with complete bed rest or imminent death being the expected outcomes. However, a group of forward-thinking physicians and social workers challenged this bleak outlook. They conducted groundbreaking studies to understand better heart disease, which was America's leading cause of death, laying the foundation for advancements in treatment and prevention.

On June 10, 1924, Dr. Paul Dudley White and five other doctors met in Chicago to sign the papers formally creating the AHA. They believed that scientific research could lead to better treatment, prevention, and ultimately a cure. The early AHA enlisted help from hundreds, then thousands, of physicians and scientists. Working together, they hoped, would speed the discovery of lifesaving solutions. 

Shortly after World War II in 1948, the association reorganized, transforming from a professional, scientific society to a nationwide voluntary health organization composed of science and lay volunteers supported by experienced staff. Instead of working with and for doctors, the AHA reorganized into a public health organization. It began raising funds and spending that on research, awareness campaigns, and more. Since then, the AHA has grown rapidly in size and influence — nationally and internationally — into an organization of more than 35 million volunteers and supporters dedicated to improving heart health and reducing deaths from cardiovascular diseases and stroke.

A Century of Progress 

When it comes to our health, most people have a general sense of what's beneficial: a balanced diet, regular exercise, sufficient sleep, and avoiding smoking. Although we might only sometimes recall the ideal weight, cholesterol, blood pressure, and blood sugar numbers, we understand their significance. We know the importance of annual checkups and know that genetics can affect health outcomes. Despite the fear of a heart attack, many of us know at least one survivor—someone who may have avoided open-heart surgery by getting a stent and possibly returning home the next day. This widespread health knowledge is mainly due to the efforts of the AHA.

While the AHA can't take credit for all the progress, much of what is known about our hearts and brains can be traced to the organization in one way or another.  Starting as a modest medical association, the AHA has blossomed into a ubiquitous presence. Today, the AHA is a leader, a convener, and a driving force for the greater good. Yet what's collectively called "the AHA" is the sum of its parts: the volunteers, donors, and supporters. This includes generous companies, charitable foundations, fellow health organizations, researchers, doctors, advocates, survivors, and more. Thanks to the tireless efforts of the collective organization, its impact on healthier living is palpable everywhere: from grocery stores and restaurants to airplanes and communities, and notably, in hospitals and doctors' offices.

The AHA has compiled a captivating decade-by-decade timeline showcasing how the organization has influenced global health over the last 100 years.

1924- Offering Hope Where There Was None

1935- Research for a Healthier Future

1948 – Making Everyone Aware of Heart Disease

1956 – Breathing Easier

1961 – Everyone Can Save Lives

1961- The Way We Eat

1976 – Heart and Brain Health

1978 – Healthier Hearts at an Earlier Age

1991 – Keeping Fit

2000 – Transforming Health Care to Save Lives

2004 – Championing Women and their Heart Health

2010 – Better Health for Everyone

2020 – Tackling a Global Health Emergency

Today – Our Future is about improving yours…..

The Second Century 

As American Heart Association CEO Nancy Brown likes to say, "Our future is about improving yours." As the AHA enters its second century, its leaders are dedicated to advancing health and hope for everyone everywhere. Their vision includes pioneering cutting-edge research, leveraging new technologies, and exploring innovative approaches yet to be conceived. For instance, Dr. Joseph Wu of the Stanford Cardiovascular Institute and AHA Volunteer President is currently studying the effects of zero gravity on the heart in anticipation of routine space travel. As the AHA's 100th-anniversary celebration draws to a close, the organization is concluding its Second Century Campaign, aiming to raise $500 million by 2024 to tackle future scientific challenges and enhance human health and patient care. At ACLS Academy, we celebrate the AHA’s milestone birthday and eagerly anticipate an exciting second century led by the next generation of leaders.

ACLS Academy is an authorized American Heart Association (AHA)- Aligned Training Center with three convenient locations in Massachusetts: Quincy, Bridgewater, and Newton Center. ACLS Academy provides high-quality courses, all taught by instructors practicing in the medical profession, for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Tiny Threats: Exploring the Link between Nanoplastics and Cardiovascular Health Risks

In the late 19th century, when an early form of plastic called celluloid was invented, promoters and the public praised its ability to mimic luxurious materials like ivory, tortoiseshell, and silk at a fraction of the cost. Additionally, its versatility, durability, and moldability sparked excitement as it offered novel solutions for various industries, from fashion to photography, ushering in a new era of innovation and accessibility. Plastic was even seen as a socially beneficial and environmentally correct substance. Since scarcity and depletion of natural materials seemed inevitable, synthetic substitutes were deemed necessary. Plastics have revolutionized modern society, but a century later their widespread use and improper disposal have led to environmental pollution and increasing, health concerns.

Plastics can adversely affect the health of both humans and animals through ingestion, leading to internal injuries, blockages, and toxicity from harmful chemicals. Additionally, plastics can disrupt endocrine systems, induce inflammation, and facilitate the transport of pollutants, posing long-term health risks to organisms across ecosystems. Medical researchers are just beginning to unravel the myriad locations within the human body where plastics are now detected, along with the corresponding negative implications. A recent study published in the New England Journal of Medicine found people with microplastics or nanoplastics in their carotid artery tissues were twice as likely to have a heart attack, stroke, or die from any cause over the next three years than people who had none, a new study found. Carotid arteries, which lie on each side of the neck and carry blood to the brain, can become clogged with fatty cholesterol plaques similar to the arteries leading into the heart, a process known as atherosclerosis. The study is the first that associated plastic contamination with human disease and raises some questions like “Should exposure to microplastics and nanoplastics be considered a cardiovascular risk factor? What organs in addition to the heart may be at risk? How can we reduce exposure?” which should be explored further.

Microplastics are polymer fragments that can range from less than 0.2 inch (5 millimeters) down to 1/25,000th of an inch (1 micrometer). Anything smaller is a nanoplastic that must be measured in billionths of a meter. Nanoplastics are the most worrisome plastics for human health, experts say. At 1,000th the average width of a human hair, the minuscule bits can migrate through the tissues of the digestive tract or lungs into the bloodstream.  From there, nanoplastics can invade individual cells and tissues in major organs, potentially interrupting cellular processes and depositing endocrine-disrupting chemicals such as bisphenols, phthalates, flame retardants, heavy metals, and per- and polyfluorinated substances, or PFAS. Nanoplastics have been found in human blood, lung and liver tissues, urine and feces, mother’s milk, and the placenta. Until now, however, research has yet to determine just what impact those polymers may have on the body’s organs and functions.

Routes of Entry into the Environment

Nanoplastics can be formed through the breakdown of larger plastic items due to various environmental factors such as sunlight, heat, and mechanical stress. Additionally, some consumer products like cosmetics, personal care products, and textiles contain intentionally manufactured nanoplastics. Several pathways contribute to the release of nanoplastics into the environment:

• Microplastic Degradation: Larger plastic items such as bottles, bags, and packaging gradually degrade into smaller particles due to environmental factors like UV radiation, temperature fluctuations, and mechanical abrasion. These fragmented plastics can further break down into nanoplastics.

• Wastewater Treatment: The improper disposal of plastic waste, as well as the laundering of synthetic clothing, can lead to the release of microplastics and nanoplastics into wastewater. Wastewater treatment plants may not effectively capture these tiny particles, allowing them to enter rivers, lakes, and oceans.

• Atmospheric Deposition: Microplastics from various sources can be transported through the atmosphere and deposited onto land and water bodies. These atmospheric microplastics can undergo further degradation into nanoplastics, contributing to environmental contamination.

• Direct Discharge: Industrial processes and activities such as plastic manufacturing, shipping, and waste management can release nanoplastics directly into the environment through spills, leaks, and improper disposal practices.

• Intentional Products: Some consumer products, particularly those in the beauty and personal care industry, contain intentionally manufactured nanoplastics. These products, such as exfoliating scrubs and toothpaste, release nanoplastics directly into wastewater when used and washed off.

Once released into the environment, nanoplastics can persist for long periods and spread widely, contaminating terrestrial and aquatic ecosystems. They can be ingested by organisms at the base of the food chain and bioaccumulate as they move up through the food web, posing potential risks to both wildlife and human health.

Reuse, Recycle and Recovery

Given the widespread presence of plastics in the environment and their persistence in ecosystems, exposure to nanoplastics is virtually unavoidable. However, there are steps individuals can take to mitigate their risk:

• Reduce Plastic Use: Minimize the use of single-use plastics and opt for reusable alternatives whenever possible. This reduces the amount of plastic waste generated, ultimately decreasing the likelihood of nanoplastic pollution in the environment.

• Proper Waste Disposal: Dispose of plastic waste responsibly by recycling and properly disposing of plastics to prevent them from entering the environment.

• Support Research and Advocacy: Support research efforts into the health impacts of nanoplastics and advocate for policies aimed at reducing plastic pollution and promoting alternatives to plastics.

While it is widely known many plastics help protect us, improve healthcare outcomes, and contribute to a more sustainable world, from bicycle helmets and blood bags to drinking water pipes and wind turbines, to help reduce new sources of microplastic in our environment there is an urgent need to focus on the reused, recycling, or recovery of plastics across the world. As medical researchers more fully elucidate the extent of the health risks posed by nanoplastics, taking proactive steps to reduce plastic consumption and exposure can help protect both individual health and the environment.

ACLS Academy is an authorized American Heart Association (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center. ACLS Academy provides high-quality courses all taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Mastering Effective Team Dynamics in CPR: Saving Lives Through Collaboration

Effective teamwork can mean the difference between life and death in high-pressure emergency medical situations. Cardiopulmonary Resuscitation (CPR) is a critical intervention that requires seamless coordination and collaboration among healthcare professionals. Whether in a hospital setting, on the scene of an accident, or responding to a cardiac arrest in public, the ability of a team to work together efficiently can significantly impact patient outcomes. Here are a few critical elements of effective team dynamics in CPR and how they contribute to saving lives.

Clear Communication

Clear and concise communication is the cornerstone of effective teamwork in CPR scenarios. Every team member must be able to communicate their observations, concerns, and actions promptly and accurately. This communication ensures that everyone is on the same page regarding the patient's condition and the steps being taken to provide care.

During CPR, roles are clearly defined, with each team member assigned specific tasks such as chest compressions, airway management, or medication administration. Effective communication ensures smooth coordination between team members, preventing confusion or duplication of efforts. Team leaders play a crucial role in directing communication flow, ensuring that information is relayed efficiently and decisions are made promptly. The team leader must give concise, clear orders with good diction and a calm tone.

Also essential is closed-loop communication (CLC), in which verbal feedback ensures the intended recipient understands the message. The CLC model is based on military radio transmissions and involves three steps:

1. Communicate: The transmitter sends a message to the receiver, ideally using their name.

2. Accept: The receiver acknowledges receipt and seeks clarification if necessary.

3. Verify: The transmitter confirms that the message has been received and understood.

Role Clarity and Coordination

In CPR situations, each team member has a distinct role to play based on their expertise and training. Role clarity is essential to ensure every task is performed effectively and that no critical steps are overlooked. From the first responder to the physician overseeing the resuscitation efforts, each individual must understand their responsibilities and execute them with precision.

Coordination among team members is equally vital. CPR often involves a sequence of actions, including chest compressions, ventilation, defibrillation, and medication administration. Timely coordination ensures that these interventions are delivered in the correct sequence and without delay, maximizing the chances of restoring circulation and achieving a successful outcome.

Mutual Respect and Support

Effective team dynamics in CPR rely on mutual respect and support among team members. Tensions can run high in high-stress situations, but maintaining a supportive and respectful environment is essential for fostering collaboration and trust. Every team member's contribution, regardless of their role or seniority, is valued and respected.

