# ACLS for the EMT-B



## yay4stress (Jan 17, 2008)

So, I'm an EMT-B in PA.  What am I doing in an ALS forum?
I heard a rumor from another EMT at work, that an EMT-B can become certified in ACLS - qualifying us to interpret ECGs and manually defibrillate, making us sort of EMT-Is even though there is no such thing in this state.

Anyone from pennsylvania know anything about this?


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## Ridryder911 (Jan 17, 2008)

No, but I heard of an emergency driving course that is strictly on-line.. sounds ludicrous huh? .. So does attempting to short cut any way to advance.  

Don't know what program you are referring to. Remember any short cut courses will bite you in the arse! 

If you are referring to the AHA ACLS course, there is no longer a restriction and almost anyone can attend it. It is *NOT* a teaching course, nor a certifying course as well, only an educational credit that you were taught their standards. 

There is ACLS course for basic's out there which is a misnomer, and it is geared to teach Basics's to assist Paramedics. Skills such as setting up an IV, applying electrodes, etc.. (which anyone can learn from the back of a EMT book and definitely should not be a course) but again, does not certify anyone as advanced. 

I am glad you want to progress. Please, instead of looking for an easy way out, do it the right way and go to school and take anatomy and physiology, then apply to real advanced classes. This way you will know what you are doing, and do it correctly. 

R/r 911


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## yay4stress (Jan 17, 2008)

Your comment is unnecessary.  I am not looking to short cut.  I will be starting medic classes as soon as the rest of my life lets me.  I have no intention of trying to get ACLS before then.

I asked because I too was incredulous, and I wanted to know if it was really an option or if this was just some wishful thinking on their part.

I heard of the ALS assist course too, but that was all stuff I learned from my medic without need of a class. The only reason I would take that is because of my con-ed requirements.

Anyhow, thanks for the rebuke


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## paccookie (Jan 17, 2008)

ACLS is not a course that will give you license or certification to perform any sort of skill.  It is more of a test of your knowledge.  Yes, you can take ACLS...but do you have the knowledge to pass?  If you haven't taken A&P, I would not recommend taking ACLS yet.  There's a lot going on that requires a good working knowledge of A&P and how the body works, and I don't mean just the basics.  I mean knowledge of the chemical level.  Also, you should take a course in rhythm strip interpretation.  It's not a difficult skill to learn, but mastery requires more than a few hours in a class.  You need to take the class and then study a little bit every day for a while before you'll truly "get it."  You also need a good working knowledge of cardiology.  

If you feel that you have the level of knowledge necessary for the class, then take it.  If not, take A&P and a rhythm strip class and then reevaluate.  I'm signed up for ACLS in March and PALS in May.  I've had 3 semesters of A&P (plus I'm retaking A&P 1&2 now), plus a rhythm strip class.  I've been studying daily, but I'm doubting myself on my level of knowledge.  I may end up waiting until October to take ACLS and November to take PALS.  By then, I will be in paramedic school.  I'm taking it as a teaching tool to help me further understand what goes on in the back of my ambulance.  I want to know everything and understand why everything happens.  I may or may not have to retake it through the school, but I don't care if it helps me to do my job better.


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## yay4stress (Jan 18, 2008)

So, general consensus is that my coworker is not correct?


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## oldschoolmedic (Jan 18, 2008)

As a service we require all of our personnel to attend PALS and ACLS regardless of their certification level. When the clases are taught, the paramedics are there to assist the EMTs and guide them so they may become more comfortable with the ebb and flow of a significant cardiac event. Our director and medical control both feel familiarity will aid in the calming reassurance necessary during these stressful moments, and we have actually seen an increase in return of spontaneous circulation and breathing in unwitnessed arrest patients. Soon we hope to see an increase in patients walking out of the hospital, we gave them a fighting chance which is more than they had before.

ACLS won't qualify you to do anything more, but becoming aware of the expectations and needs during an arrest is a good thing too. Your coworker is not correct, but taking the class isn't going to hurt either.


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## bstone (Jan 18, 2008)

yay4stress said:


> Your comment is unnecessary.  I am not looking to short cut.  I will be starting medic classes as soon as the rest of my life lets me.  I have no intention of trying to get ACLS before then.
> 
> I asked because I too was incredulous, and I wanted to know if it was really an option or if this was just some wishful thinking on their part.
> 
> ...



Rid is a genius but sometimes a little gruff or terse.

As an actual EMT-I, I'll say that an ACLS for EMT-B is cute but not the best. A full semester class barely prepared me for what I needed to know, including how to put on an EKG. When I got into the ER for my clinicals they had these 5 lead EKGs. I knew where to put 3 of the 5. They never taught us where to put the other 2. The nurses were shocked we didn't know where to put the other two and I was embarrassed. Then they asked me to do a 12 lead. Yikes! A what? How many? I can help you with 3 of them.

Well, anyhow, I wish you luck with medic school. A&P will be a big help, I think. See if you can do ride time with the medics and ask a lot of questions.


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## JPINFV (Jan 18, 2008)

bstone said:


> When I got into the ER for my clinicals they had these 5 lead EKGs. I knew where to put 3 of the 5. They never taught us where to put the other 2.



White on right, smoke over fire, clouds over grass, and chocolate is close to the heart. So easy a college volunteer can do it.


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## MedicSqrl (Jan 18, 2008)

We don't use the 5th one in the hospitals around here.


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## bstone (Jan 18, 2008)

JPINFV said:


> White on right, smoke over fire, clouds over grass, and chocolate is close to the heart. So easy a college volunteer can do it.



yeah, they never taught us the latter. White on right, smoke over fire. Then I get into the ER and see there are two more. Eek!


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## paccookie (Jan 18, 2008)

yay4stress said:


> So, general consensus is that my coworker is not correct?



