# Phtls



## skyemt (Nov 30, 2007)

Hi there...

does anyone have experience with the PHTLS course?

is it worthwhile?

thanks


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## Asclepius (Nov 30, 2007)

skyemt said:


> Hi there...
> the PHTLS course?
> is it worthwhile?


I've had BTLS, which is now called ITLS and PHTLS. I personally find the PHTLS severely lacking. ITLS is much better organized and more in depth than PHTLS, IMO. If you want fast and easy, do PHTLS. If you want to actually learn something, do ITLS.


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## Doctor B (Nov 30, 2007)

Being an instructor for both I don't have a severe bias either way. Both programs provide great information but in different ways. ITLS has done a good job of teaching the acronyms needed to perform a thorough head-to-toe survey in the trauma patient as well as presenting the specific lectures needed to understand the patterns of injuries. PHTLS essentially teaches the same philosophies but utilizes more scenarios to get their points across. The use of the scenarios allows for more interaction between the students and the instructors and can be more thought provoking. I believe that this approach does a better job of educating the adult learner especially in our careers where most of us do better with the "hands on" way of learning. I would also suggest that you talk to others in your area that have gone through the programs and find out what they thought. The issue of ITLS vs. BTLS has been around for a long time but in the end both are quality programs otherwise one would have phased out the other by now. The education you get out of them will also be largely dependent on the caliber of the instructors teaching the classes. If you have the opportunity to take both I would highly encourage it as well. There's no such thing as too much education!


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## SwissEMT (Nov 30, 2007)

The PHTLS course is great at shifting your mindset and improving your approach to trauma management. I'm a HUGE fan of the course and believe that all EMS providers should take it simply because it would help rid our profession of poor trauma management and debunk a lot of the rumors out there. Though I took the ALS version, I think that even at a BLS level this course is extremely helpful at helping reduce the fluff out there. There's a lot of junk medicine being done out there and it's killing patients. Wasting time on scene, the Trendelenburg position, flooding patients with saline till they bleed kool-aid, fearing tourniquets and the like need to stop! We're killing patients and PHTLS is one of those courses I really think makes a difference in patient outcomes (unlike GEMS lol)

oh yeah, did I mention we're killing patients?


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## SwissEMT (Nov 30, 2007)

Asclepius said:


> If you want fast and easy, do PHTLS. If you want to actually learn something, do ITLS.


I have not taken ITLS so I can't comment on it, but I think you're not giving PHTLS enough credit. Did you take both of these with the same instructors/location?


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## Ridryder911 (Dec 1, 2007)

Actually, both use the same criteria. There is little to no difference between the two. The only difference is the sponsorship. Ironically, the publishers of the two books Mosby/Brady publish each others competition. 

PHTLS is sponsored by NAEMT, where as ITLS is sponsored by National EMS Physicians (NEMSP). I have been an instructor for both, and like I described there are just a few minute differences. 

Personally, I disagree that ITLS is better. I personally prefer teaching PHTLS. They allow more skills performance and approaches at multiple levels, they also have a military division. As well, ITLS is not active in all fifty states. 

Again, the main point is to obtain additional information in learning basic trauma care. 


Good luck, 
R/r 911


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## medicdan (Dec 1, 2007)

I learned PHTS just about a month ago as a part of a first responder course in Israel. To be frank, I had a lot of trouble with it, because it contradicted a lot of my trauma management training from the US. Just the idea that the sequence is different killed me. I am a creature of habit, and was just starting to get used to using what was taught in my EMT-B class in the field. 
I admit that PHTLS is easier to teach then then the algorithm in the US-- but  at least the way I was taught it, misses critical parts. When I learned it, I took notes on the differences-- I am going to dig them up (If I have time and can find them), and post some of them.

Just my $.02


DES


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## JJR512 (Dec 3, 2007)

Is either class something that an EMT-B could take and get something out of, or is it strictly for ALS providers?


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## BossyCow (Dec 3, 2007)

You can always get something out of a course!  Some may be over your head but if you are working with ALS agencies, becoming more familiar with what they do can be enlightening. At conferences, I tend to take more ALS courses than BLS because the information is more in depth.  I try not to ask too many bone-head questions out loud in the class but I take copious notes and discuss it with my paramedic hubby afterwards.


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## Alexakat (Dec 3, 2007)

I took it & I'm BLS.  I enjoyed it very much.  It was a bit ALS-oriented, but I usually take whatever I can, whenever I can & try to keep up the best I can.  Many BLS providers were there on Day 1 & didn't come back on Day 2.  I heard them say that it was "too much ALS".  I found that to be a shame as I think we can all learn...

The majority of our calls are medical so I found value in getting into the trauma mindset & brushing up on those skills.

I took PEPP too & found it helpful.


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## Mr. Anderson (Dec 3, 2007)

I agree with most that there is little difference between the two courses. I teach ITLS, and have taken PHTLS. I like the PHTLS book better, but I believe the ITLS course structure is better run. Unless the process has changed, when I took PHTLS one person was the "team leader" for testing, and everyone's results were based off of that person's performance. 

