# EMT-B With ACLS



## Jacedc (Jun 13, 2012)

Do any emt-b have ACLS or PALS certfications ?


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## Veneficus (Jun 13, 2012)

Jacedc said:


> Do any emt-b have ACLS or PALS certfications ?



no, they should not.


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## JPINFV (Jun 13, 2012)

Veneficus said:


> no, they should not.




Well, I'm sure they're out there. It doesn't add much though.


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## Veneficus (Jun 13, 2012)

JPINFV said:


> Well, I'm sure they're out there. It doesn't add much though.



If they are, their instructor may find themselves sanctioned and while they may have a card, it will likely be invalidated by any reputable establishment.


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## JPINFV (Jun 13, 2012)

Is there anything that limits who can take ACLS?


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## Veneficus (Jun 13, 2012)

JPINFV said:


> Is there anything that limits who can take ACLS?



Yes,

Who can be certified is outlined in both the instructor manual of the respective discipline and by AHA policy which all instructors agree to abide by the terms of. 

It was determined several years ago(easily 10 maybe more) that Basic EMTs do not possess the scope of practice, knowledge base, or skill set to demonstrate competency as being capable to perform ACLS or PALS interventions. 

They are permitted to audit the class, they are not permitted to be certified.


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## Cawolf86 (Jun 13, 2012)

From http://www.heart.org/HEARTORG/CPRAn...fe-Support---Classroom_UCM_306643_Article.jsp

"ACLS is designed for healthcare professionals who either direct or participate in the management of cardiopulmonary arrest and other cardiovascular emergencies. This includes personnel in emergency response, emergency medicine, intensive care and critical care units."

Sorry the prior reply was not there when I typed this. I was just looking on the website. Makes sense what Ven said.


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## JPINFV (Jun 13, 2012)

Veneficus said:


> It was determined several years ago(easily 10 maybe more) that Basic EMTs do not possess the scope of practice, knowledge base, or skill set to demonstrate competency as being capable to perform ACLS or PALS interventions.
> 
> They are permitted to audit the class, they are not permitted to be certified.



The funny thing is that ACLS certification does not lead to a knowledge base or skill set to be able to demonstrate competency in ACLS.


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## Veneficus (Jun 13, 2012)

JPINFV said:


> The funny thing is that ACLS certification does not lead to a knowledge base or skill set to be able to demonstrate competency in ACLS.



I agree with this. 

I actually had to get permission from AHA HQ once for an exercise physiologist who was tasked with performing stress tests for an institution. 

Since her title was not listed as authorized, I had to demonstrate it was in her official duty and scope to perform the various skills.

It was a major pain, she aced both the written and practical and is now an instructor.


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## MMiz (Jun 13, 2012)

I'm confused, I know of ACLS courses for EMT-Basic providers that is actually quite popular.  One is provided by a local community college and I know that an EMS convention also provides a multiple day course.  There is even a book on the subject.

Unlike many of the opinions in this thread, I see nothing wrong with an EMT-Basic taking the ACLS course.  Quite contrary, I think that an EMT-Basic may even have more knowledge than those taking the course.  I'm surprised at the lack of knowledge by practicing healthcare providers at my AHA Healthcare Provider courses, I would imagine it's very similar for ACLS.


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## feldy (Jun 13, 2012)

Im an EMT and have taken PALS/PEPP since they were both offered in the same sitting...and just got CEUs for them.


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## Bullets (Jun 13, 2012)

feldy said:


> Im an EMT and have taken PALS/PEPP since they were both offered in the same sitting...and just got CEUs for them.



This, took PEPP/PHTLS and ACLS at a convention, just got CEUs though, no card


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## JakeEMTP (Jun 13, 2012)

Veneficus said:


> I actually had to get permission from AHA HQ once for an exercise physiologist who was tasked with performing stress tests for an institution.
> 
> Since her title was not listed as authorized, I had to demonstrate it was in her official duty and scope to perform the various skills.
> 
> It was a major pain, she aced both the written and practical and is now an instructor.



I believe you have been gravely misinformed about the AHA ACLS course. 

There should have been no problem with an Exercise Physiologist taking the course. They have been in ACLS classes for at least the past 20 some years that I can remember with no issues. Their knowledge in this area is very impressive especially since cardiac testing of various types is their thing. Exercise Physiologists are required to have ACLS in most any clinical situation especially in the hospitals. It is also taught as part of their Masters program and they are expected to have it before they get their degree.

There is nothing stopping anyone from taking an ACLS course except for limited seats. Some places can limit the seats to their own employees or those in certain professions.

There are also ACLS courses specifically designed for EMT-Bs through various agencies and for those who have an advanced understanding of the course or Experienced Provider through the AHA.