Think about it this way.  Intubation is covered in ACLS.  Nurses take ACLS, but they are generally not certified to perform intubations.  ACLS does not certify you to do anything that's not already within your scope of practice.  If you're an EMT-B, you won't be suddenly allowed to interpret EKGs or manually defibrillate if your state doesn't allow an EMT-B to do so.  Make sense?  Just because you've learned about all those drugs doesn't mean you (or I) can push them until you become a paramedic and carry that paramedic license in your pocket.  ACLS will likely teach you a great deal, but it's nothing that you can't learn on your own without the course (especially if the course is going to cost several hundred dollars out of your pocket).  I'm not discouraging you, but please weigh your options carefully.  I would strongly suggest waiting to take the class unless you've taken an intensive A&P class or two.


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## Ridryder911 (Jan 18, 2008)

Short and simple, if you are ALS provider then your not a basic... for those that want divisions. 

AHA highly recommends that you have completed the cardiac portion, and advanced airway portion before attending their ACLS. The reason is simple, if you cannot perform or interpret ECG, cardiac care, there is no reason to attend. It is not a teaching class rather a class to inform their protocols and their standards. 

R/r 911


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## MedicPrincess (Jan 18, 2008)

Intresting you all feel the A&P classes and advanced airway classes should be taken prior to ACLS.  I have encouraged my EMT partner to attend an ACLS class, as well as the others that are offered to us (ITLS, PALS, Advanced Airway/RSI, ect), for the simple knowledge of whats to come when we are in that situation.  

I don't expect for her to be able to interpret any rhythms for me, or perform the skills, but it is a comfort that she has a general knowledge base to be prepared for what I may be asking for next when we do finally have a code that isn't in Asystole/DOA/Signal 7.


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## VentMedic (Jan 18, 2008)

ACLS is now merely an overview of things you should already know. It provides an outline to be studied and tested on. The class itself is not designed to teach new skills.  The skills and prep work come from your own education and studying the resources that the AHA has referenced.  

A solid educational foundation is much better than a hodge podge mix of classes from which one is merely attending in hopes of understanding something which may mean very little in the long run or in the broad scheme of things.  The same can be said for the Paramedic.


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## paccookie (Jan 18, 2008)

Ridryder911 said:


> Short and simple, if you are ALS provider then your not a basic... for those that want divisions.
> 
> AHA highly recommends that you have completed the cardiac portion, and advanced airway portion before attending their ACLS. The reason is simple, if you cannot perform or interpret ECG, cardiac care, there is no reason to attend. It is not a teaching class rather a class to inform their protocols and their standards.
> 
> R/r 911



R/R is correct (as usual LOL).  I think the learning aspect comes from the studying that most people have to do prior to the class.  I do think it's beneficial for an EMT working with a paramedic to know the algorithms, but you don't have to attend a class to learn that.  Get a study guide and read it.  Or read your service's protocol book.


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## JJR512 (Jan 19, 2008)

oldschoolmedic said:


> As a service we require all of our personnel to attend PALS and ACLS regardless of their certification level. When the clases are taught, the paramedics are there to assist the EMTs and guide them *so they may become more comfortable with the ebb and flow of a significant cardiac event. Our director and medical control both feel familiarity will aid in the calming reassurance necessary during these stressful moments*, and we have actually seen an increase in return of spontaneous circulation and breathing in unwitnessed arrest patients. Soon we hope to see an increase in patients walking out of the hospital, we gave them a fighting chance which is more than they had before.
> 
> ACLS won't qualify you to do anything more, but *becoming aware of the expectations and needs during an arrest is a good thing too*. Your coworker is not correct, but taking the class isn't going to hurt either.


 


MedicPrincess said:


> Intresting you all feel the A&P classes and advanced airway classes should be taken prior to ACLS. I have encouraged my EMT partner to attend an ACLS class, as well as the others that are offered to us (ITLS, PALS, Advanced Airway/RSI, ect), *for the simple knowledge of whats to come when we are in that situation*.
> 
> I don't expect for her to be able to interpret any rhythms for me, or perform the skills, but *it is a comfort that she has a general knowledge base to be prepared for what I may be asking for next* when we do finally have a code that isn't in Asystole/DOA/Signal 7.


I whole-heartedly agree with taking taking classes are that are technically above one's certification or knowledge or skill level, so that one will have a basic understanding of what's going to happen in that situation and can be better-prepared to assist the higher-trained personnel in that situation.


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## Ridryder911 (Jan 19, 2008)

As an ACLS instructor for the past 23 years, I can attest many have taken the course not prepared, even as physicians. 

I have found though, instead of improving working or even encouraging, the opposite. Remember, the course requires interaction of airway control, rapid ECG interpretation, and mega code as a team leader and participate, as well as a written test. 

Placing a participate in the role of student that is ill prepared, does nothing but embarrass and discourages one. Being tested as a team leader in front of peers is hard enough when one has great knowledge in the subject. By far, I have never been against furthering education or taking advanced level courses to increase knowledge. Remember; AHA ACLS courses are not meant to teach rather emphasize the standards adapted by the Emergency Cardiac Committee (ECC) and testing over those. There is NO emphasis on teaching ECG's, IV placement, or even airway placement (there is a separate course for each of those, now from AHA). 

Rather, if one is truly attempting to increase a working environment on interacting on codes, cardiac scenarios, etc.. then I suggest this can be done internally as CEU's or even non-traditionally during down times. 

We require our non-Paramedic level EMT's to be able to be familiar with cardiac arrest, perform XII leads, have everything ready for all type of scenarios and calls. Practice and direct intervention on calls with the medic, one should be able to observe and over time will pick up on what is expected and increase their knowledge. 

R/r 911


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