EMT-B With ACLS

[DrParasite]

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!!!

 

[Tigger]

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.

 

[EMT John]

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

 

[Veneficus]

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.

 

[rmabrey]

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

 

[jwk]

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.

 

[rwheet]

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.

 

[Veneficus]

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.

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.

 

[bstone]

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.

 

[JakeEMTP]

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.

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.

 

[Veneficus]

I think you will have no problem at all.





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.

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

 

[Veneficus]

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.

 

[JakeEMTP]

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.