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## JPINFV (Jun 13, 2012)

MMiz said:


> I'm confused, I know of ACLS courses for EMT-Basic providers that is actually quite popular.  One is provided by a local community college and I know that an EMS convention also provides a multiple day course.  There is even a book on the subject.



There's a difference between what is essentially a "paramedic assistant" CE book and ACLS. ACLS for the EMT-B is using the term "ACLS" more in the sense of "BLS = EMT, ACLS = Paramedics."


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## bstone (Jun 13, 2012)

Veneficus said:


> If they are, their instructor may find themselves sanctioned and while they may have a card, it will likely be invalidated by any reputable establishment.



Really? A few years ago I had a partner who was both an EMT-B and ACLS Instructor.


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## zmedic (Jun 13, 2012)

When I was an EMT I was allowed to audit the ACLS class. Because I wasn't a medic I couldn't get a card but I was able to sit in on all the classes, participate in all the scenarios. I found it useful since I worked on an ALS rig with a medic, and was able to start IVs (in Colorado). So it was nice to know the flow of an arrest, to be able to look at the monitor and anticipate what meds the medic would want. Good prep for med school too. I think they cut me a deal on the tuition since I couldn't be certified. 

Nothing wrong with more education, and even if not getting the cert should should be able to claim ACLS/PALS/PHTLS etc for CE credit.


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## bstone (Jun 13, 2012)

Saying that an EMT-B cannot take ACLS (and that those doing the instruction risk professional censure) is like saying a an undergraduate student cannot take a graduate level course because they do not yet have an undergraduate degree. This is absurd. I took two 600 level classes when I was in college. Should my dean have faced professional censure?


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## mct601 (Jun 13, 2012)

bstone said:


> Saying that an EMT-B cannot take ACLS (and that those doing the instruction risk professional censure) is like saying a an undergraduate student cannot take a graduate level course because they do not yet have an undergraduate degree. This is absurd. I took two 600 level classes when I was in college. Should my dean have faced professional censure?



I agree with this.


And all I shall say on this subject is 'paramedic students'.


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## EpiEMS (Jun 13, 2012)

Granted, I'm neither a paramedic student, nor will I likely ever become a medic (I may do an AEMT cert), but I'd like to audit ACLS so I can work better to anticipate the ALS provider's needs and understand why they're doing what they're doing. I can't help but feel that it'll make me more confident and more useful.


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## mct601 (Jun 13, 2012)

EpiEMS said:


> Granted, I'm neither a paramedic student, nor will I likely ever become a medic (I may do an AEMT cert), but I'd like to audit ACLS so I can work better to anticipate the ALS provider's needs and understand why they're doing what they're doing. I can't help but feel that it'll make me more confident and more useful.



If you're interested in sitting in an ACLS class, there's absolutely no reason you shouldn't be able to attend one. Call the local places who do classes and ask. At my agency I can do it for CEUs, I just can't certify in it. I can sit in on any ALS class for CEUs including refreshers. I've sat in on my fair share of them to get my CEUs (then when into paramedic school. I'm surprised NREMT didn't refuse my letter when I listed the amount of CEUs I had haha). 

ACLS is a very good class, if local classes will allow BLS providers to sit in for CEUs I think its a good idea to get an idea of what's going on during a cardiac arrest. But thats just me.


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## Anjel (Jun 13, 2012)

We take ACLS and PALS I. Medic school. And get certified before we test for registry. 

Maybe there its some loop hole.


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## EpiEMS (Jun 13, 2012)

mct601 said:


> ACLS is a very good class, if local classes will allow BLS providers to sit in for CEUs I think its a good idea to get an idea of what's going on during a cardiac arrest. But thats just me.



I'd very much like to take it. Beyond the CEUs, as you say, it'd help me understand what's going on during an arrest.


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## mct601 (Jun 13, 2012)

Anjel1030 said:


> We take ACLS and PALS I. Medic school. And get certified before we test for registry.
> 
> Maybe there its some loop hole.




I don't think we will have PALS available to us, but they want us to have ACLS before we ever start hitting 'charge' on the monitor for our pts in the field. Now, not sure if they just WANT it, or REQUIRE it. because I'm not sure if the entire class is certified.



EpiEMS said:


> I'd very much like to take it. Beyond the CEUs, as you say, it'd help me understand what's going on during an arrest.



Unless you have a good foundation in cardiology, you won't understand the pathology behind the lethal rhythms, treatments, etc to your full potential. But you will see the X's and O's of how it should happen, why, and when. Of course it covers other stuff, but thats probably what you'll benefit from most.


