# PHTLS vs ITLS



## DrParasite (Oct 4, 2018)

My PHTLS cert expired, and I was looking at asking our training department to host either an ITLS or PHTLS course somewhere in the county.  Currently we don't do any cert classes (our medical director isn't a fan of the 1 & 2 day merit badge courses), but I thought PHTLS was a decent class, as a supplement to the basic EMT classes.   According to the ITLS website, their class is far superior to PHTLS, but it's not a unbiased opinion.

Anyone have any first hand experiences from both courses?   If ITLS is better, I was going to try to push for an advance ITLS class for our ambulance crews (mostly paramedics and EMTs)_, and a basic ITLS class for the fire department (mostly EMTs with a couple paramedics here and there)


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## NPO (Oct 4, 2018)

PHTLS is just more of the same that we have always heard. There's not a lot of critical thinking and last time I took it they still talked about back boarding. 

I've never taken ITLS but from what I'm told it's more about "what you can do for the surgeon" and deemphasis on prehospital care. But, like I said, I've not taken it.


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## PotatoMedic (Oct 4, 2018)

Maybe look at TAPTC.  Not many ground agencies know of it.


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## DesertMedic66 (Oct 4, 2018)

I took ITLS in medic school and PHTLS once I started working in the field. Honestly there is no major difference.


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## Summit (Oct 4, 2018)

DesertMedic66 said:


> I took ITLS in medic school and PHTLS once I started working in the field. Honestly there is no major difference.


That's what I'd always heard. I've only done PHTLS.


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## luke_31 (Oct 4, 2018)

Done both basically it doesn’t matter which one you take. PHTLS is more useful if you’re military, otherwise doesn’t matter which you take, they cover the same things.


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## TXmed (Oct 4, 2018)

Ive done both. I personally like PHTLS better but i also think its up to the instructors.


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## TXmed (Oct 4, 2018)

@PotatoMedic transport provider advanced trauma course ? TPATC?


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## PotatoMedic (Oct 4, 2018)

Yeah.  I was talking to a guy who instructed the old version and he says that there is a lot more relevant information (in his opinion) presented with the course than when they had their providers do PHTLS.  It's something I'm going to try to take next year as classes are not to often in my area.

They do have a fully online version coming out but you don't get any of the skills labs that you do with an in person class.


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## Akulahawk (Oct 5, 2018)

I have taken both PHTLS and BTLS (before they changed the name to ITLS). They both cover the same basic information but I like PHTLS a little more just because they organize things a little differently. Honestly, I found both to be fairly basic. I'm looking at eventually taking either TNCC or possibly TPATC in the future, but probably not for at least another 6 months. 

Of the two courses that I have taken, I prefer PHTLS as it incorporates tactical considerations when providing  care under fire, such as in an active shooter or military environment.


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## Summit (Oct 5, 2018)

Akulahawk said:


> I have taken both PHTLS and BTLS (before they changed the name to ITLS). They both cover the same basic information but I like PHTLS a little more just because they organize things a little differently. Honestly, I found both to be fairly basic. I'm looking at eventually taking either TNCC or possibly TPATC in the future, but probably not for at least another 6 months.
> 
> Of the two courses that I have taken, I prefer PHTLS as it incorporates tactical considerations when providing  care under fire, such as in an active shooter or military environment.


TNCC is more in depth than PHTLS, but nothing groundbreaking... adds a mindset for ER assessment and management.


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## Peak (Oct 6, 2018)

While TNCC still teaches step-wise assessment and management it is more conceptual and less protocol-feeling, and provides virtually nothing to the scene management of field trauma. ATLS/ATCN (the latter of which is the exact same course with a different skill check and half the price) is similar although much more in depth. I don't necessarily think that scene management needs to be taught in a trauma course, if I wanted TEMS education I would take a course for that specifically. 

@DrParasite I do agree somewhat with your medical director. I think that a lot of classes are good to take once, but after that it is mostly just sitting in class and listening to the same lecture I heard 2-4 years ago. Usually changes in the class are something that we changed in our practice a long time before I had to recert. That being said for our trauma certification we must have a certain percentage with TNCC trained nurses and ATLS trained EM docs and PEMS. 

As far as other classes I've heard that TCAR/PCAR are good, but I've never taken them. I can't justify dropping $600 on them given that most of the other TCRNs I've talked to seem to think it holds relatively little value if you have kept up to date with the published literature.

I think that value for money TNCC is probably the best introductory course, but since it is taught by the ENA verification is not actually available for EMS though they are certainly encouraged to take the course. You may also be able to work out a deal with a local university hospital, there are plenty of TNCC and ENPC instructors all over the place who teach for the career boost rather than for monetary gain.


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## Aprz (Oct 8, 2018)

If I recall correctly, one benefit to taking ITLS is that you only have to recert it every 3 years instead of every 2 years. I've only taken ITLS. I felt ITLS was pretty much the same thing you learn in medic school or any online CE training. The same BS: keep the patient warm, don't turn their blood into koolaid, correct C-ABC first, etc etc etc... Just another alphabet soup card.


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## DrParasite (Oct 8, 2018)

Aprz said:


> If I recall correctly, one benefit to taking ITLS is that you only have to recert it every 3 years instead of every 2 years.


My PHTLS card was good for 4 years, not 2.





Aprz said:


> I've only taken ITLS. I felt ITLS was pretty much the same thing you learn in medic school or any online CE training. The same BS: keep the patient warm, don't turn their blood into koolaid, correct C-ABC first, etc etc etc... Just another alphabet soup card.


I'm inclined to agree, however from the EMT level (and more accurately, the firefighter/first responder level), I think it expands on the traumatic assessment.  And you would be surprised (or maybe not) how many paramedics still sit on scene so they can get an IV on a major trauma....

I do like the idea of not cspining the stab wound to the next (the damage is already done by the knife), the brief correlation of injury patterns to kinematics (assuming I'm remembering it right), and I'm hoping they move further away from backboarding everyone with a possible C spine injury. 

I'm trying to see which I should make the case for to my training officer and medical director.


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