Supportive communication and encouragement can help alleviate stress and boost morale, allowing team members to perform at their best under pressure. Offering assistance or stepping in when a colleague needs help demonstrates solidarity and reinforces the shared goal of saving the patient's life.

Adaptability and Flexibility

No two CPR scenarios are exactly alike, and teams must be adaptable and flexible in their approach to each situation. Circumstances can change rapidly, requiring team members to adjust their strategies and priorities accordingly. Effective teams are quick to recognize changes in the patient's condition or response to treatment and adapt their interventions accordingly.

Flexibility also involves being open to feedback and willing to modify one's approach based on input from other team members or new information. Constructive criticism and continuous evaluation of performance enable teams to learn and improve their effectiveness over time, ultimately leading to better patient outcomes.

Training and Simulation

Effective team dynamics in CPR are not innate but are developed through training, practice, and simulation exercises. Regular training sessions allow team members to familiarize themselves with protocols, refine their skills, and practice teamwork in a controlled environment. Simulation scenarios recreate realistic CPR situations, providing valuable opportunities for teams to work together and identify areas for improvement.

Training also helps teams develop a shared mental model, ensuring everyone understands their roles, responsibilities, and the expected sequence of actions during CPR. Familiarity with protocols and procedures reduces hesitation and promotes smoother coordination during actual resuscitation efforts.

In the high-stakes environment of CPR, effective teamwork is essential for maximizing the chances of a successful outcome. Healthcare professionals can save lives and make a meaningful difference in emergencies by working together seamlessly and leveraging each team member's expertise. 

ACLS Academy is an authorized American Heart Association (AHA)- Aligned Training Center with three convenient locations in Massachusetts: Quincy, Bridgewater, and Newton Center. ACLS Academy provides high-quality courses, all taught by instructors practicing in the medical profession, for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Trauma Nursing in the Field: How TNCC Certification Prepares Nurses for Emergency Situations

In the dynamic world of healthcare, emergencies demand rapid, decisive action. Nowhere is this more evident than in trauma nursing, where split-second decisions can mean the difference between life and death. Trauma Nursing Core Course (TNCC) certification equips nurses with the knowledge, skills, and confidence to excel in high-pressure environments. 

TNCC certification is a rigorous training program the Emergency Nurses Association (ENA) developed to enhance nurses' ability to provide expert care to trauma patients. The Emergency Nurses Association (ENA) is a professional organization dedicated to advancing emergency nursing practice, advocacy, and leadership. Founded in 1970, the ENA represents over 50,000 emergency nurses from across the United States and around the world. The organization is committed to promoting excellence in emergency nursing through education, research, and standards of practice.

One of the critical roles of the ENA is the development and implementation of nursing certification programs, including TNCC. These certification programs are designed to enhance nurses' knowledge, skills, and competencies in specific areas of emergency nursing practice. The ENA’s TNCC course covers various topics, including trauma assessment, airway management, spinal immobilization, shock management, and trauma team dynamics. Through interactive lectures, skill stations, and simulation scenarios, TNCC certification arms nurses with the tools they need to deliver optimal care in emergencies. Course prerequisites are 1) participants must be an RN and possess a current unrestricted nursing license to receive verification or 2) LPNs and paramedics are eligible to attend all portions of the course except for the written and psychomotor evaluations. For this reason, they do not receive verification but are awarded contact hours.

Here are just some of the things that the Trauma Nursing Core Course will teach you:

• Comprehensive Trauma Assessment: One of the cornerstones of TNCC certification is the comprehensive trauma assessment. Nurses learn systematic approaches to quickly assess and prioritize trauma patients based on the severity of their injuries. From conducting primary and secondary surveys to identifying life-threatening injuries, TNCC certification ensures that nurses are adept at quickly identifying and responding to critical patient needs. This thorough assessment process is essential for effectively triaging patients in chaotic field environments.

• Advanced Life Support Skills: TNCC certification goes beyond basic nursing skills to train nurses in advanced life support techniques explicitly tailored for trauma patients. Nurses learn advanced airway management techniques, including endotracheal intubation and ventilation support. They also receive training in vascular access, fluid resuscitation, and medication administration to stabilize critically injured patients. These skills are invaluable in the field, where nurses often work alongside paramedics and physicians to deliver life-saving interventions.

• Team Collaboration and Communication: Effective communication and collaboration are essential components of successful trauma care. TNCC certification emphasizes the importance of teamwork and communication among healthcare providers in high-stress environments. Nurses learn strategies for clear and concise communication during trauma resuscitations, ensuring that critical information is relayed accurately and efficiently. Additionally, TNCC training includes simulation scenarios that simulate real-life trauma team dynamics, allowing nurses to practice working collaboratively with other members of the healthcare team.

• Trauma-Specific Interventions: TNCC certification equips nurses with trauma-specific interventions to address a wide range of injuries commonly encountered in the field. From managing traumatic brain injuries and spinal cord injuries to controlling hemorrhage and stabilizing fractures, nurses learn evidence-based interventions to optimize patient outcomes. This specialized training prepares nurses to address the unique challenges posed by traumatic injuries, including the need for rapid assessment and intervention in life-threatening situations.

• Psychosocial Support for Patients and Families: Trauma nursing extends beyond physical care to encompass emotional and psychosocial support for patients and their families. TNCC certification emphasizes the importance of providing compassionate care to trauma patients during times of crisis. Nurses learn strategies for communicating effectively with patients and families, addressing their concerns, and providing reassurance during traumatic events. This holistic approach to trauma care helps patients and families cope with the emotional impact of their injuries and promotes healing and recovery.

• Continuing Education and Recertification: TNCC certification is not a one-time achievement but an ongoing commitment to professional development. To maintain their TNCC certification, nurses must participate in continuing education activities and recertify every four years. This ensures that nurses stay up-to-date on the latest advancements in trauma nursing and maintain proficiency in essential skills. Recertification also provides an opportunity for nurses to reflect on their practice and identify areas for growth and improvement.

ACLS Academy is an authorized American Heart Association (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center. ACLS Academy’s TNCC course is taught by instructors practicing in the medical profession and includes: 

• Virtual learning modules, including avatar-based simulation

• Interactive teaching strategies

• Electronic, open-book testing - No more test anxiety!

• Updated evidence-based provider manual

• One and a half-day course

• 18.25 contact hours of CNE

Course Format

• Textbook: The latest edition of the TNCC Trauma Nursing Core Course Provider Manual includes evidence-based content developed by trauma emergency experts. The 24-chapter, comprehensive manual compiles current trauma nursing standards and is a valuable resource for future reference.

• Online learning: Online modules with links to additional information are provided before the course date to let you learn at your own pace, apply what you know, receive immediate feedback, and refer back to information at any time. The modules are a complete case study process — taking you through an entire sequence of care.

• Live simulation: TNCC includes hands-on training using both an individual and team approach.  Trauma nursing process psychomotor skills stations offer you the opportunity to practice trauma patient assessments and interventions in a controlled environment.

• Instructor-led classroom discussions and skill stations: TNCC is a one-and-a-half-day intensive course taught by expert instructors.

Sign up for an upcoming TNCC here.

Are you looking for additional AHA certifications? ACLS Academy provides high-quality courses, all taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Instructor Highlight: Jenna Sarruda. BS, RN

Medical Career Experience & Current Employment:  I’ve been a Registered Nurse at Beth Israel Deaconess Medical Center since 2005. I spent 17 years as a cardiothoracic nurse in the ICU, then transitioned to the Recovery Room, where I now serve as the Unit Based Educator. In the COVID years, education at hospitals was less of a priority due to staffing shortages and patient volumes. Since then, education within the Recovery Room unit has been revamped, placing a renewed emphasis on skill sessions and establishing a consistent schedule for learning new technologies, equipment, and procedures. In my capacity, I orchestrate educational sessions, act as an instructor, and simultaneously contribute to patient care as a staff nurse. This role, which blends aspects of both staff responsibilities and leadership, provides a dynamic environment for personal development while ensuring the continual refinement of my skills and firsthand knowledge of the activities in my unit.

I was also certified as an Extracorporeal Membrane Oxygenation (ECMO) specialist. 

Education: Bachelors in Science, Salem State University

What initially drew you to a career in nursing? According to my Dad, I’ve been saying I wanted to be a nurse since I was two years old. Then, when I was in high school, my grandmother had some health issues, where she had to undergo dialysis. I found myself captivated by the nurses, impressed by their kindness, expertise, and proficiency. I think personal encounters like these fuel the passion and curiosity of many to pursue a career in healthcare.

In relation to nursing, one consistently comes across the statement, “The profession of nursing is a commitment to life-long learning.”  Is it challenging to keep up to date? Navigating the vast amount of available information can be daunting. As the Unit Based Educator, I serve as a resource for nursing staff, assisting them in researching topics and condensing information into manageable pieces. I prioritize being available for staff to ask questions, and although I may not always have an immediate answer, I am dedicated to finding one for them. Nurses are also innovators, applying creativity and critical thinking to quickly address complex healthcare challenges effectively. We also work closely with the national organization for our unit, The American Society of PeriAnesthesia Nurses (ASPAN), to keep up to date on education, research, clinical practice expertise, and standards for our role. All nurses need educational credits to maintain their license, and the national organization will provide several options to satisfy those requirements. 

My hospital also offers innovative methods to fulfill Continuing Education (CE) requirements through a program called Nursing Grand Rounds. These sessions feature presentations by various staff members, including physicians, nurses, and other professionals. They are recorded, allowing staff to access valuable learning opportunities and earn CE credits at their convenience.

Teaching Background:  

• Why ACLS Academy, and when did you join?  In 2014, a colleague of mine referred me to ACLS Academy. I had been searching to become an instructor and needed help finding a place to get certified. Shelley helped me take the path to becoming an instructor, and I am forever grateful! Shelley and Chad embody remarkable qualities—generosity, honesty, and kindness—that make collaborating with them a joy. Their impact on the community is profound, evident through ALCS Academy and their tireless volunteer efforts. Their commitment extends to both students and instructors, desiring the success of every one of them. With their Instructors, they foster an environment where everyone is encouraged and supported to pursue further education or professional endeavors. It's no surprise that many instructors have remained with them for an extended period; their dedication speaks volumes.

• What courses do you teach, and are you in training to teach at ACLS?  BLS, ACLS, and PALS.

• Stories or favorite part of teaching? Learning from my students.

Training Secret Sauce:  Setting expectations at the beginning of the class. I am very explicit about what will be expected in the skills session, ensuring that participants grasp the material thoroughly. Safety is my top priority, and I stress that lack of preparation may fail, as I cannot permit putting potential patients at risk with unsafe practices.

Based on your experience, what advice would you give to aspiring nurses who are just beginning their careers? Approach your career with a receptive mindset. While you may start with a specific focus for your practice in mind, remain open to the possibility of discovering new specialties along the way. I strongly encourage new nurses to embrace a journey where the destination may be uncertain but filled with potential opportunities.

Family Life: I am married with two little girls and a dog named Lucky! Birthdays are special for us since my oldest was born on 12-12-12, and Lucky was Valentine’s Day! 

Favorite things outside of work? Anything outdoors. I love the sunshine. In the summer you can find my family at the beach. In winter, we love skiing. Whenever possible, I enormously enjoy taking my dog Lucky for walks on the beach.

Preferred Music Genre or Favorite Performers: I love all music but can’t say I have a favorite genre. My first concert was Elton John at nine years old, but then I’ve seen Pearl Jam several times and am hoping to see them this summer when they come to Fenway. So let’s say “a” favorite is Grunge, but not exclusively.