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## Veneficus (Jun 14, 2012)

JakeEMTP said:


> I believe you have been gravely misinformed about the AHA ACLS course.



I don't think it is so much a grave misinformation as it is a strict interpretation of the rules. (Which because of instructors doing their own thing are becomming more strict over time in order to maintain conformity)

I still know of instructors feeling they can do their own thing better and do not use the video, and it has not been unheard of for their classes to get invalidated. 



JakeEMTP said:


> There should have been no problem with an Exercise Physiologist taking the course. They have been in ACLS classes for at least the past 20 some years that I can remember with no issues. Their knowledge in this area is very impressive especially since cardiac testing of various types is their thing. Exercise Physiologists are required to have ACLS in most any clinical situation especially in the hospitals. It is also taught as part of their Masters program and they are expected to have it before they get their degree..



I am not saying they shouldn't be able to take it. 

What I said is it was the first time I encountered it and I had to make a few calls and fill out some extra paperwork to make sure there were no problems down the line. Doing extra work is a pain in the ***.



JakeEMTP said:


> There is nothing stopping anyone from taking an ACLS course except for limited seats. Some places can limit the seats to their own employees or those in certain professions.



Nobody disputes anyone can sit in the class, but getting a card is an entirely different matter. 

The card represents (some people get crazy of certified, but it is a semantic) that the participant can perform all the roles on the team, including that of the team leader.



JakeEMTP said:


> There are also ACLS courses specifically designed for EMT-Bs through various agencies and for those who have an advanced understanding of the course or Experienced Provider through the AHA.



By various agencies, could you provide me a list of them, I would like to see?

The EP class is an official AHA class, with specific requirements as well.


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## Doczilla (Jun 14, 2012)

I got my ACLS and PALS before I went to medic school. Then again, it was provided by an army hospital, and we all know the army isn't particularly choosy with stuff like that. Got my cards the next week, then took the instructor courses the next cycle. 

If you understand physio, you will understand both. Physio is the foundation for all learning; at least for me it is.


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## JakeEMTP (Jun 14, 2012)

Veneficus said:


> I don't think it is so much a grave misinformation as it is a strict interpretation of the rules. (Which because of instructors doing their own thing are becomming more strict over time in order to maintain conformity)
> 
> I still know of instructors feeling they can do their own thing better and do not use the video, and it has not been unheard of for their classes to get invalidated.
> 
> ...



Exercise Physiologists are considered health care professionals.
Here is a link to job listings in which ACLS is a requirement for them.
http://www.indeed.com/q-Exercise-Physiologist-jobs.html

A link was provided earlier to show who can take ACLS.
""ACLS is designed for healthcare professionals who either direct or participate in the management of cardiopulmonary arrest and other cardiovascular emergencies. This includes personnel in emergency response, emergency medicine, intensive care and critical care units."


Yes, as an instructor you can probably decide what can or can not take ACLS but that is clearly not the intent of the AHA to discriminate against those who may need it for their job. 

But, most will issue a card and the continuing ed certificate. If someone paid for the class you can not deny them proof of attending so they can earn the continuing ed.  Even if you specifically don't list their profession it doesn't mean the class is not eligible for them to receive the credits.




Veneficus said:


> By various agencies, could you provide me a list of them, I would like to see?
> 
> The EP class is an official AHA class, with specific requirements as well.



This has already been covered.

MMIz posted a link for the text book used for classes which is called ACLS for EMT-Bs.   Anyone who teaches continuing ed courses or classes for EMTs can use the book.  

I already said the EP is offered by the AHA.

Here is the link for it.

http://www.heart.org/HEARTORG/CPRAn...xperienced-Provider-EP_UCM_306644_Article.jsp

Under the audience tab you will see it says 
  Healthcare professionals
• Clinicians 
• Scientists 
• Others who frequently respond to emergency cardiovascular and special resuscitation situations in their work environment


ACLS is not a license and it does not give permission to perform any of the skills. Your instructor should have covered that and if you were an instructor you should have made that clear and pointed it out in the text.  It doesn't even go over the skills step by step to properly teach intubation or IV insertion. It is just an overview of the guidelines to advanced cardiac life support.  People taking the course will usually know what they can or can not do.  People take continuing education and college courses all the time in subjects that interest them but may not have a need for them in their professional job.

I think the AHA website is pretty clear and I have not seen the type of discrimination you have or have done when it comes to someone taking an ACLS class. 

