# Most highly valued certs for EMT-P



## Hoofguy (Sep 4, 2009)

I currently have my ACLS and PALS and am wondering what other certs I can put under my belt to both further my education and to make me more desirable as an employee. 

So what are some opinions as to the most important certs.. 

I'm currently looking into PHTLS but other than that and my current ones I'm looking for that next step.. (Yes I'm a cert :censored::censored::censored::censored::censored


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## Shishkabob (Sep 4, 2009)

My class included ACLS/PALS/PHTLS

Look into APLS, PEPP, AMLS, and ITLS.


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## rescue99 (Sep 4, 2009)

Linuss said:


> My class included ACLS/PALS/PHTLS
> 
> Look into APLS, PEPP, AMLS, and ITLS.



Thinkin Hazmat Phram would be a great course to have. PEPP is getting real popular and either ITLS or PHTLS, PALS and a partridge in a pear tree


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## Akulahawk (Sep 4, 2009)

PEPP and PALS both have their strong points. I tend to favor PHTLS. ITLS (formerly BTLS) is not a bad course... AMLS would also be a good one as it focuses on the medical stuff. A Hazmat course won't hurt. Don't just take the courses to make yourself look good... learn the stuff behind the courses so that you develop good knowledge in those areas. Learn to read 12 lead ECG... not just read what the machine says, but really learn to interpret it for yourself - beyond recognizing STEMI. There's a WHOLE LOT of info you can get from a good 12 Lead...


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## TransportJockey (Sep 4, 2009)

My medic class got us PEPP, PALS, ACLS,and PHTLS. Other than that...I'm not sure.


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## medic417 (Sep 4, 2009)

MD

10charrule


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## TransportJockey (Sep 4, 2009)

medic417 said:


> MD
> 
> 10charrule



I was thinking at least PA, maybe even CNP... MD might be a bit much for some medics.


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## LucidResq (Sep 4, 2009)

Instructor courses may make you more desirable as an employee. 

I found my Basic Disaster Life Support Class (put on by the National Disaster Life Support Foundation of the American Medical Association) to be pretty fascinating. The one I took was taught by a seasoned ED physician.


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## Shishkabob (Sep 4, 2009)

I saw something offered at a local trauma center called ATLS (Advanced Trauma Life Support)

Anyone take it?


Seems to be a doctor oriented course, but couldn't hurt the edumakashun?


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## Dominion (Sep 4, 2009)

My course included Water Rescue, Hazmat, PHTLS, AMLS, ABLS, PALS, ACLS, and PEPP.  There might be another letter vomit in there.  Lots of alphabet soup 

I liked PEPP over PALS....I also really liked PHTLS and ABLS.  Great courses to take.

If I'm not mistaken ATLS is the doc course and it's what PTHLS is based off of.  If I'm not mistaken.


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## Shishkabob (Sep 4, 2009)

The medic class before us took PHTLS while taking the trauma portion of the class... we take PHTLS after our final, a month after trauma.

me sad.


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## el Murpharino (Sep 4, 2009)

Hoofguy said:


> I currently have my ACLS and PALS and am wondering what other certs I can put under my belt to both further my education and to make me more desirable as an employee.
> 
> So what are some opinions as to the most important certs..
> 
> I'm currently looking into PHTLS but other than that and my current ones I'm looking for that next step.. (Yes I'm a cert :censored::censored::censored::censored::censored



I don't care about these alphabet soup certs, as they only reinforce and emphasize what you should already know.  Some of those classes throw in a little twist here and there, but overall the end result is the same. To answer your question, the certifications I value most are my Paramedic cert, my CPR card, and ACLS - because work requires I have them.


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## Dominion (Sep 4, 2009)

el Murpharino said:


> I don't care about these alphabet soup certs, as they only reinforce and emphasize what you should already know.  Some of those classes throw in a little twist here and there, but overall the end result is the same. To answer your question, the certifications I value most are my Paramedic cert, my CPR card, and ACLS - because work requires I have them.



But I like reinforcement.  Each class is a bit different and my PHTLS class was VASTLY different than what the paramedic book had.  The same for PEPP.


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## Ridryder911 (Sep 5, 2009)

As one that holds all the alphabet instructor rating, it is all dependent upon the instruction of those courses. If one takes any of those at face value, they are all focused upon enforcing a specific group or organization(s) policy or idea of what treatment should be. 