Sports fanatic or yawn, sports-indifferent? It’s probably blasphemous to say this as a New Englander, but yawn. I love playing basketball, and my husband is a fisherman, so we are sports-oriented, not spectators. My brother disowns me during football season because I’m not glued to the television watching the Pats.

Your happy place? The beach, the sunshine, the sand, the surf, it brings so much joy! I live in Kingston, so I’m close, and my girls love swimming in the ocean. My mom lives in Cape Cod, and my dad lives in Florida, so my family is fortunate to have the best of both worlds.

The Extra One Degree: Lessons Learned from Building Partnerships in Global Health UNC Health’s “The Beat Goes On” Keynote Address by Dr. Shelley Lynch DNP NP-BC APRN CCRN

212°, the extra one-degree concept reminds us that seemingly small, incremental changes can lead to significant positive outcomes over time and alter the course of a journey. A mere one-degree variance has a profound impact on both the boiling point of water and the landscape of healthcare. How do you get your healthcare team from bubbling to boiling to steam?  Partnerships!

Global health initiatives are crucial for addressing health disparities, promoting disease prevention, and improving access to healthcare services worldwide. By fostering collaboration among nations and organizations, these initiatives strive to achieve equitable health outcomes and enhance the well-being of populations globally.

I am employing the 212-degree analogy as a symbol for achieving optimal patient care and enhancing patient outcomes through cultivating partnerships.

Think of the patient as the pot, the team as the water, and the collective spirit or energy as the driving force to increase temperature. Adding just one additional degree of intensity to the water represents the distinction between mere heat and the powerful energy required to propel significant change. 

The collaborative effort and enthusiasm generated by partnerships act as the steam that propels the strategic plan forward. Each component is essential in realizing your ultimate goal: to achieve the GOLD standard and the 212-degree mark. This creates the steam that drives exceptional patient care. As healthcare providers, we strive to cultivate the steam necessary to deliver patient care that reflects your team's dedication and pride, knowing that this commitment will ultimately lead to improved patient outcomes.

Brocher’s Model of the six key principles to partnerships in global health

Essential to achieving a positive boiling point includes Brocher's Model, which includes six key principles for partnerships in global health. Dr. Thomas E. Novotny, the former Deputy Assistant Secretary for International and Refugee Health at the U.S. Department of Health and Human Services, and Dr. Peter J. Hotez, the Dean of the National School of Tropical Medicine at Baylor College of Medicine, proposed these principles. The model emphasizes the importance of collaboration and cooperation among various stakeholders to address global health challenges effectively, ensuring ethical practices, promoting sustainable interventions, and leading to more effective responses to global health challenges and improved health outcomes worldwide.

1. Mutual partnership with bidirectional input & learning

2. Empowered host country and community to define needs and activities 

3. Sustainability and capacity-building

4. Humility, cultural sensitivity, and mutual

5. Compliance with applicable laws, ethical standards, and codes of conduct       

6. Accountability for actions

Application to practice

In her keynote, Dr Lynch discusses these principles with examples from experiences in global health in Haiti and Rural Mississippi. The examples focused on global health partnerships, which had varying results in producing the energy to reach boiling.  She also discussed her recent publication in the Journal of Nurse Practitioners. In a small primary care practice in an urban, underserved area outside of Boston, a project was initiated to implement an evidence-based screening tool for Social Determinants of Health (SDOH) in primary care practice over 12 weeks. Another objective was to provide referrals and resources for those who screened positive.  In the study, evidence-based SDOH screening was implemented in a small urban primary care practice. This quality improvement project aimed to increase SDOH screening from 0% to 50%. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PREPARE) tool is a validated SDOH screener administered by a community health care worker during annual physical examinations over 12 weeks. PREPARE was administered to 81 of 85 patients (95.3%), and 8 (9.9%) screened positive. Benchmarks were surpassed for SDOH screening, which resulted in referrals to community resources. Research should use community health care workers as care extenders and test SDOH screening to identify needs toward improved health.

The findings of this successful local partnership project were published in April 2024 in The Journal of Nurse Practitioners as “Social Determinants of Health Screening: Primary Care PRAPARE Tool Implementation.”

It Starts with Us

Each of us takes ownership of and is accountable for doing the right thing. We empower and trust each other to step up. We support each other and hold each other accountable in our work.​ Create the steam that delivers the patient care that you and your team are proud of because, in the end, you will move towards improving patient outcomes. 

Dr. Shelley Lynch, DNP, FNP-BC, is affiliated with the School of Nursing, The University of North Carolina at Chapel Hill, is a lecturer at the Department of Nursing, Salve Regina University, Newport, RI, is a family nurse practitioner at Internal Medicine Office and in critical care at Beth Deaconess Medical Center, Boston, MA. Dr. Lynch also owns ACLS Academy, an authorized American Heart Associate (AHA) Aligned Training Center. ACLS Academy has three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center. ACLS Academy provides high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse the catalog of courses.

ACLS Instructor Highlight: Peggy Lahar. MSN, MBA, RN, CCRN

Picture yourself as a nurse for half a century! Now envision learning from someone with such extensive experience—an individual who has witnessed countless clinical scenarios and has journeyed through the evolution of nursing. One of our ALCS Academy instructors, Peggy Lahar, is this person, and she has been with us since the inception of ACLS Academy. We were lucky enough to have an opportunity to chat with Peggy about her lifelong passion for nursing and teaching.

1. Medical Career Experience & Current Employment: 

My background includes 20 years in critical care and 30 years in perianesthesia nursing. My current role is managing the Pre-Op and PACU for a community hospital, Beth Israel Deaconess Needham. PACU nurses are highly trained critical care nurses who work in a hospital's post-anesthesia care unit (PACU). They care for patients who have just gotten out of surgery and are recovering from the effects of anesthesia. I was fortunate my directors allowed me to develop this role, which covers a broad range of responsibilities, including hands-on management in the day-to-day running of the unit, budgeting and finances, staffing and orientation, and new service education and training. 

2.   Education: 

• Associate Degree, Labouré College of Healthcare

• Bachelor of Science in Nursing, University of Massachusetts

• Master of Science in Nursing & Family Nurse Practitioner, Regis College

• Masters of Business Administration, Cambridge College

3.  What initially drew you to a career in nursing? 

Ever since I was a child and experienced my surgery, I have always wanted to be a nurse. My nurse was compassionate and kind, allowing me to push some buttons and holding my hand as she guided me to the OR. My parents tried to talk me out of pursuing the profession due to the long hours, the requirement to work holidays, and poor compensation. But I knew this was my calling. I’ve never regretted my decision, but I had to take a longer educational path than most do today. As I had to finance my education, I started with an Associate’s Degree, which wasn’t common in the 1970s. Today, most nurses begin with a Bachelor of Science in Nursing, which I achieved later in my nursing journey.

4. After so many degrees specializing in Nursing, tell us more about your pursuit of an MBA.  

I tend towards a seven-year itch when it comes to education and the desire to further my knowledge and career. For the last 25 years of my career, I’ve alternated between a management and a bedside nursing role. As a manager, I didn’t have formal training and performed the role based on instinct. Then, while I was a staff nurse at Brigham and Women’s Faulkner Hospital, the seven-year itch kicked in, and I didn’t see myself going back for a Doctorate in Nursing, and I wanted to move back into management. I knew the MBA would better prepare me for the financial aspects, like budgeting, which accompanies a management role, so I took the MBA path, which has served me well.

5.  Congratulations on celebrating a 50-year career in nursing in May! How has nursing evolved, and how does one keep abreast of the latest best practices in one’s specialty? 

There have been subtle changes in the care delivery models from team nursing to primary nursing and now back to team nursing. However, the fundamentals haven’t changed: providing the best possible patient care and patient safety and economic and national/world events like COVID-19 impact the nursing profession. When the economy isn’t excellent, nurses tend to stay in their current roles and organizations, whereas, in positive economic times, nurses are in high demand and can make the role and organizational changes very quickly; they can go wherever they want.

Then of course there is the evolution of technology and the constant change this brings to everyone, including healthcare. When I started, basic nursing was on paper; now, it is all digital records. During the phase of my career when I worked in the ICU, there were significant advances in ventilated patients and hemodynamic monitoring. Nurses continue to move forward with those changes. You are left behind if you don’t move forward with them and learn, which was a driver in my educational evolution and the pursuit of additional degrees. It is true that the profession of nursing truly is a commitment to lifelong learning. 

6. Teaching Background:  

• When did you join ACLS?  I’ve been part of ACLS Academy since its inception in 2015.

• What courses do you teach?  ACLS, BLS, and PALS. I teach three evening classes and a Saturday class monthly.

• Stories or favorite part of teaching? Empowering my students with knowledge and student interaction with a diverse group of students taking the classes is interesting to learn something from them as well. I’ve had experienced healthcare professionals, such as cardiologists and anesthesiologists, in my classes, and I encourage active participation as they bring so much knowledge to the discussion. It’s a win-win as everyone learns from the discussion and sharing, making the class more interesting and informative.

7.  Why ACLS Academy?  

Shelley and I were both part of the ACLS program at Quincy Medical Center. Shelley was a clinical specialist, and I was asked to set up and run an ACLS program. Quincy Medical Center had a BLS program but not ACLS, so I recruited some of my colleagues to be instructors for the program. Though I wasn’t an instructor at that particular point, I eventually became an ACLS instructor, then subsequently added BLS and PALS to my repertoire of classes I teach. I enjoy teaching, and though I am looking to retire this year, I expect to continue teaching well into retirement.

8.  Training Secret Sauce: 

I have a straightforward approach to teaching. Since I was a critical care nurse for 20 years, I’ve taken many ACLS courses over the years; ten since you have to renew your certification every two years. Some would say the course is known for being challenging, even painful. When I set up the program at Quincy Medical Center, I wanted to make sure my students had the tools to remember the information and be able to apply it in their work. I took what I considered the “best practices” for learning the material from all the classes I attended and used them in my teaching approach. This is still my method of teaching at ACLS Academy. I want my students to be so confident in their skills that they not only pass the certification test but have the confidence, tools, and knowledge to help anyone requiring lifesaving procedures, whether that be someone on the street, in your family, or at work, should the situation arise. 

Post-examination, I also reviewed with the students the questions that they answered incorrectly. I want to make sure they know the correct answer so that they have the information and tools to apply the material in real-life situations.

While following the AHA guidelines, I also appreciate that ACLS Academy provides the opportunity to teach in the style I prefer and does not have a stringent teaching approach to which they expect their instructors to adhere. 

9.  What advice would you give aspiring nurses just beginning their careers, based on your wealth of experience? 

Ask as many questions as possible to ensure the best patient outcome. Post-COVID, there are fewer experienced nurses to learn from; I advise my new nurses to seek an experienced mentor as a sounding board to ask questions before they possibly cause harm. Don’t go it alone. The second piece of advice would be to adhere to Florence Nightingale’s principle of “Do no harm.” Develop a practice focused on patient safety, checking once, twice, or even three times before taking action. Don’t get caught up in the fast-paced environment and do not focus on safety. 

10.  Favorite Pastime outside of work?

My favorite pastime outside of work is spending quality time with family. My husband and I have three children, including twins and six grandchildren. I love spending time with all of them. We continue our family’s traditions of Sunday dinner two to three times a month. We spend a lot of time talking and sharing during these evenings.

I also love to read and needlepoint. I took up needlepoint about ten years ago as something to do at 3-4 a.m. when working a night shift and work was slow. I started out making a quilt for each of my grandchildren, which I hope they pass down to their children. Since I’ve accomplished the grandchildren's quilt goal, I have moved on to needlepoint Christmas tree skirts for each of my children. 