Doing a search here there is an instructor RidRyder who explains ACLS and the EMT-B stuff. That was in 2008 so this is nothing new.

http://www.emtlife.com/showthread.php?t=6302


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## Veneficus (Jun 14, 2012)

JakeEMTP said:


> ACLS is not a license and it does not give permission to perform any of the skills. Your instructor should have covered that and if you were an instructor you should have made that clear and pointed it out in the text.  It doesn't even go over the skills step by step to properly teach intubation or IV insertion. It is just an overview of the guidelines to advanced cardiac life support.  People taking the course will usually know what they can or can not do.  People take continuing education and college courses all the time in subjects that interest them but may not have a need for them in their professional job.



Thanks for the insight. 

But arguing certification of ACLS is like arguing licensure vs certification for EMS persons. 

The practicality of it makes it pointless. 

I don't dispute anyone can take the class and recieve something saying they attended. 

I sent an email this afternoon to the AHA to make sure it is not just a local training center rule, but I am very sure there is a restriction on who can get a card.


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## Veneficus (Jun 14, 2012)

*update*

As for EMT Basics taking ACLS page 44 of the ACLS instructor manual states "the AHA has developed the ACLS provider Course for currently active healthcare providers (eg. medical , nursing, emergency medical or allied health personnel ), whose daily occupation or volunteer activities demand proficiency in the knowledge and skills of ACLS., WHO CAN TAKE THE COURSE- Any currently active healthcare provider can take the course.In addition the course director has the discretion to allow other professionals who are deeply involved in the field of resuscitation (eg. scientist, educators, researchers, and manufacturers of medical devices) to attend the ACLS Provider Course. * WHO CAN RECEIVE A COURSE COMPLETION CARD Only active healthcare providers whose training and scope of practice include a knowledge base encompassing the foundations of ACLS knowledge and skills may enroll in the ACLS provider course and receive and ACLS course completion card."*


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## VFlutter (Jun 14, 2012)

Veneficus said:


> As for EMT Basics taking ACLS page 44 of the ACLS instructor manual states "the AHA has developed the ACLS provider Course for currently active healthcare providers (eg. medical , nursing, emergency medical or allied health personnel ), whose daily occupation or volunteer activities demand proficiency in the knowledge and skills of ACLS., WHO CAN TAKE THE COURSE- Any currently active healthcare provider can take the course.In addition the course director has the discretion to allow other professionals who are deeply involved in the field of resuscitation (eg. scientist, educators, researchers, and manufacturers of medical devices) to attend the ACLS Provider Course. * WHO CAN RECEIVE A COURSE COMPLETION CARD Only active healthcare providers whose training and scope of practice include a knowledge base encompassing the foundations of ACLS knowledge and skills may enroll in the ACLS provider course and receive and ACLS course completion card."*



I am in my last year of nursing school (graduate in 6 months), so if I took the class now I would not be able to receive a course completion card?  I was thinking about taking ACLS before applying for jobs. A lot of floors do not require ACLS so I think it would be good to have compared to other new grads. Plus I have been working cardiac step down for a year so I know all the code algorithms already


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## Veneficus (Jun 14, 2012)

*Furhter clarified from national*

EMT-B instructor, absolutely not.

The guidline was left ambiguous for EMT-Bs taking the course and receiving a card because of the variation in EMT-B scope. 

However, the answer I got was further qualified that it was unlikely any place allows EMT-Bs to perform the peri-arrest electrical or pharmaceutical therapies and therefore would not be able to perform the skills outside of the arrest scenarios and to issue them a card would not accuratley reflect the intent of the rule.


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## JakeEMTP (Jun 14, 2012)

Veneficus
Regardless of your email to me that you are the Senior Head of the American Heart Association, you contradict what the AHA states. 

The AHA says that the certification of completion does not give you an expanded scope of practice or a license to be anything other than what your are. 

Student Paramedics and nurses who still do not have a license take the course before graduation as do many others. They receive a cert of completion.  It is a requirement for their course.

http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_429832.pdf

You can take ACLS even if you don't intubate, start IVs or push meds if you actively participate in code situations or need the CEs and can meet the prerequisites.  Getting an ACLS card is how many qualify for a position. It doesn't mean they are doing the skills right now.


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## Veneficus (Jun 14, 2012)

_Veneficus
Regardless of your email to me that you are the Senior Head of the American Heart Association, you contradict what the AHA states._ .[/QUOTE]

*Actually, i didn't say that. I said I was taught by andpersonally know a senior member, it is probably best if you do not misrepresent what I said. 

I also said I was a senior TCF at a very respected center.

misrepresentation does not help an argument.

If you like I can post that PM here, so the readers can judge the accuracy of your statements.

The reason I sent it PM is because I try to give my employers plausable deniability of my opinions if they don't like what I say.

my last two posts we copies of email that I recieved from both  regional and national faculty members regarding this subject.*

_The AHA says that the certification of completion does not give you an expanded scope of practice or a license to be anything other than what your are. _

*I never said that it did. I think you need to reread the statements.*

_Student Paramedics and nurses who still do not have a license take the course before graduation as do many others. They receive a cert of completion.  It is a requirement for their course._

Yes they do. Usually by convention, they are issued cards upon graduation, which are dated as such, with rosters submitted around time of graduation.

