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Posted: 2/12/2017 10:48:05 PM EDT
Seems like the current trend is that it's a pay your money and get a card. I was an instructor in the early 90s right before the change to pass everyone started.
Example. ACLS initial course was 2 days. Good solid lectures and good hands on experience at various stations. Then testing on each station. Maybe it was overkill. And if you wanted to be an instructor you had to tell them at the beginning so they could pimp you extra hard to assess for "instructor potential". ? So, my advice for those seeking training in these areas? Take your initial course with paramedic trainers. Preferably, with paramedic students. The paramedics still take ACLS/PALS etc. very seriously. The paramedic students get pimped brutally and ran through the ringer. That is good. For your renewal courses? If you use ACLS/PALS/BCLS routinely continue to use quality instructors and put in the time. If you rarely if ever use it? I guess pay one of the scam instructors to give you a card. I catch grief at work as I take a full day to renew instead of paying one of the scam instructors in our dept. |
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FL, USA
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Posted: 2/12/2017 10:56:50 PM EDT
[#1]
No argument here. The line the instructors liked to use was that there would always be help around if there was a code so why stress too much in class...which is fine unless everyone at the code had the same class.
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Posted: 2/12/2017 11:12:30 PM EDT
[#2]
That's what I do full time for our hospital system. You won't get any breaks with me. Sadly the courses have gotten much easier than they were when I first went through in '94. Now the written tests are "open resource" and your team can help on the megacodes if you get stuck.
ACLS/PALS New Providers are still 14-15 hours by the book. I might be able to trim that down a little if they are a well prepared group. Renewals take 6-8 depending on the group. |
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Posted: 2/12/2017 11:14:25 PM EDT
[#3]
I took the new PALS a couple of weeks ago at my facility. It was open book and open note. Holy shit, and people still fail.
On top of that it seems ACLS and PALS have gotten easier every couple of years..... |
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Posted: 2/12/2017 11:16:58 PM EDT
[#4]
Quote HistoryOriginally Posted By HELOBRAVO:
I took the new PALS a couple of weeks ago at my facility. It was open book and open note. Holy shit, and people still fail. On top of that it seems ACLS and PALS have gotten easier every couple of years..... They still fail, and it takes them two hours to take the test because they want to look up every answer. |
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Posted: 2/13/2017 1:43:45 AM EDT
[Last Edit: AGW]
[#5]
FWIW, I don't think ACLS is easier today because it's been dumbed down for the sake of dumber participants. I just think it gets distilled further down every 5 years to the things that have actually been proven to work (or removes things that have been shown to cause harm or no net benefit). The fact is it's just not that complicated to code someone the majority of the time. A lot of the foundations for ACLS was based on consensus agreements and expert opinion, and as big trials have tested the recommendations over time, things have changed accordingly.
It's become mostly a cookbook for physicians in a clinic setting or unsharpened nurses on the wards to uniformly apply before more advanced support can be provided. I think that's where it has its place and we should strive to cater to this population as professional resuscitationists. And of course, once the patient is in our care, we can eschew the cookbook protocol because we are more chef-like. |
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Posted: 2/13/2017 10:01:41 PM EDT
[#6]
It's true that we do dump the cookbook and use our own assessment and intervention. Example--knowing the patient just came from the OR and lost 1500 of blood and has had low urine output, of course you will go to volume right away.
I do like that ACLS pounds it into people to perform cpr and bag patient along with reassessment and trying other interventions. |
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Posted: 2/13/2017 10:15:45 PM EDT
[#7]
Spray and pray.
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Posted: 2/18/2017 10:14:10 PM EDT
[#8]
That's surprising. I usually take it from the local helicopter medical service (Air Evac) and they don't make it easy. If I wasted time and money on a gimme course and didn't feel challenged I'd be pretty irritated.
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OH, USA
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Posted: 2/18/2017 10:40:17 PM EDT
[#9]
Local healthcare system recently switched to a quarterly renewal of BLS/ACLS which is great IMO. Hopefully we see improved response times.
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Posted: 2/18/2017 10:56:27 PM EDT
[#10]
Acls is just another sacred cow that isn't the golden idol it's made out to be.
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Posted: 2/18/2017 11:20:27 PM EDT
[#11]
If your department's instructors are pencil whipping your co-workers, you might want to consider passing that up to the regional coordinator. Recerts are required to spend X hours training, have Y instructors per Z students, etc. A regional coordinator can make heads roll since it's their job to make sure people aren't doing pay-to-win. If it bothers you that much.
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Posted: 2/19/2017 12:41:04 PM EDT
[#12]
Quote HistoryOriginally Posted By mr_kong:
Local healthcare system recently switched to a quarterly renewal of BLS/ACLS which is great IMO. Hopefully we see improved response times. Is that RQI? I think the local VA is switching to that system this year. I think my staff would kill me if I told them they had to come do BLS somewhere every quarter to maintain their certs. I fully support the intent, but most people just view it as a required piece of paper so they can keep working. |
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Posted: 2/19/2017 12:42:28 PM EDT
[#13]
Quote HistoryOriginally Posted By sircam671:
If your department's instructors are pencil whipping your co-workers, you might want to consider passing that up to the regional coordinator. Recerts are required to spend X hours training, have Y instructors per Z students, etc. A regional coordinator can make heads roll since it's their job to make sure people aren't doing pay-to-win. If it bothers you that much. Sadly that group pretty much has their hands tied. I think the AHA is more concerned about losing money than coming down hard on poorly run TCs. I reported a group that was offering 30 minute ACLS/PALS courses two years ago. They are still running those classes. |
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Posted: 2/22/2017 11:20:41 PM EDT
[#14]
Originally Posted By EvanWilliams:
If you rarely if ever use it? I guess pay one of the scam instructors to give you a card. During residency the powers that be decided all residents, ALL OF THEM, needed to be ACLS certified. I tried to argue that this represented a conflict of interest for the pathology residents, but since none of the other path residents liked autopsies I got no traction. 