12.  Favorite book genre? 

After a lifetime of learning for work and reading technical books that require studying, my pleasure in reading is pure fluff. My friends and family make fun of me for my choices, but I want to read material that is an escape, not something you need to think about.  The genres I tend towards are romantic comedies and murder mysteries.

13.  Digital books or hardcopy?

I'd prefer digital. The Nook is my preferred device. I loved reading the Outlander series of books, but those “weigh” in at 1300 pages; that is a lot to prop up in bed or a chair. A Nook is much easier to handle, plus when I finish a book, there’s a whole digital library online to choose from immediately. Immediate gratification.

We’ve Got PEARS: Because Even Superheroes Need a Crash Course in Toddler Cardiopulmonary Support

Have you ever felt like you needed a crash course in deciphering the language of tiny humans during medical emergencies? Welcome to the PEARS Provider Course, your ticket to mastering the art of swift assessment, recognition, and stabilization when the tiniest patients need you most.

To bridge the training gap between healthcare providers who regularly provide advanced pediatric life support and those who infrequently care for critically ill or injured children, the American Heart Association created an intermediate course -- Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS).

This course supports healthcare providers who do not regularly provide advanced pediatric life support or are not credentialed for advanced pediatric treatment. Specifically, PEARS develops skills in recognizing signs and symptoms of a child in cardiopulmonary distress who needs rapid support.

Because the providers for whom PEARS is intended do not regularly treat critically ill children, the course utilizes several unique visual cues and learning tools to help students recognize the signs of distress and to teach and reinforce the most relevant steps in handling a child at risk of cardiopulmonary arrest. One of the unique tools used in the course is video-based simulation, which enables providers to see and hear critically ill children. Students also participate in and practice various skills at learning stations, after which they must pass skills tests and a final written exam. Upon course completion, students receive AHA PEARS certification.

What is the difference between AHA PEARS and PALS?

The American Heart Association (AHA) offers two pediatric training courses: PALS and PEARS. The Pediatric Advanced Life Support (PALS) course is designed for healthcare providers who manage cardiac and respiratory emergencies in children, focusing on advanced life support interventions such as advanced airway management and cardiac rhythm interpretation. On the other hand, the PEARS course targets healthcare providers who may encounter pediatric emergencies, but do not require the advanced skills covered in PALS, emphasizing early recognition and basic stabilization techniques. While PALS delves into more complex scenarios and interventions, PEARS provides a foundational understanding tailored for a broader range of healthcare professionals working with pediatric patients.

The PEARS course was established in 2007 by the AHA and co-branded with the American Academy of Pediatrics (AAP) to address feedback from students who had taken PALS and found that it went far beyond their scope of practice. In pre-release trials, students taking PEARS reported that the course did a much better job of meeting their needs than PALS, primarily by emphasizing initial recognition and stabilization.  Though it is not a prerequisite for PALS, PEARS provides a good foundation for succeeding in PALS and can serve as a starting point for providers interested in learning more advanced pediatric life support skills.

PEARS Course Format

The AHA’s PEARS course is a classroom-based, Instructor-led course, where students learn how to use a systematic approach to quickly assess, recognize the cause, and stabilize a pediatric patient in an emergency. In the course, skills are taught in large-group sessions and small-group learning and testing stations where case-based scenarios are presented using the course video. The PEARS Course includes child and infant BLS skills practice and testing.

During PEARS, students interact with real patient cases, realistic simulations, and animations to assess and stabilize pediatric patients experiencing respiratory and shock emergencies and cardiopulmonary arrest. PEARS prepares students to provide appropriate lifesaving interventions within the initial minutes of response until a child can be transferred to an advanced life support provider.

Specifically, the course teaches: 

• Systematic pediatric assessment

• Recognition and stabilization of respiratory emergencies

• Recognition and stabilization of shock emergencies

• Recognition and stabilization of cardiopulmonary arrest

• Resuscitation team concept

Are there prerequisites for taking the PEARS Course? 

Before taking PEARS, students should master child and infant BLS skills, including CPR and using an AED.

Who should take this course?

The AHA’s PEARS Course is designed for healthcare providers and others who might encounter pediatric emergencies during their work, including:

• Physicians and nurses not specializing in pediatrics

• Nurse practitioners

• Physician assistants

• EMTs,

• Respiratory therapists

• Prehospital and in-facility healthcare providers (outside of critical-care areas)

• Outpatient clinic staff

• School-based providers

• Any other healthcare provider who infrequently sees critically ill or injured infants and children

Course Completion Card

Students who complete the PEARS Course will receive a PEARS Provider course completion card (print or eCard), valid for two years. Course completion requirements include:

• Active participation in case discussions

• Active participation in the rescue breathing skills station and cardiac arrest case simulations

• Pass the skills tests in 1- and 2-rescuer child BLS with AED and 1- and 2-rescuer infant BLS

• Pass the video-based written exam with a minimum score of 84%

ACLS Academy is an authorized American Heart Association (AHA) Aligned Training Center. We follow the AHA Curricula for PEARS Provider. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

ACLS Academy Founder and AHA Instructor Dr. Shelley Lynch Author’s Article on Social Determinants of Health

Dr. Shelley Lynch has been passionate about public health for a very long time. On a trip to Jamaica during a collegiate trimester nursing program, she saw the delivery of a baby in a rural, poverty-stricken town. With no medical professionals on hand, the locals carried water and towels to the woman’s tin home. This life-changing experience was an early calling for Shelley’s focus on global public health, which eventually led to a Doctorate of Nursing Practice from UNC-Chapel Hill, where she studied Translational Science and the Social Determinants of Health.

Shelley’s latest public health efforts include a keynote address at her alma mater, UNC-Chapel Hill, on “The Extra One Degree: Lessons Learned from Building Partnerships in Global Health” and recently authoring a paper published in The Journal of Nurse Practitioners on “Social Determinants of Health Screening: Primary Care PRAPARE Tool Implementation.” 

This project aimed to implement an evidence-based screening tool for Social Determinants of Health (SDOH) in a primary care practice over 12 weeks. Another objective was to provide referrals and resources for those who screened positive.  In the study, evidence-based SDOH screening was implemented in a small urban primary care practice. This quality improvement project aimed to increase SDOH screening from 0% to 50%. The Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences (PREPARE) tool is a validated SDOH screener administered by a community health care worker during annual physical examinations over 12 weeks. PREPARE was administered to 81 of 85 patients (95.3%), and 8 (9.9%) screened positive. Benchmarks were surpassed for SDOH screening and resulted in referrals to community resources. Research should use community health care workers as care extenders and test SDOH screening to identify needs toward improved health.

Highlights of the paper include:

• Patient’s social determinants of health (SDOH) are key drivers of health outcomes.

• Beginning in 2023, accredited organizations are required to screen for SDOH.

• We implemented validated SDOH screens in primary care, screening 95% of patients.

• Implementing SDOH screening can lead to appropriate referrals and improved health

Health is impacted by where we live, where we play, and where we work.  SDOH are the conditions in which people are born, grow, live, work, and age, and they encompass a wide range of factors that influence health outcomes. These determinants can significantly impact health in several ways:

• Access to healthcare: SDOH can affect an individual's ability to access healthcare services, including primary care, preventive care, and specialty consultations. Income level, education, and geographic location can influence access to healthcare facilities and health insurance coverage.

• Social and economic factors: Economic stability, employment opportunities, income level, and social support networks are critical determinants of health. Individuals facing economic hardship may struggle to afford healthy food, safe housing, transportation to medical appointments, and other essential resources, leading to poorer health outcomes.

• Education: Education level is strongly linked to health outcomes. Higher levels of education are associated with better health behaviors, increased access to healthcare, and improved overall health status. Education provides individuals with the knowledge and skills to make informed decisions about their health and access available resources.

• Environmental factors: The physical environment in which individuals live, work, and play can significantly impact health. Exposure to environmental hazards such as air and water pollution, toxins, and unsafe living conditions can increase the risk of chronic diseases, respiratory problems, and other health issues.

• Social support networks: Strong social support networks, including relationships with family, friends, and communities, are protective factors for health. Social isolation and lack of social support have been linked to poor mental health outcomes, increased stress levels, and higher rates of chronic diseases.

• Behavioral factors: SDOH influences health-related behaviors such as diet, exercise, smoking, and substance abuse. Individuals with limited access to healthy food options or safe recreational spaces may be at higher risk for obesity, cardiovascular disease, and other chronic conditions.

• Stress and discrimination: Social determinants such as discrimination, racism, and socioeconomic inequality can contribute to chronic stress, which has been linked to a range of adverse health outcomes, including hypertension, cardiovascular disease, depression, and anxiety.

If healthcare providers strive to improve health, we need to focus on the social determinants of health. To improve the social determinants of health, we need to start with screening for them during office or hospital visits and provide a link from patients to community services to help improve the social determinants.

ACLS Academy is an authorized American Heart Association (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Understanding the Heart-Stress Connection: Observing Stress Awareness Month

April isn't just about welcoming spring blooms and warmer weather; it's also a time to spotlight stress. Stress Awareness Month is a crucial opportunity to delve into the intricate relationship between stress and heart health. While stress is often viewed as a mental or emotional burden, its impact extends far beyond that, deeply affecting our physical well-being, particularly the health of our hearts.

The connection between stress and heart health is undeniable. When stressed, our hormones, like adrenaline and cortisol, trigger the "fight or flight" response. While this response can be lifesaving in emergencies, chronic stress keeps these hormones elevated, leading to a cascade of adverse effects on the cardiovascular system.

One of the most significant ways stress impacts heart health is through increased blood pressure. When stress hormones flood the body, blood vessels constrict, causing blood pressure to rise. Over time, this elevated pressure can damage the arteries, leading to conditions like hypertension and increasing the risk of heart disease, heart attacks, and strokes.

Furthermore, chronic stress contributes to inflammation throughout the body, including in the arteries. Inflammation plays a key role in developing atherosclerosis, where fatty deposits build up in the arteries, narrowing them and impeding blood flow. This process can ultimately lead to heart attacks and other cardiovascular events.

Stress also influences behaviors that can harm the heart. Many people turn to unhealthy coping mechanisms when stressed, such as overeating, smoking, or consuming excessive alcohol. These habits can increase the risk of obesity, high cholesterol, and diabetes—major risk factors for heart disease.

Moreover, stress can disrupt sleep patterns, another factor linked to heart health. Poor sleep not only leaves us feeling tired and irritable but also increases the risk of conditions like obesity, diabetes, and hypertension, all of which can harm the heart.

It's essential to recognize that stress affects individuals differently. What might be manageable stress for one person could be overwhelming for another. Genetics, upbringing, personality, and external circumstances affect how we respond to stress. However, regardless of our thresholds, managing stress is crucial for protecting our heart health.

So, what actions can be taken to mitigate the impact of stress on our hearts? The key lies in adopting healthy coping mechanisms and lifestyle habits that promote resilience and well-being.

1. Prioritize Self-Care: Engage in activities that promote relaxation and calmness, such as meditation, deep breathing exercises, yoga, or spending time in nature. Taking daily breaks to rest and recharge can also help manage stress levels.

2. Stay Active: Regular physical activity is beneficial for cardiovascular health and an excellent way to reduce stress. Aim for at least 30 minutes of moderate exercise, whether walking, cycling, swimming, or dancing, most days of the week.

3. Eat Well: A balanced diet of fruits, vegetables, whole grains, lean proteins, and healthy fats provides the nutrients your body needs to combat stress and support heart health. Limiting processed foods, sugary snacks, and excessive caffeine can also help stabilize mood and energy levels.

4. Build Strong Connections: Cultivate supportive relationships with friends, family, and community members. Sharing your feelings and experiences with others can provide comfort and perspective, reducing feelings of isolation and stress.