_http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_429832.pdf_

*After spending time today actually calling and talking to somebody in Dallas,(an international call on my dime) and in my home state making sure i had the proper information, I am not really interested in your link.*

_You can take ACLS even if you don't intubate, start IVs or push meds if you actively participate in code situations or need the CEs and can meet the prerequisites.  Getting an ACLS card is how many qualify for a position. It doesn't mean they are doing the skills right now._

*Your opinion does not seem to equate to the information I have received this afternoon.*

*If you are willing to provide me with the name and location of a training center doing something in contra to the statements posted above, I will be more than happy to have it looked into ASAP.*


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## Veneficus (Jun 14, 2012)

*copy of the PM I sent.*

AHA 

--------------------------------------------------------------------------------

I have read many if not all of Rid's posts. 

But I would like to kindly point out, that I am an instructor and TCF also, and turned down a regional faculty position because I didn't have time to dedicate to it because of my other pursuits. 

I am also a senior faculty at the AHA training center that the AHA sends other instructors and training centers to in order to see "how it should be done."

The head of the AHA ACLS training was actually my former boss before he accepted that position.

I am rather familiar with the AHA, including its intentions and realities past liability limiting statements.


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## WTEngel (Jun 14, 2012)

Veneficus said:


> EMT-B instructor, absolutely not.
> 
> The guidline was left ambiguous for EMT-Bs taking the course and receiving a card because of the variation in EMT-B scope.
> 
> However, the answer I got was further qualified that it was unlikely any place allows EMT-Bs to perform the peri-arrest electrical or pharmaceutical therapies and therefore would not be able to perform the skills outside of the arrest scenarios and to issue them a card would not accuratley reflect the intent of the rule.



I am also TC Faculty and the quote above pretty much sums everything up. 

Unfortunately TC's that follow the rules are the exception, not the rule...and most instructors give a card to anyone with a pulse and $180.00.

An EMT-B instructor...absolutely astounding!


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## JakeEMTP (Jun 14, 2012)

Then who can take ACLS _according_ to you Veneficus?

I don't care how many titles you want to give yourself or who you think you might know.  All of this info is easy enough to confirm and anyone here who has taken an ACLS class knows that.

I call bogus to most of what you said since nurses who don't intubate, students, Exercise Physiologist, IR Techs, Cath Lab Techs, CVTs and a whole bunch of others take the course everyday. 

It is an ACLS cert. Not a license and nothing more than something that says you sat through a class and met the minimum.  Don't lose any sleep over it if nurses, Exercise Physiologists, EMTs or whatever take the course who you believe are not worth a certificate.  You are making a big deal out of something that is very easy and not much worth the paper it is printed on anymore. It is just a formality to go through for most and money in the AHA pocket.  It is an okay review for some taking it for the first time.  Paramedics should already know this stuff and it just is another way to test them but not much more.


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## JakeEMTP (Jun 14, 2012)

WTEngel said:


> I am also TC Faculty and the quote above pretty much sums everything up.



Is this what you are agreeing with?

_You can take ACLS even if you don't intubate, start IVs or push meds if you actively participate in code situations or need the CEs and can meet the prerequisites. Getting an ACLS card is how many qualify for a position. It doesn't mean they are doing the skills right now._

*Your opinion does not seem to equate to the information I have received this afternoon.* (per vene)

Are you saying you don't teach or give a card to nurses or anyone else who can't intubate or run a code themselves?  

We have never denied a card to a nurse, Exercise Physiologist or anyone who has had a need to get the card for a job if they meet the requirements. That sounds like bull:censored::censored::censored::censored: if you believe only a few like only Paramedics can take the course.


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## Veneficus (Jun 14, 2012)

WTEngel said:


> An EMT-B instructor...absolutely astounding!



in another PM to Bstone, I speculated that the only way I could see this being legit would be a situation similar to what happened to medics with NRP.

At one time a medic could be an NRP instructor, then AAP decided they didn't spend enough time doing it. 

They permit medics who were certified instructors prior to their change to renew their instructor cards, but if they lapse, they cannot get it back. 

If you go to their website on the drop down boxes, "medic" on the instructor page is not even present to select.

I know a couple of medics who were able to submit a petition supported by the medical director of an educational institution and a pediatrician they recruited to certify a medic as an NRP instructor after the policy change, but the medics had to document over 100 extra hours of time in labor and delivery and there was an "educational need" due to no other instructors in the region.


