ACLS/PALS/iTLS VS AMLS/EPC/PHTLS

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d3653je

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With respect to the above courses, which do you all think is better?
 
Well... ACLS has no equivalent in the other courses you named.



I have ACLS, PALS, and PHTLS. I'm getting PEPP on Monday. I'm wanting to get AMLS and NRP some point in the near future.

No reason why you have to stick with just one agency (AHA vs NAEMT) . Expand yourself and learn all the alphabet classes.
 
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the best ones are the ones that get you hired and maintain employment.
 
firecoins said:
the best ones are the ones that get you hired and maintain employment.
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Which typically is ACLS, a pediatric course (typically PALS, but many places accept PEPP) and a trauma class, either PHTLS or ITLS.



ITLS is aimed more at intigrating BLS with ALS. PHTLS is pretty much aimed at ALS providers.
 
I have ACLS, AMLS, PALS, HPBLS, ITLS, ASLS, NRP and GEMS.

The toughest I think was AMLS then ITLS, NRP
 
I also have CEVO, EVOC, CIA and FBI
 
For what?

If I'm having critical cardiac problems, I could really care less if you are ITLS or PHTLS. By the same token, if I have a shotgun blast to the torso or I am pinned under a one ton log, I really don't need you to have an ACLS class under you.
 
hmm, i have acls, amls, pals, pepp, and itls. I thought they where all good, they all have their differences, but it was all stuff that I learned in medic school. amls and pepp where similar in structure, one for adult and one for kids. acls and pals where similar, again adult and kids except pals had some medical in it. and i think most trauma courses are the same, maby rural areas with a long transport have a need for more advanced trauma care, but here trauma calls rarely get past the BLS stage before we are pulling into the hospital.
 
lightsandsirens5 said:
For what?

If I'm having critical cardiac problems, I could really care less if you are ITLS or PHTLS. By the same token, if I have a shotgun blast to the torso or I am pinned under a one ton log, I really don't need you to have an ACLS class under you.
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Yes you do.:o
 
d3653je, each class is good in its own respect. If you are becoming a medic or are a first responder that has to assist ALS a lot than ACLS and PALS, its pediatric equivalent are right for you. Also, if you do a good number of medical calls (vs. trauma) or like me operate a fly car for first response than AMLS is a good choice because you will get drilled with many different scenarios and twists to see the medical side to dx and treat emergency illness in a way that is presented to really make you think.

PHTLS is good if you do more trauma than medical where AMLS would be more of a viable option however it is still a good course from what I hear because med/trauma are every EMS providers two core areas.

Some states additionally require EVOC or CEVO and in other states it is nice thing to have though not mandatory. I was also able to have a few dollars of my car insurance because EVOC correlates to "safe driver" with *some* insurance companies but not all.

As for the other courses, if you do a lot of peds calls or simply want it to accompany your PALS than EPC may not be a bad option for you. AHA's PEARS is also a viable equivilant and I myself am hoping to do PEARS within the next month or two, oddly enough peds was one of my weak areas on the state exam though I scored very well overall. It would not hurt to use it as a knowledge boost.

I don't know much about ITLS but there is one other interesting point to bring up, you can always keep going in NIMS, we are required to take ICS-100 & IS-700 but I am in the process of becoming a NIMS instructor and in order to teach NIMS/ICS you may need to get certified at the 200, 300, 400 and/or 800 level as well as have past instructional experience. On the instructors side of certs you can always look into teaching BLS (or ACLS, etc.) and if proficient you will not only be certified but know it inside and out to say the least.
 
Horse for courses

Are all these credentials/certificates/qualifications/tickets/letters next to peoples names organised and sold by the private sector?

By way of comparison here in Aussie land there are basically only two levels of qualification in EMS services. BLS and ALS. We call them Paramedics (BLS come intermediate ALS - US EMT-I equivalent) and MICA/intensive care.

There is no market (allowed) for the private sector companies to spruik courses with a certificate nor University based add-ons to your existing qualifications beyond post grad courses that upgrade you to degree level if you don't already have a B applied science.

There are now some bridging course developing that link nursing to ambulance partly because a number of our staff come from nursing backgrounds and have recognised qualifications that fast track them through the ambulance course at uni.

Not to seem critical but the US seems awash with people from private companies flogging off online education courses for EMS. How do your respective services and national representative bodies keep up with accrediting this plethora of "qualifications" from so many different providers.
How do your states and local authorities rationalise standards across so many different curriculum's?

To say it must be incredibly confusing is an understatement.

MM
 
confusing kinda, ACLS (advanced cardiac life support) and PALS (pediatric advanced life support) are gennerally required by all agencys and must be renewed every two years. this is because it keeps your knowledge current in these areas as processes and dosages change every few years. these two are only offered from the american heart association. the other courses are sometimes required but not always, some areas they are suggested. these classes would be ITLS (international trauma life support, former BTLS) PHTLS (prehospital trauma life support) ATLS (advanced trauma life support) they are basicly the same but they serve to guide how a trauma call should be handled, by everyone having the same cert everyone on scene should be able to know what is going on. then the last few AMLS (advanced medical life support) and PEPP (pediatric education for the prehospital professional) they both are add on classes that basicly teach you how to think critically about your assessment and everything you are seeing and how to form differential diagnosis and then eliminate them untill you know what you are dealing with. usualy not required but beneficial to the new medic.

none of them are the same so there is no need to standardize them, and the govt here dosnt give two drops of poop anyway. as long as you have a little piece of paper that says you have taken the class and the date is still current you are good to go. and all the courses listed are 16 hours each, so there isnt much to cover.
 