5. Get Adequate Sleep: Aim for 7-9 hours of quality sleep per night. Establish a relaxing bedtime routine, create a comfortable sleep environment, and avoid screens and stimulating activities before bed.

6. Practice Mindfulness: Incorporate mindfulness techniques into your daily routine to cultivate awareness and reduce stress reactivity. Mindfulness meditation, body scans, and mindful eating can help you stay grounded and centered amidst life's challenges.

7. Seek Support: If stress feels overwhelming or unmanageable, don't hesitate to seek professional help. Therapists, counselors, and support groups can provide valuable guidance and support in developing coping strategies and improving resilience.

As we observe Stress Awareness Month this April, let's commit to prioritizing our heart health by managing stress effectively. Adopting healthy habits and seeking support when needed can protect our hearts and cultivate a greater sense of well-being. Remember, caring for your mental and emotional health is just as important as caring for your physical health—both are essential for a thriving life.

ACLS Academy is an authorized American Heart Association (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Unveiling the Silent Link: How High Blood Pressure May Secretly Fuel the Onset of Dementia

Most people are familiar with the link between high blood pressure to an increased risk of stroke and heart attack, but high blood pressure can also affect your memory. According to the Alzheimer's Society, long-term studies have shown that people with high blood pressure between the ages of 40–64 are more likely to develop dementia later in life, especially vascular dementia. Vascular dementia is the second most common form of dementia after Alzheimer's disease. It is caused by reduced blood flow to the brain, which starves brain cells of the oxygen and nutrients they need to function correctly. Researchers have known about the link between blood pressure and Alzheimer’s for years. In 2013, investigators showed that older people with high blood pressure, or hypertension, were more likely to have biomarkers of Alzheimer’s in their spinal fluid.  

High blood pressure can damage small blood vessels in the brain, affecting parts of the brain responsible for thinking and memory. So logically it would make sense that controlling blood pressure through medication could also lower Alzheimer’s risk. A 2013 Johns Hopkins report published in the journal Neurology confirmed earlier work from Johns Hopkins researchers that found the use of potassium-sparing diuretics reduced the risk of Alzheimer’s nearly 75 percent, while people who took any type of antihypertensive medication lowered their risk by about a third.

What they found was if you didn’t have Alzheimer’s and you were taking blood pressure medication, you were somewhat less likely to develop dementia. And if you had dementia from Alzheimer’s disease and you took certain antihypertensives, the disease was less likely to progress. However, it was not clear if the connection comes from managing the blood pressure better or if the particular drugs might have properties that interfere with other processes relating to Alzheimer’s.

Ages Matters in the High Blood Pressure – Dementia Link

Nearly half of U.S. adults have high blood pressure. According to the FDA, high blood pressure is 130/80 or higher. Stage 1 high blood pressure is 130/80, and stage 2 is 140/90 or higher. If your blood pressure is 180/110 or higher more than once, you should seek medical treatment immediately.

Research shows people who develop high blood pressure before middle age have smaller brains and a higher risk for dementia than those whose blood pressure falls within the normal range. The study, published in October 2021 in the American Heart Association journal Hypertension, found people diagnosed with high blood pressure between the ages of 35 and 44 were 61% more likely to develop some type of dementia within the next decade than those whose blood pressure was normal. The results suggest maintaining good blood pressure control early in life can help reduce the risk of dementia later in life.

In this study, researchers analyzed brain health data – including brain volume size and dementia status – using the UK Biobank, a large database of anonymous health information for half a million people living in the United Kingdom. For every age group, they found those diagnosed with high blood pressure had less brain volume overall, as well as in certain regions of the brain. Those diagnosed with high blood pressure before 35 showed the largest reduction in brain volume compared to those with normal blood pressure, even if their blood pressure later returned to normal.

In a separate analysis, the team looked at the relationship between when people were diagnosed with high blood pressure and whether they developed any form of dementia up to 14 years later. They compared data for 124,053 people with high blood pressure to the same number of people without. The earlier a person develops high blood pressure, the higher the risk of developing vascular dementia. The risk was 69% higher for those diagnosed with high blood pressure between ages 35 and 44 and 45% higher for those diagnosed between ages 45 and 54.

The High Blood Pressure – Dementia Link in Older Populations

Specifically about the older adult population, subsequent research published in JAMA Internal Medicine in January 2022, reported high and low blood pressure levels among different older age groups were associated with varying dementia risks. The prospective observational study showed that high systolic blood pressure in people more than 60 years old decreases the risk of dementia. Still, both lower and higher blood pressure are associated with decreased dementia risk in people older than 75.

Although midlife hypertension is associated with an increased risk for dementia, this risk in older people has not been well researched. Previous studies have reported a U-shaped association between blood pressure and dementia risk, where both high and low blood pressure are associated with increased risk; however, the evidence for this association is limited. 

Researchers analyzed data on more than 17,000 participants from seven cohort studies and divided the participants into different age groups. In the younger age groups (60 to 70 years old), higher blood pressure was associated with lower dementia risk. The older age groups (75 years and older) showed a U-shaped association where high and low blood pressures were associated with decreased dementia risk. Interestingly, these associations for decreased dementia risk were not attributable to longer survival with lower blood pressure.

This study provides new evidence about how blood pressure affects dementia risk in older people, which previously has not been clearly defined. The researchers note that these observational study results contradict evidence from randomized controlled trials, including the NIA-supported Systolic Blood Pressure Intervention Trial - Memory and Cognition in Decreased Hypertension (SPRINT MIND) study that suggested controlling high blood pressure can reduce dementia risk. They explain that the novel association in this study may be because their cohorts consist of a broader, older population rather than a specific subgroup of older people with high blood pressure and other cardiovascular risk factors.

Since this was an observational study, the study authors suggest further research is needed to understand the cause behind the associations that it found, including randomized controlled trials to find the best strategies for controlling blood pressure in older people. 

Mitigating the High Blood Pressure – Dementia Risk in Mid-Age Population

In American Heart Association Scientific Sessions 2023, Abstract in LBS.04 covered a four-year blood pressure intervention program in rural China aimed at significantly reducing systolic blood pressure by an average of 22 mmHg and risk of all-cause dementia by 15% in people with high blood pressure.

The trial was conducted from May 2018 through March 2023. The average age of study participants at enrollment was 63 years old. 61% identified as women, and 39% as men; researchers observed similar reductions in blood pressure and dementia risk in women and men. The study was conducted in 326 villages in rural China and included approximately 34,000 adults, ages 40 and older, with an untreated blood pressure of 140/90 mm Hg or higher, or 130/80 mm Hg or higher for people at high risk for cardiovascular disease or those currently taking blood pressure medication. 

Half of the villages were randomly assigned to a village doctor-led intensive blood pressure intervention strategy, and half of the villages were randomly assigned to usual care. The trained interventionists initiated and titrated antihypertensive medications based on a simple treatment protocol in which the medication dose was adjusted with a target blood pressure of less than 130/80 mm Hg. The village doctors also provided discounted and free medications to patients and conducted health coaching on lifestyle modifications, home blood pressure measurement, and medicine adherence.

The analysis found that the people in the intervention group showed significant improvement in blood pressure control and reduced dementia and cognitive impairment, with no dementia compared to those who received usual care. Future studies are needed to examine whether lowering blood pressure will reduce the risk of dementia among adults with a high risk for dementia without high blood pressure.

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Unlocking Lifesaving Potential: The Crucial Role of AHA Training Center Alignment for Instructors

Becoming an AHA instructor empowers individuals to equip others with life-saving skills, fostering a safer community, and potentially saving lives in emergencies while simultaneously advancing personal and professional development through teaching and leadership opportunities. To become an AHA certified instructor, candidates need to align with an AHA Training Center (TC) to purchase AHA materials, teach courses, and issue American Heart Association certificates. 

Here are the steps to becoming an instructor:

• Complete Provider Courses: Instructor candidates must first complete the provider courses they wish to teach, such as Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), or Pediatric Advanced Life Support (PALS), depending on their area of interest.

• Meet Eligibility Requirements: Candidates need to meet the eligibility requirements set by the AHA and the specific Training Center with which they intend to align. These requirements include holding a current provider certification in the course they want to teach and demonstrating proficiency in the skills covered in the course.

• Attend Instructor Course: Instructor candidates are required to attend an AHA Instructor Course conducted by a Training Center Faculty member. During this course, candidates learn about teaching methodologies, AHA guidelines, and how to effectively deliver AHA courses.

• Demonstrate Skills: Candidates must demonstrate their skills in teaching CPR and other life-saving techniques to their instructor course classmates and the Training Center Faculty.

• Complete Monitoring: After completing the Instructor Course, candidates will need to be monitored while teaching their first course as an instructor. This monitoring ensures that they can effectively teach the course content and adhere to AHA guidelines.

• Align with a Training Center: Once they have completed all requirements, instructor candidates can officially align with a specific AHA Training Center. This affiliation allows them to teach AHA courses under the auspices of that Training Center.

• Maintain Certification: Instructors must maintain their certification by regularly renewing their credentials, staying up-to-date with AHA guidelines, and fulfilling any continuing education requirements set by the Training Center.

The AHA requires that instructors be at least 18 years of age to teach Heartsaver and BLS courses. ACLS, PALS, and PEARS Instructors must be at least 18 years of age and licensed or certified in a healthcare occupation where the skills are within the provider’s scope of practice.

Choosing the Right AHA Training Center and Alignment Considerations

The AHA established a fleet of Training Centers to help strengthen the Chain of Survival by monitoring the proper administration and quality of the Emergency Cardiovascular Care Courses.  Choosing the right Training Center for alignment is essential to ensure you have the appropriate support, teaching materials, equipment, administrative support, and opportunities for professional development as an instructor. 

As an AHA Training Center, ACLS Academy works closely with the AHA to provide the utmost care and education when teaching others American Heart Association courses.  We adhere to rigorous guidelines and uphold the highest levels of integrity in our business practices while facilitating quality education.

As an AHA Training Center, ACLS Academy is responsible for providing our Training Sites and instructors with timely communication of any new or updated information about the Training Centers, communication of regional or national procedures, and course content. It is also our duty to make sure Instructors are current on AHA protocols and certified to teach the AHA programs.

The benefits of alignment with ACLS Academy are: 

• No alignment fees 

• No charge for biennial monitoring (every two years) 

• Free use of our software system to submit rosters and purchase AHA cards making the process efficient with the quick turnaround of certification card issuance

• Acceptance of instructors in all AHA disciplines (e.g. Heartsaver, BLS, ACLS, PALS) 

• Assignment of Training Sites when locations have 5 or more instructors

• Assignment of a Training Site Coordinator for Training Sites

• Free training of a Training Center Faculty for Training Sites

• Alignment with an established Training Center with an impeccable reputation for quality training and customer service

• Three training locations in the greater Boston area for the convenience of our instructor and student network

• Established Training Center with over 24 instructors and committed to providing Emergency Cardiovascular Care training to healthcare professionals and individuals in the community 

Instructor Alignment Process

After an instructor candidate has completed an Instructor Course, they will automatically be aligned with the Training Center where the instruction occurred, although some exceptions may apply. While most AHA Instructors align with a single Training Center, the AHA does allow for secondary Training Center alignment. An example scenario of when this occurs is where an instructor is aligned with a hospital but the hospital doesn’t allow for instruction in the community. The instructor in that case may align with an outside Training Center. In the case of a secondary Training Center alignment, the primary Training Center is not alerted as to the secondary alignment, and no transfer forms are required.