As has already been stated, the point is to learn (or refresh), and possibly leave the class with something you didn't show up with.


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## Ridryder911 (Dec 3, 2007)

It is not that anyone is trying to "hold" anyone back or not to allow anyone from learning. It has been proven in the past, that many BLS providers will assume or take upon themselves to provide ALS care because they took a specific course or class. Of course none of these alphabet courses allows or certifies anyone to provide or perform any special procedures that is not already allowed per license or medical control. 

R/r 911


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## Alexakat (Dec 4, 2007)

The EMT-Bs I spoke of made their own decision to not continue in the class...they weren't told they couldn't continue.  I interpreted (from their comments) that they felt they couldn't get anything out of the course b/c they weren't ALS.  There were ALS steps to verbalize, however, the practical part was basic patient assessment first (although there were parts where we had to verbalize "2 large bore IVs"---no problem---I verbalized it!), backboarding, a little extrication...all skills/practice that would benefit everyone.


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## Guardian (Dec 4, 2007)

The difference is ITLS (BTLS) is owned by a bunch of doctors and PHTLS is owned by NAEMT.  Who do you want to give your money, doctors or EMS advocates?  The classes are about the same and it really matters more who is instructing the course.  I wouldn't even take the stupid course if it weren’t required by the agency where I work.  However, if you have taken neither and are looking to brush up on your skills as a basic, I would highly recommend it.


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## BossyCow (Dec 4, 2007)

Ridryder911 said:


> It is not that anyone is trying to "hold" anyone back or not to allow anyone from learning. It has been proven in the past, that many BLS providers will assume or take upon themselves to provide ALS care because they took a specific course or class. Of course none of these alphabet courses allows or certifies anyone to provide or perform any special procedures that is not already allowed per license or medical control.
> 
> R/r 911



So, you are saying that in your experience, EMS providers are working above their scope of practice, outside of their level of experience and training just because they took a class?  

I take a lot of ALS classes, because I enjoy learning more about what I do, but my practice is dictated by the license under which I operate, and while a class may increase my understanding, it is all relative to the legal aspects of the protocols under which I work.  

Any basic who performed an ALS skill, not under the direction and supervision of an EMT-P in my system would be facing loss of licensure and a complete lower orificial roto-rooter without benefit of anesthesia by the MPD.


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## Ridryder911 (Dec 4, 2007)

BossyCow said:


> So, you are saying that in your experience, EMS providers are working above their scope of practice, outside of their level of experience and training just because they took a class?



One of the reason(s) ACLS is no longer a "certification" course is because of that. Many EMT's at one time assumed that if they took an ACLS course and passed it, it was equivalent to an Paramedic course and they should not have take or expand their education level. 

As well,  many attempt to take short cuts assuming that they will be qualified and educated enough after a week-end courses Not all EMT's are as responsible as you Bossy. I am sure you can attest, if there were a patch or pin associated, most would attend and strain, to be able to obtain. Many want to attend to be able to perform " the neat skills, to save lives" without proper and formal education, neglecting their limitations of their certifications and license. Just read some of the posts on here, where many maybe expanded their scope or protocols to the limit. 

One has to remember why and the main emphasis are in these type of courses. I was on the original BTLS and PHTLS committees in the early 80's when these were established. The main points of both, were to expand trauma care from the curriculum and as well give more hands on for those that did not have the 2-3 years experience. Still remains true. The courses do teach more than is covered in the routine curriculum and gives a hand up on tricks of the trade. 

Also, the main emphasis of each course is to cover and develop an understanding of whatever that sponsoring institution guidelines albeit AHA, NAEMT, EMSP, EIOU, etc.. 

R/r 911


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## JJR512 (Dec 4, 2007)

Hmm... I recently took a GEMS course, an ALS course, and I have to admit that although I am only a Basic, I am using some of what I've learned on my patients.

The communication skills, attitude tips, and scene size-up clues as to the general or baseline condition of the patient.

I, like a few others who have responded here, will take any class they'll let me in so I can have a better understanding of what's going on around me, whether it's something going on with the patient, something an ALS provider is doing, or asking me to do. I function much better when I know why I'm doing something. These classes help me. Of course, there's still a lot I don't understand and won't ever be able to until I'm part of the target audience for the class.

Oh, and for the record, BLS providers are not allowed in ALS courses offered by the state of Maryland if enough ALS providers show up to fill the class. BLS providers are only allowed to take these classes if there are empty seats. This way, no ALS providers are denied the chance to learn something that's more for them. The ALS classes are rarely ever full, though. That's either a good thing (if you're a BLS provider wanting to learn whatever you can, even if some of it you won't understand and most of it you can't use) or a bad thing (if it says something to you about the willingness of people to expand their knowledge).


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## Ridryder911 (Dec 4, 2007)

That is similar to physician level ATLS courses. One cannot actually become certified even if they pass all the stations and written test, unless they are a physician...period. One can acclaim they audited it, if they have successfully attended or passed it. 

R/r 911


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