I was certified in 1994 to 1996 and then again from 1999 to 2001. The first time around there were not so many changes. But OMG at all the changes now. New CPR changes, new AED's seeing things out in the field that ALS providers can do, a sternum IO. I am so excited to get back into things but it is kind of hard comming from the streets from way back to having to go to the classroom sitting again. But I am having fun and love my instructor.