Transferring an Instructor AHA Training Center Alignment

An instructor can transfer their Training Center alignment to a new Training Center organization. The transfer process works as follows: 

• Completion of an AHA transfer form - The accepting Training Center will sign off on the form and communicate the form to the old Training Center requesting a copy of the instructor records. Communication of the form must be solely between the two Training Centers; the instructor cannot be the facilitator of the form communication.

• The completed form will also be submitted to the AHA by the accepting Training Center.

• The accepting Training Center will monitor the instructor teaching a class to ensure AHA quality standards are being upheld. This can be completed in person or virtually through the recording of the class. This is a requirement in all cases even if a current AHA instructor certification card is still valid.

• An Affiliation agreement will typically be signed by the Training Center and Instructor. 

• The AHA will issue a new instructor certification card with the new Training Center affiliation indicated.

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses. If you’re interested in becoming an instructor and/or affiliating with ACLS Academy as an instructor, please reach out to us.

Celebrating Certified Nurses: Champions of Excellence

March 19th is Certified Nurses Day, an annual day honoring healthcare leaders who are dedicated to nursing professionalism, excellence, recognition, and service of recognition for nurses. According to the American Association of Critical-Care Nurses (AACN), as healthcare becomes increasingly complex and challenging, the value of certification as a mark of excellence is more important than ever. Achieving board certification demonstrates to patients, employers, and the public that a nurse’s knowledge reflects national standards and a deep commitment to patient safety. National certification is a voluntary process that demonstrates advanced nursing knowledge and promotes excellence.

The Benefits of Certification

Certification not only contribute to optimal outcomes for acutely, critically ill patients and their families, but it also advances the professional and personal goals and aspirations of the nursing population. Nursing certification offers several benefits to patients, employers, and nurses alike:

• Patient Care Quality: Certified nurses demonstrate advanced knowledge and skills in specialized areas, such as critical care, oncology, or pediatric nursing. This expertise enhances patient care quality by ensuring that nurses have the necessary competencies to provide specialized care effectively.

• Increased Patient Safety: With certification, nurses are better equipped to recognize and respond to complex patient needs, which can enhance patient safety. They have a deeper understanding of patient assessment, medication administration, and intervention techniques, leading to better outcomes and reduced risks of errors.

• Professional Development: Nursing certification requires ongoing education and skill development, encouraging nurses to stay updated on the latest evidence-based practices and advancements in their field. This commitment to continuous learning enhances nurses' professional growth and ensures that they deliver high-quality care aligned with current best practices.

• Employer Confidence: Certification signifies a nurse's commitment to excellence and professionalism. Employers value certified nurses for their specialized skills and expertise, leading to increased confidence in their abilities to deliver superior patient care. This can result in better job prospects, career advancement opportunities, and higher levels of trust from employers.

• Recognition and Prestige: Nursing certification is a mark of distinction within the nursing profession. It demonstrates dedication, expertise, and a commitment to meeting high standards of practice. Certified nurses often receive recognition from peers, patients, and employers, which can boost morale and job satisfaction.

• Standardization of Care: Certification programs establish standardized guidelines and competencies for specific areas of nursing practice. This helps ensure consistency in care delivery across healthcare settings, promoting uniformity and quality in patient outcomes.

Lifelong Learning

Certified Nurses Day is also an opportunity to recognize certified nurses for their dedication to lifelong learning and professional development. As nursing and medicine change nurses must keep pace. Procedures, treatments, ideas, and concepts all change over time. It is the expectation patients have of all nurses, they will always do the right thing and if things change, they will advance their knowledge and know how to do those things as well.

Recognizing the dynamic nature of healthcare, nurses continually seek to expand their knowledge and skills to provide the highest quality care to patients. Through ongoing education and training, they stay updated on advancements in medical technology, treatments, and best practices. This commitment to learning not only enhances patient outcomes but also fosters personal and career growth for nurses. Whether through formal education, like certifications in specialty areas, conferences, or self-directed study, nurses embrace opportunities to refine their expertise and adapt to the evolving healthcare landscape.

Why March 19th? 

The date was chosen as it is the birthday of Margretta "Gretta" Madden Styles, a renowned expert in nurse credentialing. Gretta Madden Styles was a pioneer in nursing education, advocating for advanced training and certification for nurses. She played a significant role in shaping the profession by emphasizing the importance of continuous learning and professional development among nurses. Madden Styles spearheaded the establishment of the American Nurses Credentialing Center, which provides certification programs for nurses. Additionally, she advocated for the recognition of nursing as a distinct profession with standardized educational requirements and encouraged nurses to pursue higher levels of education and specialization.

Join the Recognition of Certified Nurses

Take this time to acknowledge the importance of certified nurses in delivering patient care, emphasizing the value of their specialized knowledge. In recognizing their nursing contributions, we also affirm their critical role in shaping the future of healthcare. Certified nurses are champions of excellence, embodying a commitment to quality care and lifelong learning.

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

A New ACLS Academy Course on the Horizon: PALS Plus

ACLS Academy is excited to announce the expansion of our training offering to include the PALS Plus Course starting in April 2024.  The PALS Plus Course is a pediatric advanced life support (PALS) course for more experienced pediatric healthcare providers seeking advanced educational content. The course teaches more than the traditional PALS curriculum and includes 9 additional modules related to pediatric emergencies. The full course includes an online portion consisting of HeartCode PALS Online and the student’s selection of at least 6 of the 9 PALS Plus Advanced Modules, combined with a HeartCode PALS skills session with an Instructor.

Target Audiences

The PALS Plus Course is for healthcare providers who either direct or participate in the management of respiratory and/or cardiovascular emergencies, cardiopulmonary arrest, and other emergent and critical conditions in pediatric patients. These individuals may include:

• Physicians

• Physician Assistants

• Nurse Practitioners

• Nurses

• EMS

HeartCode PALS Online

HeartCode® PALS Online is the online portion of PALS blended learning that will prepare students for hands-on skills sessions with an AHA PALS Instructor or on a simulation station.

Course Learning Objectives - Perform high-quality cardiopulmonary resuscitation (CPR) per AHA basic life support (BLS) recommendations:

1. Differentiate between patients who do and do not require immediate intervention

2. Recognize cardiopulmonary arrest early and begin CPR within 10 seconds

3. Apply team dynamics

4. Differentiate between and perform early interventions for respiratory distress and failure

5. Differentiate between compensated and decompensated (hypotensive) shock

6. Perform early interventions for the treatment of shock

7. Differentiate between unstable and stable patients with arrhythmias

8. Describe clinical characteristics of instability in patients with arrhythmias

9. Implement post-cardiac arrest management

PALS Plus™ Advanced Modules 

PALS Plus: Advanced Airway Management

Pediatric airways are not just small adult airways; they carry special considerations and treatments. This module compares those differences and further reviews the clinical features, diagnosis, and management tactics for obstructions and upper and lower airway diseases of the lungs. It covers positive-pressure ventilation and the requirements for advanced airway placement. Additionally, the module addresses aerosol-generating procedures in the COVID-19 era.

Module Learning Objectives:

1. Describe necessary precautions during aerosol-generating procedures to avoid transmission of infectious particles to providers (eg, with COVID-19)

2. Compare the anatomic and physiologic differences between adult and pediatric airways

3. Recognize a general approach to pediatric airway emergencies, including the difficult airway

4. Describe clinical features, diagnosis, and management of upper and lower airway obstruction and diseases of the lung

5. Describe interventions for respiratory distress vs respiratory failure

6. Recognize the requirement for positive-pressure ventilation

7. Recognize the requirement for an advanced airway

PALS Plus: Child Abuse

This module covers the concepts and interventions related to pediatric child abuse. Content includes topics such as recognition of risk for abuse, understanding gross-motor development, recognition of “red flags,” distinguishing bruising patterns, and burn characteristics, and recognition of potential exposure to illicit substances.

Module Learning Objectives:

1. Recognize signs and symptoms associated with physical abuse in infants and children

2. Describe the appropriate approach to the diagnostic evaluation for physical abuse in infants and children

3. Demonstrate systems-based components of caring for an infant or a child with physical abuse

4. Recognize patient presentations suggestive of human trafficking

PALS Plus: Congenital Heart Disease

In this module, students learn about the general management of patients with single-ventricle anatomy and physiology. This includes changes as palliation progresses from stage I to stage III, physiologic features that can increase the risk of decompensation, monitoring, mechanical ventilation strategies, and their impact, and differences in cardiopulmonary resuscitation for these patients.

Module Learning Objectives:

1. Explain the concept of neonatal single-ventricle anatomy and physiology and the general types of strategies to manage these patients

2. Describe how the anatomy and physiology change from stage I to stage II and stage III, including how therapies differ

3. Describe the mechanisms that result in increased risk for decompensation and death in patients with single-ventricle physiology

4. List and explain the different types of monitoring that can be beneficial in the acute and chronic management of a patient with shunt-dependent single-ventricle physiology

5. Explain mechanical ventilation strategies and how they impact the physiology of a patient with single-ventricle anatomy and physiology, specifically about the stage of surgery and the presence of heart failure

6. Describe the treatment strategies of the single-ventricle patient with near arrest or cardiac arrest

PALS Plus: Post–Cardiac Arrest Care

The purpose of this module is to educate providers on the pathophysiology and clinical manifestations of pediatric post–cardiac arrest syndrome (PCAS), implementation of cardiac monitoring as part of PCAS, implementation of respiratory support of the intubated child during PCAC, implementation of neurologic support and monitoring during PCAC, monitoring for and managing other physiologic/organ/secondary complications of PCAS, outcomes, and prognostication after cardiac arrest, and recovery after cardiac arrest.

Module Learning Objectives:

1. Recognize the pathophysiology and clinical manifestations of pediatric post-cardiac arrest syndrome

2. Implement cardiac monitoring as part of post-cardiac arrest care

3. Implement respiratory support for the intubated child during post-cardiac arrest care

4. Implement neurologic support and monitoring during post-cardiac arrest care

5. Monitor for and manage other physiologic, organ, and secondary complications of post-cardiac arrest syndrome

6. Formulate outcomes and prognostication after cardiac arrest

7. Describe recovery after cardiac arrest

PALS Plus: Sedation and Analgesia

Procedural sedation in the pediatric population presents additional factors beyond the sedation of an adult patient. This module addresses levels of sedation and the pediatric-focused considerations associated. It covers the common medications and monitoring needed to keep the patient safe. The module includes several clinical scenarios for students to apply their knowledge practically.

Module Learning Objectives:

1. Describe basic concepts of sedation and analgesia

2. Identify common medication types used in procedural analgesia and sedation

3. Describe special considerations of procedural analgesia and sedation

4. Describe appropriate procedural sedation and analgesia for specific circumstances

PALS Plus: Technologically Dependent Child

This module describes the identification and management of medical emergencies in pediatric patients with special healthcare needs. It is designed to educate students about potential complications related to intrathecal baclofen pumps, tracheostomy tubes, vagal nerve stimulators, and ventriculoperitoneal shunts.

Module Learning Objectives:

1. Recognize the emergency management of a child who has an intrathecal baclofen pump

2. Recognize life-threatening emergencies that might be encountered in a child with a tracheostomy tube

3. Recognize the emergency management of a child who has a vagal nerve stimulator

4. Outline the emergency management of a child who has a ventriculoperitoneal shunt

PALS Plus: Toxicology

This module covers the basics of the identification of toxic substances through targeted history, physical exams, and diagnostic studies. It introduces common therapies for ingestion, including methods used to minimize drug absorption and enhance excretion for common poisons. This module also reviews the effects of commonly misused or abused drugs. Additionally, it includes a section describing treatments for caustic eye injuries that children may encounter.