Err... ATLS is definitely NOT the same as ITLS and PHTLS short of it being about trauma. The first is geared towards physicians, the last two are geared towards prehospital providers. In fact, PHTLS was built off of ATLS. It's sorta of like saying that CPR for health care provider and CPR for lay rescuer is essentially the same thing because they both teach CPR, even if the curriculum is vastly different.
 
Confusion indeed

I guess having EMS in Australia handled by government simplifies things where as the US has such an eclectic model of service providers - private, public, mixed, fire services, hospital services, volunteers etc the standardisation is to offer areas of clinical skills and have your government bodies set minimum standards of qualification (is this via the NREMT and other bodies?) so you can go to an employer and meet their respective hiring criteria. Still what happens when you have a multi-jurisdictional event like a major disaster with mixed patient profiles? - eg, paeds, adult, trauma, medical all in the one basket? Do the scene commanders shop around amongst the EMS staff to see who has what and can do what? Do you have pissing contest with one bloke saying he has the ITLS another the PHTLS arguing about who should do what?

When you do either the ALS (EMT-I) Paramedic course or the MICA course here all the components are included in the programme. To highlight my point, up until recently the NSW ambulance service had skill sets attached to levels of qualification -so level one qualified, level 2 etc. What happened though was two crews would get to a scene and some had one qualification but not the other, some could put in an IV some couldn't, some had paeds, some didn't or you would get two crews with the same levels but not the skill sets needed for the patient. The system relied heavily on the ALS guys being around who could do everything.

Since you would never be able to predict what was going to be needed at a scene the idea of levels soon went the way of the Dodo. Everybody is trained up to the same level now.

Nonetheless and at the very least, it sounds like somebody out your way needs to simplify things a bit.

Thanks for the info.

MM
 
PHTLS was one of the most informative CEU courses I have taken in EMS. I felt like there were some issues touched on in PHTLS that weren't necessarily stressed in EMT school. We went in depth with regard to the kinematics of trauma and deceleration injuries, we spoke about the latest research in fluid rescuscitation, we discussed the rationale behind the Parkland Formula, went over advanced airway assessment techniques such as Mallampatti airway classification, thyromental distance, and even performed face to face intubation, we learned new techniques in moving patients and how to use a sheet as a makeshift C collar and a device to move a patient whenever a c collar or help wasn't available. We discussed the finer points of the ABCDE patient assessment and clinical findings such as Cushing's Triad, Beck's Triad, the significance of JVD, Compensated vs Decompensated shock and symptomology of the 4 stages, etc, covered some of the skills that most of us get rusty on like Thomas Half Ring/Sager, and even covered some of our more advanced skills such as needle decompression and surgical airways. I am fortunate enough to work at the same hospital as the physician who wrote the PHTLS textbook and hosts the podcast.

I truly came out of this course feeling more confident.

Also, my certificate makes me feel like an Emergency Mail man.
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I think that the purpose of these classes is misunderstood.

They are not meant to be difinitive medical education. (Of anykind) They are meant to help keep the skills current for providers who don't frequently use them or to have some sort of credential demonstrating their skills are current.

They are supposed to be standardized but are not. Many of the instructors of these classes see them as an easy avenue to teach or show off to a certain cohort. Physicians are exceptionally gifted at this. Because the material in the classes is so basic and boring they like to "take it up notch," just so they are interested. Consequently any 2 people could take a class at the same time and have incredibly different information and experience.

If you could truly learn how to take care of patients in a class 16-24 hours long, it would totally eliminate the need for paramedic, nursing, or medical school. In fact you couldn't even read the textbooks telling you what you would need in a month.

What those classes do teach you is: In the event you observe condition X, you should do Y and if that doesn't help move to Z until an expert can be brought to bear. (either by going to the expert or the expert coming to you)

Many organizations use these classes as requirements because it is a much easier way to demonstrate you are current with your skills than running every person through every competency themselves.

"Advanced X life support" is a bold faced lie. It is the minimum people who see patients should know. Things like when to unsynchronized cardiovert (shocking, or defibrillation) How to intergrate it in CPR, identifying and intervening in the pediatric periarrest state, not to rapidly infuse gallons of chrystalloid in the trauma patient and take them to an appropriate facility, how and when to deep suction meconium in a new born, etc.

Incidentally NRP is about the most advanced, if you really could call it that, of these merit badge courses, and a majority of what is needed is not even on an EMS truck. "hold on while I put on sterile gloves and create a field for my umbilical vein catheter set up." right? I have had students in these classes not even know what a flow inflating bag was.

The full title for ATLS is: "ATLS for doctors" and it is designed for nontrauma physicians or ones that see it so infrequently they need to be "refreshed." A paramedc or a nurse tking the class is certainly not going to learn how to read radiology in it. Many places remove or do not let non physicians practice all of the surgical skills. If you learn them in class, you are certainly not authorized to do them. (After you tell med control that you performed a DPL on the rig on your way in to rule in or out a peritoneal bleed, please post it on the forum, see if you can before your license is pulled and don't forget to change your title to add "former") Maybe stop by a thread about getting recertified with a felony conviction too. (not that anyone in the modern world would use a DPL over a FAST or a CT)

Also remember, these classes are based from common emergencies, not all emergencies, and are the recommended baseline to start from, not the definitive treatment there of.

My favorite are the retards that list them as credentials behind their name. like: Joe Shmoe EMT-P, ACLS, PALS, ITLS, NRP, AMLS, GEMS. (you know who you are)
 
Veneficus said:
My favorite are the retards that list them as credentials behind their name. like: Joe Shmoe EMT-P, ACLS, PALS, ITLS, NRP, AMLS, GEMS. (you know who you are)
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They makes me laugh .... its like bro seriously :D
 
Melbourne,


They are continuing education. Nothing more. Not "addons" to your cert, and not "proof" that the US way of doing things is dumb/ confusing.
 
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