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## Doczilla (Jun 14, 2012)

One of the great things about the army: want ATLS? Knock yourself out! You just have to be willing to pick up trash in the mojabe desert in the middle of August after NTC.


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## WTEngel (Jun 14, 2012)

JakeEMTP said:


> Is this what you are agreeing with?
> 
> _You can take ACLS even if you don't intubate, start IVs or push meds if you actively participate in code situations or need the CEs and can meet the prerequisites. Getting an ACLS card is how many qualify for a position. It doesn't mean they are doing the skills right now._
> 
> ...



The fact of the matter is that in the conventional role of the EMT-B, their scope includes ZERO of the skills involved in ACLS care, other than CPR. While CPR is one of the most important interventions, an EMT-B taking ACLS to learn that is absurd.

A nurse, paramedic, doctor, RT, etc. has a scope of practice that includes at least a portion of skills required to provide ACLS care, such as pushing meds, advanced airway management, ordering meds, planning and executing a course of care, etc.

No need to get all worked up about the issue. It is what it is.


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## Veneficus (Jun 14, 2012)

JakeEMTP said:


> Then who can take ACLS _according_ to you Veneficus?



"As for EMT Basics taking ACLS page 44 of the ACLS instructor manual states "the AHA has developed the ACLS provider Course for currently active healthcare providers (eg. medical , nursing, emergency medical or allied health personnel ), whose daily occupation or volunteer activities demand proficiency in the knowledge and skills of ACLS., WHO CAN TAKE THE COURSE- Any currently active healthcare provider can take the course.In addition the course director has the discretion to allow other professionals who are deeply involved in the field of resuscitation (eg. scientist, educators, researchers, and manufacturers of medical devices) to attend the ACLS Provider Course. WHO CAN RECEIVE A COURSE COMPLETION CARD Only active healthcare providers whose training and scope of practice include a knowledge base encompassing the foundations of ACLS knowledge and skills may enroll in the ACLS provider course and receive and ACLS course completion card." 

As that is the official position as postulated in the instructor manual, that is my position also.



JakeEMTP said:


> I don't care how many titles you want to give yourself or who you think you might know.  All of this info is easy enough to confirm and anyone here who has taken an ACLS class knows that.



I'd be curious to know your titles and what you might know, because while pasisonate, you don't seem overly informed. 



JakeEMTP said:


> I call bogus to most of what you said since nurses who don't intubate, students, Exercise Physiologist, IR Techs, Cath Lab Techs, CVTs and a whole bunch of others take the course everyday..



I would like to point out that intubation is not part of the mandated ACLS requirements, if you watch the video you are supposed to use, not only can you select not to watch it, but it even says it is not suggested inexperienced people try it. 

Furthermore, if you look at the standard testing form, the performace of endotracheal intubation is not on it.

Just because you watch a nonsanctioned practice happen every day, doesn't make it right.

Like I said, let's put it to the test, tell me where it happens and I'll see to it somebody comes to check it out.   



JakeEMTP said:


> It is an ACLS cert. Not a license and nothing more than something that says you sat through a class and met the minimum.  Don't lose any sleep over it if nurses, Exercise Physiologists, EMTs or whatever take the course who you believe are not worth a certificate.  You are making a big deal out of something that is very easy and not much worth the paper it is printed on anymore. It is just a formality to go through for most and money in the AHA pocket.  It is an okay review for some taking it for the first time.  Paramedics should already know this stuff and it just is another way to test them but not much more.



I think you should check out some of my threads on AHA, ACLS, and it's usefulness. (or in my opinion its rather lack of usefulness) but the AHA has mandated that its instructors follow its criteria. It has mandated and sought to enforce the standardization of the class. 

An instructor and as such a representative, has actually signed a piece of paper agreeing to follow its dictates. So if you are not, because of your opinion, local practices, etc. then you are in violation of that agreement and subject to censure.

I appreciate your empassioned defense and even recognize your invalid argument as witnessed by the ad hominem attacks, but I don't think you are going to be able to do anything further to effectively demonstrate your point.


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## DrParasite (Jun 14, 2012)

bstone said:


> Really? A few years ago I had a partner who was both an EMT-B and ACLS Instructor.


Yeah, I took a class (I think it was my PHTLS refresher, I don't remember which one exactly), and the guy sitting next to me was an EMT and ACLS instructor (and no, never was a paramedic or advance provider).  When I asked about it, he said he could test students on all the BLS related stuff, but not the advanced stuff (or so he said, I didn't really ask as class was starting).

I'm still trying to weasel my way into Advanced Burn Life Support.... apparently sleeping with one of head nurses in the program wasn't enough to get squeezed in!!!