Module Learning Objectives:

1. Recognize the importance of identifying ingestions, providing first aid, and contacting Poison Control

2. Identify methods used to minimize drug absorption

3. Describe the specific therapies, including antidotes, for common poisons

4. Summarize the effects of drug abuse and misuse

5. Describe different routes of exposure (eye, cutaneous)

6. Summarize the effects and management of smoke inhalation and carbon monoxide poisoning

PALS Plus: Trauma—Overview and Approach

This module covers concepts and interventions related to pediatric trauma. The content describes unique anatomic and physiologic characteristics that affect the interventions and responses to injury and subsequent management.

Module Learning Objectives:

1. Describe unique anatomic and physiologic characteristics of the pediatric age group that affect response to injury and management

2. Define concepts of the primary and secondary surveys and systematically discuss the evaluation of the trauma patient by using these tools

3. Discuss management priorities based on immediate life-threatening injuries identified in the primary assessment

4. Discuss the identification and initial treatment of life-threatening injuries to major organ systems

5. Describe the systematic approach to trauma

PALS Plus: Ultrasound

This module covers the basic principles of ultrasound physics, basic controls common to most medical ultrasound equipment, images obtained for an e-FAST ultrasound study, other applications of point-of-care ultrasound, and performing ultrasound assessments of the airway (A), breathing (B), circulation (C), and disability (D) (trauma).

Module Learning Objectives:

1. Describe the basic principles of ultrasound physics

2. Identify the basic controls common to most medical ultrasound equipment

3. Recognize images obtained for an e-FAST ultrasound study

4. Discuss some other applications of point-of-care ultrasound

Upon successful completion of the hands-on skills session, PALS Plus students receive a PALS Provider eCard with the special designation of “PALS Plus” to indicate that they have completed the advanced modules as well as meeting all course completion requirements for a standard PALS Provider eCard.

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

EmPOWERED To Serve: Opioid Education for Nonclinical Staff and Lay Responders

128 people die every day after overdosing on opioids in the United States. Education of the public and lay responders is a small step in mitigating the impacts of an overdose. The American Heart Association (AHA) has created a course for nonclinical staff and lay responders to educate individuals on identifying and responding to opioid overdose, ultimately saving lives and promoting public health. The course is part of the AHA’s EmPOWERED to Serve initiative aimed at addressing health disparities and promoting health equity in underserved communities.

The Opioid Education Course

The AHA course provides a basic understanding of the opioid epidemic, the symptoms of an opioid overdose, how to recognize and respond to someone who might have overdosed on opioids, and care after an overdose.

Upon completion of the course, participants will be able to:

1. Understand the current opioid epidemic in the United States

2. Identify some prescription and illegal opioids

3. Recognize why opioids are so addictive

4. Identify a possible overdose and how to respond to it

5. Identify the antidote for an opioid overdose

6. Understand what naloxone is, how it works, and how to give it to someone who has overdosed on opioids

7. Recognize the importance of treatment options after an opioid overdose.

Knowledge of how to perform cardiopulmonary resuscitation, including opening the airway, administering rescue breaths, using high-quality chest compressions, and ensuring early use of an automated external defibrillator, is highly recommended before taking the online course.

The training course is available on YouTube in both English and Spanish: Opioid Education for Nonclinical Staff and Lay Responders (English) and Educación sobre opiáceos para personal no médico y rescatadores legos

What is EmPOWERED to Serve? 

The American Heart Association’s EmPOWERED to Serve platform harnesses the passion of individuals and organizations to overcome barriers to health equity, create positive changes in health behaviors, and provide access to healthcare to improve cardiovascular health and overall well-being.  The program emphasizes collaboration, education, advocacy, and innovative solutions to promote health equity and reduce disparities in heart disease and stroke outcomes.

EmPOWERED to Serve accelerates innovative solutions to eliminate disparities in under-resourced communities caused by social determinants of health, also called structural determinants. Social determinants may affect your health more than DNA does. Where you live, work, play, and worship – factors called social determinants of health – can affect the quality and length of your life. Social determinants of health are influenced by how money, power, and resources are distributed at local, national, and global levels. Under-resourced communities often face higher risks for heart disease, stroke, and other major health problems because of social determinants such as limited access to affordable and safe housing, healthy food, and quality health care. These factors also impact the economic stability of a community.

EmPOWERED to Serve partners with social entrepreneurs and local leaders who understand the unique challenges in their communities, working together to change societal factors. Galvanizing resources and volunteers, the initiative creates and implements sustainable solutions to:

• Increase affordable housing options

• Provide fair wages

• Improve school systems

• Develop safe streets

• Provide access to healthy foods

The formation of strategic alliances with like-minded national organizations is the key to the initiative’s success. These strategic alliances with partner organizations are a far-reaching network of multicultural communities that helps more than 45 million people live longer and healthier.

Partnership Organizations are:

African Methodist Episcopal Church

Alpha Kappa Alpha Sorority, Incorporated

American Council on Exercise

The Balm In Gilead, Inc.

Delta Sigma Theta

FamilyWize

The Links, Incorporated

National Association of Hispanic Nurses

National Charity League, Inc.

Sigma Gamma Rho

Student National Pharmaceutical Association

The partner organizations make an impact by:

• Participating in AHA/ASA programs

• Engaging in advocacy efforts

• Driving community environment improvement

• Leveraging influence

Through creative and innovative action in advocacy, policy, education, and social change models, these community Ambassadors are the heartbeat of the EmPOWERED to Serve mission.

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, HeartSaver CPR/AED, First Aid, and Instructor Courses. Please browse our catalog of courses.

Blended Learning Works

Very few folks look back at 2020 and think positively about the myriad of changes the world experienced, EXCEPT when it comes to the idea that doing everything in person is necessary. The time we spend shuttling ourselves and loved ones from place to place can absorb a significant part of any day. Sure there are things we prefer and enjoy doing in person, but fitting in those continuing education (CE) credits at a half-day or all-day class might not be one of them. Indeed, the material may be well known and understood by you, so why sit through hours-long classes listening to the instructor cover this material? Thank goodness for blended learning where from the comfort of your own home, or whatever location you choose, you can complete the coursework online and only have to show up for the in-person skills session. 

While a blended learning approach is convenient, the little devil’s advocate sitting on your shoulder may be snidely asking if blended learning works. Our emphatic answer is YES, and we have a study to back that up. A systematic review of randomized control trials was conducted and published in Science Direct in November 2023. The review examined the effectiveness of the BLS blended learning module on knowledge and skills of Basic Life Support (BLS) compared to the traditional in-person module.

There a number of approaches to teaching a BLS course. The first method is traditional face-to-face instruction. Another option is the blended approach, which is separated into two sections: a face-to-face component and an online section. The traditional approach, also known as offline, is designed to provide in-person instruction for students seeking a BLS certificate. The goal of blended learning (BL), which combines offline and online instruction, is to provide online sessions before bringing a candidate in for in-person instruction and training.

Although the findings of the review suggest that BL is as effective in teaching BLS as a traditional face-to-face method for educational outcomes, some aspects are better in the BL. These aspects include but are not limited to knowledge, skills acquisition, and cost saving. Referencing a separate 2021 review to understand the effectiveness of BL in BLS training among nursing students revealed BL is superior to face-to-face BLS learning in terms of knowledge, attitude, skills, self-efficacy, problem-solving abilities, and willingness to perform resuscitation. Additionally, the beneficial effect of BL also extends to lowering the cost of such courses and reducing the expense on candidates, providers, and suppliers of BLS.

Finally, the challenges of emergency crises such as the COVID-19 pandemic, which restricted face-to-face meetings in all life events, emphasize the need for another educational module. Blended learning or distance learning (DL) has provided an excellent result in dealing with trauma patients and as an alternative to traditional approaches in this pandemic.

Now that you can effectively silence your devil’s advocate about the BL approach, we hope you will take advantage of ACLS Academy’s curriculum and expert instructors to complete your CE and achieve your career goals in the best way for you!  

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online component to minimize in-class time. The following courses at ACLS Academy offer the option to complete the coursework in a BL format:

Heartsaver CPR/AED or CPR/AED/First Aid or Pediatric CPR/AED/First Aid

Stop the Bleed

Heartcode BLS

Heartcode ACLS

Heartcode PALS

Neonatal Resuscitation Program (NRP)

Trauma Nursing Core Course (TNCC)

Emergency Nursing Pediatric Course (ENPC)

Each class has an online module with links to additional information that you are provided before the course date to let you learn at your own pace, apply what you know, and receive immediate feedback.  Plus, you can refer back to the information at any time. The modules are a complete case study process — taking you through an entire sequence of care, followed by the in-person skills session to develop your proficiency in the procedure.  

Sign up here for ACLS Academy's courses, or contact us for questions or additional information.

A New Ground-Breaking Way to Treat High Blood Pressure

If you are one of the 122 million people battling high blood pressure, that is nearly half of Americans ages 20 years and up, there are some interesting new developments about potential treatments for hypertension. In November 2023, the FDA granted two medical device companies premarket approval (PMA) for a renal denervation system for treating hypertension. Hypertension increases the chances of heart disease and stroke and now new revolutionary treatments are available that can reduce that risk. 

Recor’s Paradise Ultrasound RDN was approved in early November with the first commercial procedures conducted at New York-Presbyterian/ Columbia University Irving Medical Center in New York, at the Cleveland Clinic at Smidt Heart Institute at Cedars-Sinai in Los Angeles, and at Gates Vascular Institute in Buffalo, New York. Paradise uRDN treats hypertension by ablating the nerves around the renal arteries, disrupting the overactive sympathetic nerves that can cause hypertension. The system uses a water-filled balloon catheter to deliver two to three doses of 360-degree ultrasound energy, each lasting seven seconds. The system also includes a HydroCooling system that circulates sterile water through the catheter to help protect the renal artery wall.

The second RDN system approved mere weeks later was Medtronic’s Symplicity™ Spyral RDN. Medtronic’s system delivers radiofrequency energy to nerves near the kidneys that can become overactive and contribute to high blood pressure. Dr. Barry Bertolet of Cardiology Associates of North Mississippi was involved in the clinical trials for the Symplicity™ Spyral procedure and was granted early access to the technology to perform the first procedure at North Mississippi Medical Center after FDA approval. The Symplicity Spyral RDN system uses a catheter that has an electrode pattern in a helical arrangement, which allows ablation in all four quadrants either simultaneously or individually. Radiofrequency energy is delivered separately to the main renal artery, accessory arteries, and branch vessels to maximize the achieved denervation. The procedure is currently performed through the patient’s femoral (leg) artery through radial artery access (through the patient’s wrist) it is expected to be an option in the future. The procedure takes less than an hour, and the patient can go home the same day.

With these FDA approvals, the United States begins to catch up with other countries on renal denervation procedures. The European market is already full of contenders in the renal denervation marketplace with device makers that have received approval to sell hypertension devices in Europe, including Medtronic Inc.; St. Jude Medical, Inc.; Covidien Plc; ReCor Medical; and Vessix. Vessix also has won approval to be sold in Australia.

Medtronic and Recor designed their competing systems to ablate overactive nerves between the brain and the kidneys that help regulate blood pressure. Both RDN systems are effective for patients with resistant hypertension and mild to moderate hypertension who can't tolerate enough medication. 

Getting a renal denervation therapy to market is one of the biggest wins that the world of devices has seen in a long time. According to the American Heart Association, about 30 million Americans have resistant hypertension, which is defined as uncontrollable high blood pressure and regulated with at least three different medications. Both RDN systems are intended as an adjunctive treatment option when lifestyle changes and medications have not adequately controlled a patient’s blood pressure.