For example, AHA has their ACLS and even BLS based upon the ECC guidelines, even though research has proven other methods just as if not more successful. 

PHTLS/ITLS are synonymous except the financial backer is different, these courses are intended to condense and emphasize rapid trauma assessment and treatment. ATLS yes is physician level course that one may attend but cannot officially pass unless you are a physician. I have attended this course and even though there was some good points found it very weak especially if it was intended for such a level. 

PALS and PEPP are both endorsed by American Academy of Pediatrics and I have found both to be very nice for new providers but very weak in content. From what I have read many places are now phasing out PEPP due to the newer pediatric course emergency pediatric course (EPC) from NAEMT. The best pediatric course I have attended was advanced pediatric life support (APLS) which is a physician level course. They are difficult to locate and enter due to the limitations of courses and physicians are preferred. 

AMLS is again a good course new providers for medical cases. 

As mentioned if was properly educated to begin with, most of these courses will be nothing more than a good refresher and maybe some fine points. If one learns something totally new then I would be concern of the education or training I had received. 

When interviewing applicants, I expect them to have already obtain these certifications if they have been a Paramedic for more than a few years and have kept current. If they have not, I presume that they are not really that interested in maintaining their proficiency. 

Ironically, nursing has similar courses of course sponsored by their respected nursing organizations. 

R/r 911


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## VentMedic (Sep 5, 2009)

Ridryder911 said:


> Ironically, nursing has similar courses of course sponsored by their respected nursing organizations.
> 
> R/r 911


Yes but few RNs rush right out of their 2 or 4 year degree to start accumulating the alphabet. As well, the certs with the most value in the nursing profession require 1 -2 years of experience in a specific area and some may require several additional hours of education.

When a Paramedic is interviewing for a Flight position, it is very easy to tell those that have just accumulated letters and very little knowledge. The ones that impressed have sought the additional education to support the weekend "certs" that barely break the surface of most topics and that definitely includes ACLS and PALS which is so easy one doesn't need much education or experience to pass. One just has to memorize a few charts. Almost any interviewer will be able to trip up those that just memorize for weekend certs very easily within the first 3 minutes of the interview.


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## Sasha (Sep 5, 2009)

My school did ACLS and PEPP. While I liked PEPP better as a course than PALS, it seems employers in my area are all asking for PALS. Don't know if they will accept PEPP in place of it, haven't really asked.


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## MrBrown (Sep 5, 2009)

What's with all the add-on courses? Should this not be included in the cirricula for Paramedic rather than a bunch of addons?

I've never heard of half of these courses and I doubt any of them are even taught here (we do have ACLS and ITLS/PHTLS but they are not "required" to get hired and aimed more at physicians).


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## daedalus (Sep 5, 2009)

MrBrown said:


> What's with all the add-on courses? Should this not be included in the cirricula for Paramedic rather than a bunch of addons?
> 
> I've never heard of half of these courses and I doubt any of them are even taught here (we do have ACLS and ITLS/PHTLS but they are not "required" to get hired and aimed more at physicians).



These certification classes are like a CPR class. Most are two days in length and serve to create confidence and reinforcement in trauma care, cardiac arrest, pediatrics, and medical calls. They are nothing special, but they do have their uses. As mentioned, a good paramedic should find these nothing but review, but review is always good, and being able to prove mastery of the basics with a certification is also pretty cool.

The American Heart Association created the ACLS class to teach a variety of different health care providers (Physicians, Nurses, Paramedics, RTs, and PAs) the minimum expectations in emergency cardiovascular and stroke care based on the latest science they have come up with. I like the new ACLS because it really emphasizes quality CPR and using evidence based interventions in resuscitation.


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## Ridryder911 (Sep 5, 2009)

VentMedic said:


> Yes but few RNs rush right out of their 2 or 4 year degree to start accumulating the alphabet. As well, the certs with the most value in the nursing profession require 1 -2 years of experience in a specific area and some may require several additional hours of education.
> 
> When a Paramedic is interviewing for a Flight position, it is very easy to tell those that have just accumulated letters and very little knowledge. The ones that impressed have sought the additional education to support the weekend "certs" that barely break the surface of most topics and that definitely includes ACLS and PALS which is so easy one doesn't need much education or experience to pass. One just has to memorize a few charts. Almost any interviewer will be able to trip up those that just memorize for weekend certs very easily within the first 3 minutes of the interview.