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## Tigger (Jun 14, 2012)

It seems to be if I were a medic, I would not want a basic teaching me ACLS. Isn't part of being a good instructor being an expert in one's field? I fail to see how a basic could ever be an expert in ACLS, and I don't trust those that claim to be "self-daught." Great, you read Dale Dubin's book, that does not make you an expert in identifying rhythms, nor does reading a book on pharmacology make you an authority on the use of medications during cardiac arrest. If the AHA wants to retain its credibility, you'd think that they would want people who actually run arrests and other cardiac patients to be the ones teaching the course.

Edit: That said, I would happily audit the class to get some better insight into the process of managing the arrest so as to be able to work with the medics just a little bit better. I sat in on a FD cardiac refresher and while many of the ALS topics went over my head, a lot of them were presented in an understandable way and I could apply my own knowledge to better determine my role with these patients.


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## EMT John (Jun 15, 2012)

My god what a pissing match we have here...


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## Veneficus (Jun 15, 2012)

Tigger said:


> It seems to be if I were a medic, I would not want a basic teaching me ACLS. Isn't part of being a good instructor being an expert in one's field? I fail to see how a basic could ever be an expert in ACLS, and I don't trust those that claim to be "self-daught." Great, you read Dale Dubin's book, that does not make you an expert in identifying rhythms, nor does reading a book on pharmacology make you an authority on the use of medications during cardiac arrest. If the AHA wants to retain its credibility, you'd think that they would want people who actually run arrests and other cardiac patients to be the ones teaching the course.
> 
> Edit: That said, I would happily audit the class to get some better insight into the process of managing the arrest so as to be able to work with the medics just a little bit better. I sat in on a FD cardiac refresher and while many of the ALS topics went over my head, a lot of them were presented in an understandable way and I could apply my own knowledge to better determine my role with these patients.



Expert content instructors. 

Both NRP and ATLS permit non-course instructor expert content instructors to instruct part of the course. (But not test people) 

Examples I have seen are medics teaching traction splinting in ATLS and non neonatal anesthesiologists teaching intubation in NRP. 

These providers were not NRP or ATLS instructors. They were instructing part of the class. That is a key difference. 

They did not have instructor cards in those respective courses.

Just imagine the uproar of a medic claiming to be an ATLS (for doctors) instructor.

Along the same lines of professional credibility. Imagine somebody who read Harrison's Internal Medicine and then suggesting they were capable to be a medical school professor. (clinical or otherwise) 

Imagine applying for a nursing educators license, without a nursing degree.

If an EMT-B is doing some "light reading" in order to better themselves to the point they are a content expert, they need to be doing it in a school, because the point of school is to verify minimal levels. 

A self taught student has no verifiable competency. Even if they attain higher understanding than somebody in school.


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## rmabrey (Jun 17, 2012)

I only saw it mentioned once in this thread but at any given time I know several EMT-B's that have taken and have cards in ACLS and PALS but of course they are all Medic students


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## jwk (Jun 17, 2012)

Let's remember that ACLS has been incredibly dumbed down over the last 10-15 year.  It used to be a really big deal to take ACLS - two full days of class and testing, a physician had to be the course director and be present and participate in the instruction, etc.  AND, we could fail students if they did a lousy job with their skills checks or tests.  Now it's generally a cake-walk, especially so for recerts for experienced providers.  Entire programs are frequently taught/run by RN's, many of whom probably haven't actually touched a live patient in years.  A single instructor can do the whole class on their own.  Nobody fails, skill tests are a joke, and written tests are done by group discussion and consensus.  Now there are even online programs (non-AHA) with names that sound almost like Advanced Cardiac Life Support, and are accepted by many hospitals and agencies the same as a regular AHA-ACLS course.  And, I still think the requirement for recertification every two years is to provide a steady stream of income to AHA.

That being said, when I was an instructor years ago, the best students routinely were the medics and medic students - they studied their asses off, practiced skills like crazy, and took nothing for granted.  Next were the RN's, PA's, etc., who already had quite a few of the skills and a good knowledge base.  The worst students were frequently physicians - they took everything for granted, assumed they knew everything already, and most depended on other people actually doing the hands-on skills for them.


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## rwheet (Jun 17, 2012)

I am a Basic and took PALS and ACLS about a month ago.  Did I need it no.  But I plan on starting Paramedic classes in the Fall.  I know in cant do anything that was taught besides CPR and some airway stuff.  The reason I took it was just to learn and hopefully start out ahead when school starts.  I don't see the big deal about people wanting to learn more and improve themselves.  As long as they know what the can and cant do.


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## Veneficus (Jun 17, 2012)

jwk said:


> And, I still think the requirement for recertification every two years is to provide a steady stream of income to AHA.



