Murphy's Laws of ACLS FIRST LAW OF ACLS 1. An arrest will not occur until the ACLS provider begins to eat. COROLLARY 1. Few arrest would occur if ACLS providers would not eat. COROLLARY 2. ;Always order food to GO. ACLS LAWS OF TIME AND DISTANCE 1. The probability that a patient will arrest increases proportionally with the distance of the crash cart from that's patients room. 2. The severity of acidosis in the arrested victim increases directly with the resistance met when injecting an amp of sodium bicarbonate. 3. The probability of an arrest occuring increases proportionally to the time elaspsed since the ACLS provider last went to the bathroom. 4. The probability that an arrest will occur increases as the time to get off work decreases. ACLS GROSS DYSRHYTHMIA RULE 1. If a gross dysrhythmia occurs which is sickening to the provider, the monitor should be discontinued at once. ACLS RULES FOR THE ROAD 1. If you stop along the road to assist in a disaster after midight and do not see a drunk, KEEP looking, someone is still missing. 2. Assume that any physician found at the scene of an arrest is a podiatrist until proven otherwise. COROLLARY 1; never turn your back on a proctologist. 3. A life or death situation will be created by jogging away from a person complaing of chest pain that you just advised to make an appointment with his private physician. The seriousness of the circumstanc will increase as tshe date of your trial approaches. By the time your ex-patient reaches the witness stand; the jury will be amazed how a person with such serious cardiac problems could have ever run past you on the track field. COROLLARY 1: Transport all you talk to. ACLS RULES OF RESPIRATORY ARREST 1. All persons on whom mouth to mouth resuscitation is performed will have just completed a meal of barbeque and onions which was washed down with beer. COROLLARY 1: Never remove an EOA without suction, intubation equipment,and lysol COROLLARY 2: Never insert an ET tube without a wet- suit and goggles. 2. The length of all oxygen tubing will decrease in an arrest situation, especially if an ambu bag is used. ACLS RULES OF EQUIPMENT 1.Any life saving equipment will not malfunction unless: a. you need it to save a life. b. the saleman leaves c. the service contract expires. ACLS RULES OF COORDINATION 1. Eye to hand coordination diminishes as the provider attempts to inject epinephrine or NaHCo3 into an injection port of an IV tubing during an arrest. 2. Eye to hand coordination and provider panic threshold will decrease as the accessability of peripheral veins decreases. ACLS LAWS OF MEDICATIONS 1. Any medicationwill always be ordered in the least usable unit of measure. Dopamine, for example will be ordered in grains per microgram per kilogram per square inch per millisecond. COROLLARY 1: In a given drug calculation, any error that can creep in will do so. COROLLARY 2: Any error in calculation will be in the direction of the most harm. 2. The probability of all allogorhythms is 50% either it will work or it won't. ACLS LAWS OF NATURE 1. Under the most rigorously controlled conditions of cardiac index, pulse rate, stroke index, left ventricular stroke volume, right ventricular stroke volume, total peripheral resistance, pulmonary vascular resistance, oxygen consumption, cardiac rhythm, and other variables, the heart will do as it damn well PLEASES. 2. 10% of the male population over 50 will suffer acute myocardial infarction (AMI), the other 90% will suffer an ugly one (UMI).