The stupidification of ACLS.

[mediccjh]

I took my ACLS refresher today. What a f--king joke!

When I initially took ACLS in medic class in the Spring of 2001, the fear of God was instilled into you if you failed. There was no hand-holding. When you went in for you Megacode scenario, it was you and the instructor, no one else, and if you screwed up, the evaluator let you know about it and failed you. I passed and got the only perfect score in my class.

When I went in today, it was a joke. Videos-very cheesy videos that made me want to vomit. Also, the Megacode scenario was a joke! You take the test as a group, with hand-holding and kumbaya, and everyone passes!! It was a horror seeing these doclings and nurses unsure about themselves asking to do things, instead of barking out orders like I did. I was involved in 3 scenarios, and ended up becoming the "team leader" because they didn't have a clue or took no initiative. And of course, everyone passed. And they were impressed that a lowly am'blance driver can intubate!!

I talked to the instructors afterward, all whom I have worked with in the field. They all seem to agree with me-that the ACLS curriculum and methodology of teaching is a joke. I find it scary that these are the people in the hospital, who are all allegedly better and smarter than me because they have a college degree, taking care of a loved one in the case of a cardiac arrest.

Why is it 2 paramedics and 2 EMTs can run a cardiac arrest better, in deplorable conditions, far superior to hospital RNs and doctors in a controlled environment?

End rant.

Discuss.

[Ridryder 911]

As an ACLS Instructor for the past 25 years, I can attest it is no longer a credentialed course like it once was. At one time when someone had a ACLS card or wore an ACLS lapel pin, you could feel assure that person had an understanding of emergency cardiac care & could manage a cardiac arrest, knew proper airways, etc.

Yes, it has been diluted down. I agree the videos are cheesy, but in all honesty at least it does cover some of the basics better than the videos in the past.

We have to remind ourselves this is just a continuing education program and has no validity of knowledge of cardiac care, like it once used to.

I truly would like to see another organization take over or NREMT and other EMS license/certification agencies require the ACLS for Experienced Provider program (which is similar to the old ACLS format) for re-certification.

[Asysin2leads]

Welcome to capitalism. Supply and demand. More baby boomers hitting the age of cardiac problems means more people required to have ACLS certification to care for them. However, the number of people who actually have the skill, education, and determination to pass an old school ACLS course remains the same. The solution? Dumb down the skill set.

Rid, Medic, for guys like you and me, the thought of walking into a cardiac scenario half cocked is horrifying. The though of watching someone succumb because our skills and knowledge are not what they could have been is absolutely horrifying to us. But guess what? We're the exception, not the rule anymore. People don't want to go to ACLS class so they can come out and be confident of themselves and their skills, they want to go so they can get their card so they can work and make money.

[Just Plain Ruff]

I was a regional faculty for AHS, and I felt the same way. Watered down. We gave students more than 2 chances to pass.

During the megacode I always told the strongest student in the group who always seemed to be the lead sheep while the other three or four students followed like lost sheep that he had to go to the other room to get a piece of equipment and I would tell him when he found it. He may have never found the piece of equipment.

I can't tell you how many times I had a crying student, male and female both, give me a sob story that they were gonna get fired if they didn't pass. Some times I didn't pass them and told them to come back after they had read the material which was glaringly evident that they had not read prior to class.

Open book tests - pre and post tests

ACLS Jeopardy

Teams of 4

They could use the algorythms to run the code.

I always liked to give them a rhythm that made them think.

I felt badly that we passed so many students who obviously didn't have a clue.

There were some that I wouldn't want to work on my dog let alone a relative. If they didn't know the material and couldn't even give me basic epi and atropine doses without haviing to look at the book or cheat sheets those people did not pass.

It was my reputation and my faculty credentials that were on the line if I passed someone who didn't know the material. If they could prove to me that they could learn the material I'd work with them but I do know of one instructor who was sued by a patients family because he passed someone who should not have been passed. I do not know the outcome of that suit though.

[Spock]

I've been an ACLS instructor for 17 years and I have to agree with everybody. AHA was worried about getting sued because people might not pass the class and lose their jobs. Never mind that they just didn't study or read the book. I do think pretests can help if used properly. It gives the student motivation to study if they have to submit the pretest before the class and pass it.

Live long and prosper.

Spock

[strippel]

As an EMT, I had read the book, asked questions, and followed scenarios from my paramedic partners. In years past, they had talked about stories "conquering" the Megacode. They were damn proud to pass, because the code was not "by the book", or made easy in any way.

I now have ACLS, as part of paramedic school. I too wondered about the over-acted and dramatized video we watched more than once. The written test was way too easy. Luckily we had to take the old and new written tests.

Does the attractive recorder with the clipboard and lab coat ever arrive on anyones scene, keep track of your timeline, and then ask about considering the H's and T's? And what was up with that guy's eyebrows?

[firefighter523]

"The thought of watching someone succumb because our skills and knowledge are not what they could have been is

absolutely horrifying to us. "

You people are all off of your rockers!!!!!!!

Do all, ya'll know the chances of surviving a code????

Answer: 2% !!!!

Deflate your heads a little, and realize that we are just tools. If you are going to live, it will not be up to us!!!! We are not doctors, and are FAR lacking the information that they know!!!

Be humble, do your best, and quit talking SH#T!!!

Renagade Paramedic

[firefighter523]

"We gave students more than 2 chances to pass.

You are a student yourself!!!

[Ridryder 911]

Spoken, like truly from someone whom does not know emergency medicine. Yes, codes are futile, but that is not what ACLS is all about. Looking at your described age, I know that you were not around when having the knowledge and education of treating cardiac emergencies from having ACLS, so I don't expect much. I am sure that you were never tested in ACLS for central lines, oxyhemoglobin curve, surgical airways, and yes several cardiac arrhythmias more than the usual seven major dysrhythmias. Yes, this was the usual ACLS course for all partcipants.

No, I am not a physician but I am educated enough to know, that I do have as much education in cardiac resuscitation measures as a physician. I have taught such at both of our local medical schools (D.O. & M.D.). As well, as have knowledge in emergency cardiac and clinical experience care that physicians do ask my opinion. (p.s. FYI; resuscitation measures are more successful in EMS than the in-hospital phase, might want to check facts before spouting off numbers) So speak for yourself; just because you may feel that you are not qualified or educated enough (or as some of us call that trained :wink: ), that is your problem. This type of attitude and mind set is why we had to "water it down, with pretty pictures & mindless DVD's" so to quote you...." quit talking SH#T!"...

R/r 911

[AZCEP]

The point of ACLS is not to restore the dead, it is to prevent it from occurring in the first place. The chances of surviving a prehospital code is <1% if it is unwitnessed. The chances of surviving a witnessed arrest in the presence of an EDUCATED ACLS provider is on the order of 15-20%. Add a patient that you can prevent from arresting in the first place, and it will increase even more.

Nice that you've decided to quote numbers in your attempted southern twang. It does nothing for the impression you present. There was a time that ACLS meant something. Rid is absolutely correct when he mentions that you probably never had the opportunity to be tested thoroughly on what you think you might know.

Were you to look a bit deeper than MD/DO titles, you would quickly realize that every paramedic response unit has the same ability to manage a cardiac arrest that anyone in a hospital does. Now before you pull some obscure cardiology suite procedure out, realize that those "special skills" do not have a place in an ACLS guideline resuscitation.

Now might be a good time to return to the engine company and leave the resuscitations to those that understand what they are.