I agree with this statement but would like to offer clarification?

Yes, the AHA does approach ACLS like a business. They recognized a need and are filling it. But the need comes from accrediting agencies that mandate regular "emergency" training for healthcare providers with patient contact. 

I don't pretend that ACLS or anything the AHA does is the true and proper faith, and in fact would very much like to see it replaced with something far more practical and worthwhile. But untill such a time, I play their game by their rules.



jwk said:


> the best students routinely were the medics and medic students - they studied their asses off, practiced skills like crazy, and took nothing for granted.  Next were the RN's, PA's, etc., who already had quite a few of the skills and a good knowledge base.  The worst students were frequently physicians - they took everything for granted, assumed they knew everything already, and most depended on other people actually doing the hands-on skills for them.



I think medics are the best students for ACLS, whether they are students or recerting. Whether they agree with the curriculum or not, they perform it as part of their training/specific role.

RNs cause the most of my headaches. The ED and Critical care ones are quite a pleasure and similar to medics, but most are in nonacute practice and don't handle being the decision maker well and consequently try to blame their failings on everything except themselves. 

Physicians are an interesting bunch. That come in different forms, and usually in equal quantities. 

There are the ones who are forced to be there, don't buy the AHA thing, and make no secret of it. 

There are those who don't buy it, but play the game as they want to take the path of least resistance.

The ones who don't deal with resuscitation regularly and actually do buy it. 

Finally, the ones who actually do buy it, lock, stock, and barrel and whose support enables and encourages others. 

I can say, if I wasn't an instructor and actually had to take the class, I would certainly would fall into the 1st or 2nd, depending on how else I could be using that time.


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## bstone (Jun 26, 2012)

Just because of this thread I am taking ACLS next month. The training center said that Intermediates are fully allowed to take it. I'm also going to ask if I can become an ACLS Instructor.


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## JakeEMTP (Jun 26, 2012)

bstone said:


> Just because of this thread I am taking ACLS next month. The training center said that Intermediates are fully allowed to take it. I'm also going to ask if I can become an ACLS Instructor.



I think you will have no problem at all.





Veneficus said:


> Expert content instructors.
> 
> non neonatal anesthesiologists teaching intubation in NRP.



This is overthinking some of these certs.

NRP does not actually teach intubation anymore than it is taught now in ACLS.  It merely covers what equipment is used and the basic techniques. There is no need for an anesthesiologist to teach the course or the intubation part of it.  If you are an intubator or involved in the resuscitation  of neonates, most of the responsibility will fall on your facility or FTO to ensure you know your stuff. This is just a course that brings it all together for a nice overview of how the resuscitation of a neonate should be. Hospitals and ambulances will have their own equipment and preferences with protocols or guidelines to follow. I doubt if even neonatal anesthesiologists will use a Neopuff.


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## Veneficus (Jun 27, 2012)

JakeEMTP said:


> I think you will have no problem at all.
> 
> 
> 
> ...



Have you considered that some hospitals actually do supplement material to these courses and use it as the facility or FTO training?


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## Veneficus (Jun 27, 2012)

bstone said:


> Just because of this thread I am taking ACLS next month. The training center said that Intermediates are fully allowed to take it. I'm also going to ask if I can become an ACLS Instructor.



By far a more noble reason than mine.

I do it for the money.

For $75 an hour if they want me to tell people the best way to resuscitate somebody is to stick a tube in the patient's *** and blow, I will demonstrate my value to the organization by being the best at telling people about it.


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## JakeEMTP (Jun 27, 2012)

Veneficus said:


> Have you considered that some hospitals actually do supplement material to these courses and use it as the facility or FTO training?



If the program is given at a hospital it will usually follow the format of the AAP.   Well baby LVNs and RNs don't need to have strong intubation skills. Paramedics will not need to know the Neopuff.  The NICU and L&D teams will have their own training outside of NRP that exceeds the requirements.  NRP does not cover much on congenital heart disease so that will be done more thoroughly outside of NRP since there is too much material for the amount of time allowed.   Adult code teams, ER and ICU personnel will usually have their own training and competencies. Those taking ACLS for the card will know the stuff or have to study to be introduced to it. Their facility will put them through the crashcart training and see those in certain areas know what their role is in a code.  

Most of ACLS and NRP are now taught online and in the classroom you do a little run through of the concepts, work the mega and take the test. 

UCSD also has their own form of ACLS through their resuscitation center. 

Right now the discussion is on ACLS an AHA cert but with a sidetrack to NRP which is just another overview cert.

Take the certs for what they now are which is essentially a no fail overview or refresher of things you should already know.


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