True, but as well nurses usually are not specialized when exiting school. Very few know how to turn on a monitor as much as read an ECG, thus the reason for the intern/externship programs. At one time the new grad would work in less critical area such as step down ICU for a while then apply to ICU extern and be trained within the speciality area and take courses along the way. Now, we are seeing more and more new grad's being directly placed into speciality areas. 

Let's be truthful saying that the majority of brand new nursing students have very little critical care and emergency knowledge. It is not a routine part of the curriculum. I agree most nurses used to not run out and obtain these alphabet cert's but within the past few months I have seen a drastic change. Emphasis in new nurses wanting those courses to be able to apply into a speciality area (as most will either require such as ACLS, PALS, etc.. or to obtain within a short period of time). Many feel that it might be to their advantage to have these certification(s) prior to application as it is getting harder to enter the nursing workforce. 

I also feel many of these nurses just alike new medics sometimes place a higher regards to these courses than many of the seasoned nurses. Just alike seasoned EMS providers know that the ACLS card is only vital for recertification and employment, yes it may indicate that at least one time you were abreast of the current AHA standards. It and other such courses definitely does not represent or validate your knowledge or skill level of providing care. 

I too agree, you are right when you see the "cowboy" Paramedic type that has immediately obtained every cert card and class to hurry up and get onto a flight service. One of the reasons of my concern about the new CCP-C examination is that no required experience is needed to take it but suggested. I know at least two Paramedics that have obtained the FP-C with < than a one year experience and now are working on a helicopter. An issue at one time that would never have been considered, but I am seeing more changes within the aeromedical industry in requirements. 

R/r 911


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## VentMedic (Sep 5, 2009)

Ridryder911 said:


> True, but as well nurses usually are not specialized when exiting school. Very few know how to turn on a monitor as much as read an ECG, thus the reason for the intern/externship programs. At one time the new grad would work in less critical area such as step down ICU for a while then apply to ICU extern and be trained within the speciality area and take courses along the way. Now, we are seeing more and more new grad's being directly placed into speciality areas.


 
We only have a couple of hospitals in our area that will take new grad RNs into the Critical Care Program. But, the additional education is 6 - 40 hour weeks in the classroom, 6 weeks of shadowning a CCRN in the unit, 6 months of being under the watchful eye of an assigned preceptor and 6 more months of a probationary period. Then, if they want to join a specialty transport team, they will need two more additional years of experience in the unit after that all the initial training to apply and then the serious training begins which can take over another year. This allows time for additional education and to gain competency in skills. Example: RNs on either the Pedi or Neo team will need at least 10 intubations (RRTs as the primary intubator need 100 to apply and 25 more after accepted to the training program). At least 10 UAC/UVC insertions are needed. Then even with all of the required skills competencies and additional education, they will still need to be with a preceptor for 5 to 10 transports depending on prior experience and finally the direct approval of the medical director who also may determine if they are allowed to start the training in the beginning. This still is all with a base RN (RRT) education of 2 or 4 years. You can't imagine how excited some Flight programs are to get RNs that have done specialty transports as they can also adapt very easily to doing 911 HEMS as well. 

Compare that to some of the new Paramedics who may have some of the eduation or classroom training with few to no prerequisites to establish a foundation for medicine. As well, many of the necessary skills which are the "technical foundation" of the profession are not being obtained such as intubation. Then, when some companies only require 5 rides, that pales in comparison with the number of patients a nurse must see after he/she has gotten more hours of education/training just for entry into a Specialty AFTER nursing school than some Paramedics get in their entire program or orientation by their employer. Then, some in EMS wonder why there is criticism for certain skills and Paramedics not being allowed to have access to many of the medications that might allow them to do better critical care transport or facilitate certain procedures in the field. You can also see how difficult it might be to compare the education and skills of the Paramedics that do apply for Flight where the experience and scope will vary. You can easily see this from a Paramedic that worked as a Southern CA with a very busy service for several years with a very limited scope but now wants to do Flight or CCT in say Oklahoma or another progressive area. As you have probably read on the forums, not everyone is aware Paramedics are even allowed to transport IABPs in some areas. You can talk to California Paramedics about certain drips and all they can say is "MICN only". 

