Emergency Room CPR Ability

I am writing in response to a letter from Richard C. Creighton (Jan. 31), “CPR Ability.” Creighton states that he is a firefighter, an American Heart Assn. ACLS (advanced cardiac life support) instructor, and that neither he nor his firefighter associates have seen adequate CPR performed by Emergency Department personnel. Creighton takes issue with the new state Board of Medical Quality Assurance ruling that physicians do not need to be certified in CPR to be licensed in this state.

If Creighton is, as he states, as AHA ACLS instructor, he has only himself and other instructors (of which I am one) to blame for the failure of Emergency Department personnel to perform. In this county in any paramedic receiving center Emergency Department there is a mandated requirement by the Emergency Medical Services Agency (EMSA) that there must be on duty at all times at least one physician and one registered nurse who are certified in ACLS. Practically speaking, in the interests of responsible scheduling, this means that all physicians and all registered nurses working in Emergency Departments are ACLS certified.

Furthermore, the Joint Commission on Accreditation of Hospital (JCAH), the voluntary certifying and accrediting body for hospitals, requires that all Emergency Department personnel (even secretaries) be certified in basic cardiac life support (BCLS). Therefore, at least in Orange County, patients arriving in any paramedic receiving center Emergency Department should receive the finest cardiac and respiratory resuscitative measures available, as best as we know now. I feel that Creighton does a disservice to this community to allege otherwise.

As for physicians being required to have BCLS certification--CPR, basic CPR, is a life skill like driving a car. CPR is a manual skill that is easily taught to almost anyone, even younger children, and should be something that every human should want to know, for his or her own peace of mind. Practically speaking, in an cardiac-arrest situation, few physicians participate in the actual CPR physical activity because their education mandates that they have other responsibilities at that time. Personally, I hope that all physicians in California care enough to learn CPR, if only to save their own loved ones should a situation occur. Mandating the requirement seems unnecessary.

KATE REEVES RN

Orange

Reeves is administrative director of the Emergency Department at St. Joseph Hospital.