ACLS

[AZCEP]

ASHI ACLS and ASHI PALS are excellent accepted alternatives.

They are the same class without the depth of administrative requirements. They use the same ECC guidelines that AHA classes use without doing any of the work to achieve them.

"Excellent" may be a bit of an over-statement, since the faculty of a given program has more to do with the course utility than the administrative body you get your card from.

[northernmedic]

We have to pass ACLS as part of our ACP course but there is no requirement to maintain it. I find that most of the courses around here are heavily focussed on hospital based resuscitation rather than prehospital. That and the course is completely watered down. I almost laughed out loud when they told us in class not to stress because the exam was open book.

[Just Plain Ruff]

My favorite is ACLS Jeopardy. Whatever idiot or "educator" came up with that idea needs their head examined.

and open book test, what a way not to test their knowledge.

Again, ACLS, so easy a caveman can do it.

[Dustdevil]

I find that most of the courses around here are heavily focussed on hospital based resuscitation rather than prehospital.

Having worked both for the last thirty years, I can't see any significant difference between in-hospital and pre-hospital resuscitation that would need to be addressed. Other than the fact that a lot of EMS agencies carry a lot fewer medications to remember, what else is there?

[1EMT-P]

I recently attended an ACLS provider course and to be honest with you I was shocked at just how much content the AHA had left out. The AHA basically deleted the advanced airway and pharmacology sections of the book...

[Spock]

I agree about the ACLS text book. It used to contain alot more information than the current 8th grade reader. The dumbing down of ACLS?

Live long and proper.

Spock

[JakeEMTP]

I recently attended an ACLS provider course and to be honest with you I was shocked at just how much content the AHA had left out. The AHA basically deleted the advanced airway and pharmacology sections of the book...

I agree. Did you notice that the AHA suggests that an airway would be nice, but just keep doing compressions, not in the same words, but the implication was there. Also, the second line drug of preference ( according to the AHA ) is amiodarone instead of Lidocaine.

[Dustdevil]

There is another way to look at it. Is it possible that the curriculum and text changes are not so much a "dumbing down" of the course, but maybe a reflection of the changing purpose of the course?

In the early days, ACLS was developed as an actual teaching course that took general providers and trained them to handle ACLS care, based on the premise that they already had a medical foundation but lacked an ECC focus. But things have changed in the last thirty years. Physicians are now expected to all be exposed to, and proficient in ECC already, so ACLS has become less of a teaching course and more of a simple protocol review and validation of familiarity with current standards. With that in mind, it does make a certain amount of sense to adjust the curriculum accordingly. Properly educated medics, like physicians, should already know that foundational core of information too. They should not need an ACLS course to teach them anything. Consequently, it makes more sense to focus the course on a full two-days of reviewing protocols and relevant new science than to try and make it a crash course in ECC for the uneducated.

Let's face it. A mertit badge is all it is. I don't think it has lost it's meaning or purpose. It is still important to keep people current in their knowledge of current practices. But it's not an educational course, so there's no need in trying to make it into one.

That said, I do seriously disagree with what can only be described as a "dumbing down" of the examination process. I mean seriously, with the content being watered down to nothing more than a basic protocol review, the least they could do is make the examination process valid and meaningful.

[Spock]

Very good point Dust. It seems the students in the classes I teach are either very experienced and bored to tears or lacking in the necessary fundamental knowledge to get the most out of the class. Neither group is well served. I'm not sure what the answer is but what we have now is not up to the task. One good thing is the emphasis on evidence based medicine for the updates every 5 years although if evidence is lacking there are often more questions than answers.

Live long and prosper.

Spock

[chbare]

Dustdevil described the situation quite nicely. It seems that the AHA have changed their paradigm over the last several years. The emphasis of ACLS is not on teaching or educating people in cardiac pharmacology, advanced procedures, or advanced physiology. The AHA simply looks at research and current data and makes recommendations based on their interpretation of that data. ACLS is simply a course where clinicians can review the current recommendations and guidelines. If you take an AHA instructor course, you should be taught that ACLS is not a means of obtaining primary cardiac education.

It seems people have a misconception regarding the purpose of ACLS. Pharmacology is not emphasized, because in a code, medications do not appear to do much if anything. Obviously, you can argue one way or the other depending on how you spin the numbers; however, in the big picture, medications do not seem to do much. The current emphasis even at the level of ACLS is on good CPR and defibrillation. This is what the AHA thinks of the research, and this is what they emphasize. In addition, advanced physiology, 12 leads, and advanced procedures are not emphasized as well. You simply cannot teach a person this in a two day class and it would seem that AHA gutted most of that teaching and decided to stick with simply teaching the current AHA recommendations. Finally, the ACLS card is not a certification or license. The AHA is quite upfront and honest about that fact. I do not see the AHA pushing the ACLS requirements for employment. This seems to be employer based. Employers want a card to show everybody that their employees are competent providers in ACLS. Obviously, much education I needed to rectify this false belief.

While I understand the AHA stance, and it may seem like I am sticking up for the AHA, I simply see ACLS for what it is. Providers should be competent and well educated in the aspects of emergency cardiac care prior to attending ACLS. If people would come to realize this fact, and perhaps educate providers during that providers core program, I would bet that this whole watered down ACLS debate would be a thing of the past. Sorry guys, you cannot use ACLS as part of your cardiac educational component anymore.

Take care,

chbare.