Most experts agree the two RDN systems probably produce comparable reductions in blood pressure. The data show renal denervation is synergistic with other medications and that it can bring about an effect similar to a good antihypertensive medication taken as prescribed. So far, with follow-up out to about 3 to 5 years, the blood pressure reduction appears durable. 

The renal denervation procedure does not work for everyone, according to Naomi Fisher, MD, Director of hypertension at Brigham and Women's Hospital in Boston, Massachusetts, who has been involved in clinical trials for both companies. In the studies, around two-thirds of patients responded to the treatment. So, not all patients will respond and the studies haven't been able to identify subgroups who respond better than others, but this additional data will be sought in the future. 

Everyone agrees that the renal denervation procedure should not be used in new patients with hypertension who have not engaged in significant lifestyle modification and use of antihypertensive medications. Lifestyle modification and medications should be the first line of attack which will work for many patients. The procedures also have not entered the medical mainstream, therefore the cost of the renal denervation procedure has not yet been established in the United States but is likely to be at least several thousand dollars, much more than available antihypertensive medications, which may be prohibitive to insurers who are unlikely to allow widespread funding.  

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, Heart Saver CPR/AED, First Aid, and Instructor Courses. Browse our catalog of courses.

Heartfelt Intelligence: How AI's Precision Unveils Hidden Cardiac Secrets

It is hard to turn on or read the news without the topic of Artificial Intelligence (AI) cropping up – it seems to be everywhere. Some of the AI news trends to doom and gloom with AI taking over the world, and Hollywood definitely jumping on that bandwagon to stoke the fires. However, AI, and the subfield of deep learning, have real positive and tangible benefits for the healthcare world. AI is already being used in healthcare to improve diagnosis, treatment, and patient outcomes. And now, AI may be able to help detect heart valve disease and predict the risk of cardiovascular events according to two studies presented at the American Heart Association’s Scientific Sessions 2023. 

The American Heart Association’s Scientific Sessions annual meeting is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science. At the 2023 Scientific Sessions held Nov. 11-13, 2023 two preliminary research studies were presented utilizing AI and deep learning models to detect heart valve disease and predict cardiovascular risk.

Real World Evaluation of an Artificial Intelligence Enabled Digital Stethoscope for Detecting Undiagnosed Valvular Heart Disease in Primary Care (Abstract 306)

The first study sought to compare the ability of a primary care professional to detect potential heart valve disease using a standard stethoscope versus that of an AI program using sound data taken from a digital stethoscope to do the same. 

AI refers to the broad field of computer science dedicated to creating machines or systems that can perform tasks that typically require human intelligence. AI systems are designed to learn from experience, improve performance, and adapt to new situations without being explicitly programmed. The tasks performed by AI may include problem-solving, learning, understanding natural language, speech recognition, and decision-making. The ultimate goal of AI is to create machines that can simulate human intelligence, including reasoning, problem-solving, and creativity.

The study comprised of 369 adults without a prior diagnosis of heart valve disease or a history of heart murmurs who received primary care at clinics in Queens, New York, and Lawrence and Haverhill, Massachusetts. Heart valve disease is a common condition that affects millions of people worldwide. It can lead to serious complications, including heart failure, stroke, and even death.

The analysis found:                                                

• The AI method with the digital stethoscope detected 94.1% of cases of valvular heart disease compared to the standard stethoscope used by primary care professionals, which detected only 41.2% of cases.

• The AI method identified 22 people with previously undiagnosed moderate-or-greater heart valve disease, and the professionals using the standard stethoscopes identified 8 previously undiagnosed people with heart valve disease.

Deep Learning-Based Retinal Imaging for Predicting Cardiovascular Disease Events in Prediabetic and Diabetic Patients: A Study Using the UK Biobank (Abstract Poster Mo3070)

The second study utilized a deep learning model in determining patients’ risk of cardiovascular disease events by evaluating eye images of people with prediabetes and Type 2 diabetes.

Deep learning is a specific subfield within machine learning that involves the use of neural networks with multiple layers (deep neural networks) to model and solve complex problems. These networks are inspired by the structure and function of the human brain. Deep learning models can identify complex patterns in data such as text, pictures, and sounds to produce predictions and insights.

Using data from the UK Biobank, a second study by another research group evaluated the effectiveness of using pictures of the retina at the back of the eye that were analyzed by a deep-learning algorithm tool to predict the risk of cardiovascular disease events. The researchers defined cardiovascular disease events as heart attack, ischemic stroke, transient ischemic attack, or death due to heart attack or stroke.

The research team provided the deep learning tool with retinal images of 1,101 people with prediabetes or Type 2 diabetes and asked the model to categorize each individual into low-risk, moderate-risk, and high-risk groups based on likelihood of cardiovascular disease. Subsequently, the participants were tracked for approximately 11 years for the number of cardiovascular disease events they experienced. 

The analysis found:

• 8.2% of participants in the low-risk group, 15.2% of participants in the moderate-risk group and 18.5% of participants in the high-risk group had experienced cardiovascular disease events by the end of the study period of 11 years.

• After accounting for demographic and other potential CVD risk factors, such as age, gender, high blood pressure medication use, cholesterol medication use and smoking history, people in the moderate-risk group were 57% more likely to experience a cardiovascular event compared to people in the low-risk group; and people with high-risk scores were 88% more likely to experience a cardiovascular event compared to those in the low-risk group.

Study lead author Chan Joo Lee, M.D., Ph.D., an associate professor at Yonsei University in Seoul, Korea, concluded “These results show the potential of using AI analysis of retinal imaging as an early detection tool for heart disease in high-risk groups such as people who have prediabetes and Type 2 diabetes.”

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, Heart Saver CPR/AED, First Aid, and Instructor Courses. Browse our catalogue of courses.

Heart Health Risks Rise with Menopause

February is American Heart Month and the first Friday of February is Go Red for Women Day to raise awareness of women’s cardiovascular health risks. Since 2004, the American Heart Association’s signature women's initiative, Go Red for Women, has addressed the awareness and clinical care gaps of women’s greatest health threat, cardiovascular disease (CVD). As America ages, a significant portion of this message is targeted at women entering their late 40s and early 50s who are experiencing menopause and don’t realize their CVD risks are automatically rising with this life transition.  

Cardiovascular disease claims more women’s lives than all forms of cancer combined. According to a 2022 American Heart Association Presidential Advisory, investing in and improving research, awareness, and equity in women’s heart health are critical for the health and well-being of women. Women, who typically develop CVD several years later than men, are largely unaware of their risk for heart disease. 

Menopause is a normal part of aging that occurs when a woman's menstrual periods stop. It's usually a natural change that happens between the ages of 45 and 55. Menopause occurs when the ovaries stop releasing eggs for fertilization. In a woman’s 40s, menstrual periods begin to change and may become longer or shorter, heavier or lighter, and more or less frequent. On average, by age 51, the ovaries stop releasing eggs, and a woman has no more periods. While menopause itself is not a direct cause of heart problems, the hormonal changes associated with menopause can have various impacts on heart health.

• Changes in Cholesterol Levels: Throughout the period before, during, and after menopause, also known as the menopause transition, midlife women are at a heightened risk for cardiovascular disease with changes in their lipid levels, such as a sharp increase in LDL-C or “bad” cholesterol. A study published in the Journal of Clinical Lipidology identified a link between a lesser-known hormone called anti-Müllerian hormone (AMH) and lipid, or cholesterol, levels in midlife women. Through this study, it was found that, while a high estrogen level was important for lowering LDL-C or bad cholesterol levels, high AMH was responsible for lowering HDL-C or good cholesterol. This means that as women traverse the menopause transition, they lose estrogen and AMH, increasing both their bad and good cholesterol levels. 

• Increased Risk of Heart Disease: After menopause, the risk of heart disease tends to increase. Estrogen, a hormone that decreases during menopause, is believed to have a protective effect on the cardiovascular system, as it has an anti-inflammatory effect on the lining of the blood vessels and increases the levels of chemicals that protect your heart and the blood vessels. The decline in estrogen levels may contribute to an elevated risk of heart disease.

• Changes in Blood Vessels: Hormonal changes during menopause can affect the flexibility and function of blood vessels as arteries get thicker and stiffer and become more vulnerable to disease. This can lead to an increase in blood pressure and contribute to cardiovascular issues.

• Weight Gain: Many women experience weight gain during and after menopause, along with changes in body composition, particularly an increase in abdominal fat. Excess abdominal fat is part of a cluster of symptoms that become more common after menopause, known as metabolic syndrome. It is when a person has at least three of the following: abdominal obesity; high triglycerides; low "good" HDL cholesterol; high blood pressure or high blood sugar all of which contribute to cardiovascular issues.

• Metabolic Changes: Menopause is often accompanied by changes in metabolism. Insulin sensitivity may decrease, increasing the risk of diabetes, which is itself a risk factor for heart disease.

• Effects on Blood Clotting: Estrogen has an influence on blood clotting factors. Reduced estrogen levels during menopause may affect the balance of clotting factors in the blood, potentially increasing the risk of blood clots and related cardiovascular events.

• Increased amount of fat around the heart:  A higher volume of a certain type of fat surrounding the heart is significantly associated with a higher risk of heart disease in women after menopause and women with lower levels of estrogen at midlife, according to research led by the University of Pittsburgh Graduate School of Public Health. The findings revealed a previously unknown, menopause-specific indicator of heart disease risk.

• Problems sleeping: Sleep problems during and after menopause are linked to heart health risks. Consistently getting a good night’s sleep is one of the most beneficial things you can do for the health of your mind and body. And it’s particularly important for your heart, as during normal sleep, your blood pressure goes down. Having sleep problems means your blood pressure stays higher for a longer period of time. 

• Hot flashes and night sweats: The common gripes of hot flashes and night sweats most women going through the menopausal transition phase have been linked to a greater risk for high blood pressure and other cardiovascular risk factors.

It's important to note that individual experiences can vary, and not all women will experience the same impact on heart health during and after menopause. 

Heart-Related Symptoms Experienced During Menopausal Transition Phases

Many women report during perimenopause and menopause that they become particularly aware of their heart beating and that their heart rate can feel irregular or particularly fast. This sensation of the heartbeat being more noticeable or beating irregularly or fast is called ‘palpitations’. Heart palpitations, which can last from a few seconds to a few minutes can coincide with a hot flush or a night sweats, a dizzy spell, or happen on their own.

Palpitations can be due to changing or declining levels of estrogen, which can affect the pathways in your heart through which electrical impulses travel. While they can feel alarming, in most cases they are usually harmless.

Prevention Prior to Menopause

Women would benefit from intensifying cardiovascular prevention efforts in the years leading up to menopause. The lifestyle changes driving prevention efforts are well-known to those who are sensitive to heart health as well as overall general health. They are the usual suspects: not smoking, being physically active, eating a healthy diet, maintaining a healthy weight, getting enough sleep, and keeping cholesterol, blood pressure, and blood glucose levels under control. Doctors typically agree the most impactful preventive advice is increasing physical activity because it can affect multiple heart risks – heart disease, stroke, high blood pressure, Type 2 diabetes, and cancer. Additionally, physical exercise improves bone health, weight control, sleep, and mental health. While it's never too late to add or increase physical activity levels the earlier you do it in life, the greater the health benefits. Also, maintaining good habits is easier than reversing bad ones.

ACLS Academy is an authorized American Heart Associate (AHA) Aligned Training Center. We have three convenient locations in Massachusetts – Quincy, Bridgewater, and Newton Center with most of our classes including an online training component. We provide high-quality courses taught by instructors practicing in the medical profession for ACLS, TNCC, BLS, ENPC, NRP, PALS, Bloodborne Pathogen, Heart Saver CPR/AED, First Aid, and Instructor Courses. Browse our catalog of courses.