You can criticize RNs all you want but still, the number of patients and patient hours they get when they do enter critical care training AFTER they have a 2 - 4 year foundation of general knowledge is impressive. Yes, nursing school doesn't teach everything indepth but they do have enough pathophysiology to where explaining pharmacology actions, perfusion concepts, pressor interactions, ventilation theory and even O2 delivery a little easier. Myself and other instuctors usually don't have to resort to fire hose examples in explanations and try to avoid misleading the new RNs by saying "lido numbs the heart" or "CPAP pushes the water". 

Unfortunately, ACLS and PALS can also foster some of the bad knowledge when people get their instructor cards too soon. Or, they have no experience especially with kids. Some Paramedics even get very offended when they are not allowed to become NRP instructors "to complete their set" of instructor certs for their alphabet soup. Yes, CPR (BCLS) has instructors that teach without ever doing CPR on a real person but that is purely a "skill" and doesn't require much critical thinking. The critical thinking requirement is what ACLS and PALS are also becoming very weak in but then effective CPR is now the emphasis.

BTW, have you looked lately at the competencies the NPs and PAs are going through in some areas in addition to the increasing educational requirements? Very impressive and not just in the specialty areas. The additional post grad programs for specialization, especially for the PAs, are gaining a lot of recognition and their grads are highly sought after.


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## Ridryder911 (Sep 5, 2009)

There was no disagreement at all, other than to leave an impression that new nursing graduates are more prepared to provide care than being projected. I teach within nursing programs and realize that for the most part they will pass the minimal acceptance level. 

I am not against the nursing profession, as one being a member within it. I do agree as well the false illusion of ill prepared instructors attempting to train EMS students is ridiculous. Graduates of the majority of programs do not meet the normal requirements of any health care providers programs: that is majority and not all. Alike RT and even nursing programs; there are good and bad alike. Yes, unfortunately the over all appearance is poor. Those in EMS much rather work twice as hard and long to make an excuse than to do it right the first time. 

My anguish from an all day meeting regarding new standards and how instructors are poorly prepared to make lesson plans and focused base teaching in lieu of the current objective base that is now prescribed. No, we much rather attempt to water down and hope new text books will do it for us. My resolution is simple, make those that teach actually have at least a basic education of an associate degree (w/requirement of a under grad in a limited time) and pass the National EMS Educators test. At the least, we would know that they possess some knowledge in adult education. An uproar from non-academic level programs of course pursued. 

Alphabet courses are okay if they are thought as not a certification but rather a recognition that one has passed an agency idea of how to perform specific treatment plans. It definitely does not and should not be interpreted that the provider has special skills or knowledge than any other provider. This again is much more different than board and license certification(s), which many may confuse the two. 

Yes, I have noticed the post graduate requirements, and as well the debate that is currently going on. I am glad to see such programs be put in place, but do worry with the current economy if compensation will accompany these graduates? My state has a very active PA programs as the first state that had a graduate degree program and now will be requiring NP's to have post graduate/doctoral level within a certain time frame. Again, another argument and discussion elsewhere. 

R/r 911


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## Scott33 (Sep 5, 2009)

AMLS is probably the most relevant alphabet soup course to get.

I liked NRP too, but not something most paramedics can draw from, every shift.

I am taking PNCCT in a couple of weeks, and have heard a lot of good things about it (a little longer than 16 hours though).


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## VentMedic (Sep 5, 2009)

Since I have several "certs" that are required to be current, I use the recert classes as a chance to network and see what others are doing just to keep an active interest in these classes.   We will get professionals occasionally from other hospital or Flight systems and sometimes a class offered at another facility fits better into my schedule.  I might even attend a cert class offered at a national conference just to get out of my own region.  Of course I have also learned where not to take some classes.  I now try to take EMS related classes at a trauma center rather than some of the FDs.   In previous years, some of the FDs offered the better classes.   Things change as more people are just being pushed through cert classes. 

At these classes I will engage in conversations as time allows about about new blades, scopes, ETTs, monitoring equipment, transport brackets and L&D setups that could be put on a future budget.  I also get "cheap" tips about a better way to store or have certain equipment more accessible for a meconium baby or deplugging a tube mid-flight.   Thus, even if the recert classes become routine and even a little boring at times, there is something that can be learned if you are actively seeking education in whatever you do.   It also makes the class a little easier to tolerate if the instructors are poorly prepared to teach.


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## Lifeguards For Life (Sep 10, 2009)

Am taking AMLS this month


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