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Posted: 2/22/2017 11:26:30 PM EDT
[#15]
Quote HistoryOriginally Posted By Polupharmakos:
During residency the powers that be decided all residents, ALL OF THEM, needed to be ACLS certified. I tried to argue that this represented a conflict of interest for the pathology residents, but since none of the other path residents liked autopsies I got no traction. LOL!!!!!! A path resident once found himself near a code. I was intubating the patient. I saw the guy later and said what the hell were you doing? He said "drumming up business!!' That was years ago, I still see the guy around the hospital. He is an attending now. |
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Posted: 2/23/2017 1:11:50 AM EDT
[#16]
Quote HistoryOriginally Posted By Polupharmakos:
During residency the powers that be decided all residents, ALL OF THEM, needed to be ACLS certified. I tried to argue that this represented a conflict of interest for the pathology residents, but since none of the other path residents liked autopsies I got no traction. Blanket policies like that are dumb. I usually see a couple of the path residents coming through ACLS/PALS as they are nearing the end of their program and getting ready to embark on a fellowship. They really struggle. Had one stop by the office today that went IM to Path and is now going to be one of our IM hospitalists. |
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Posted: 7/28/2017 5:40:39 PM EDT
[Last Edit: bestiller]
[#17]
I've practiced anesthesia for the last 17 years and couldn't tell you the last time I actually "took" a BLS/ACLS/PALS/ test. It really used to be a resume builder in 90s but a lot of instructors started realizing how much more $ was in just "selling" the cards. Just my .02
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Posted: 7/29/2017 12:24:26 AM EDT
[#18]
Quote HistoryOriginally Posted By bestiller:
I've practiced anesthesia for the last 17 years and couldn't tell you the last time I actually "took" a BLS/ACLS/PALS/ test. It really used to be a resume builder in 90s but a lot of instructors started realizing how much more $ was in just "selling" the cards. Just my .02 |
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Posted: 7/29/2017 10:04:57 PM EDT
[Last Edit: EvanWilliams]
[#19]
Quote HistoryOriginally Posted By bestiller:
I've practiced anesthesia for the last 17 years and couldn't tell you the last time I actually "took" a BLS/ACLS/PALS/ test. It really used to be a resume builder in 90s but a lot of instructors started realizing how much more $ was in just "selling" the cards. Just my .02 Word came down to change the culture I stopped being an instructor. We smoked people and double so in the instructor course |
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Posted: 7/29/2017 10:29:24 PM EDT
[#20]
TLDR;
ACLS/PALS here. It's gotten simpler every time they change it. I'm not complaining. |
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OH, USA
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Posted: 7/29/2017 10:47:21 PM EDT
[#21]
Yep. AHA's RQI program. It's a pain in the ass, but I can get paid to do it. Doesn't bother me.
I don't think it'll make much of an impact in the ICUs since most are on top of their game. On the floor is a different story, especially when everyone is new and you're the only one with ACLS |
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Posted: 7/30/2017 10:50:24 PM EDT
[#22]
Quote HistoryOriginally Posted By AGW:
FWIW, I don't think ACLS is easier today because it's been dumbed down for the sake of dumber participants. I just think it gets distilled further down every 5 years to the things that have actually been proven to work (or removes things that have been shown to cause harm or no net benefit). The fact is it's just not that complicated to code someone the majority of the time. |
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Posted: 10/22/2018 9:58:46 PM EDT
[#23]
Quote HistoryOriginally Posted By medicmandan:
A lot of truth to that. I know of a local place that will give you all three in one hour for $500. Quote HistoryOriginally Posted By medicmandan:
Originally Posted By bestiller:
I've practiced anesthesia for the last 17 years and couldn't tell you the last time I actually "took" a BLS/ACLS/PALS/ test. It really used to be a resume builder in 90s but a lot of instructors started realizing how much more $ was in just "selling" the cards. Just my .02 
 WHAT WEBSITE THOUGH - It's Always Sunny in Philadelphia |
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AZ, USA
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Posted: 10/28/2018 8:43:33 AM EDT
[#24]
Quote HistoryOriginally Posted By Nate19: This right here.
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Posted: 10/28/2018 10:47:57 AM EDT
[Last Edit: medicmandan]
[#25]
Quote HistoryOriginally Posted By BillyDoubleU: I always joke that before long ACLS will be nothing but compressions with an advanced airway. Shockable rhythms when apparent.
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Posted: 10/28/2018 3:42:23 PM EDT
[Last Edit: nick89302]
[#26]
Quote HistoryOriginally Posted By medicmandan:
I start out most of my classes with a joke along those lines: Once we boil the evidence based science down we're left with compressions and defib: BLS. Anyone want to give up on ACLS and go for pancakes? Quote HistoryOriginally Posted By medicmandan:
Originally Posted By BillyDoubleU: I always joke that before long ACLS will be nothing but compressions with an advanced airway. Shockable rhythms when apparent. |
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Posted: 10/28/2018 4:03:46 PM EDT
[#27]
Quote HistoryOriginally Posted By nick89302: It's only funny because it's true. When you get off the algorithm, that's the "advanced" part. They need to teach a BLS algorithm and and ALS algorithm for the HCP and refocus ACLS on addressing the unusual cases. 
The ACLS EP course really needs to get more attention. |
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Posted: 1/27/2020 9:21:58 AM EDT
[#28]
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