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A kinder, gentler ACLS


mrmeaner

Do you think ACLS training is improving as time goes on?  

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  1. 1.

    • Yes
      2
    • No
      11


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I just took the ACLS class on the 19th. There was less emphasis on knowing your $#!+ and more emphasis on communicating effectively and correcting each other appropriately. Anyone else experience this or did I end up with the Brady Bunch version? I understand that throughout the course of AHA's existence the training styles have changed, but this seemed a little extreme.

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Yeah, we've discussed the decline of the ACLS programme here before. You're right. It's all about teamwork now, and not individual, critical decision making. Possibly a good approach for physicians and CCRNs who are renewing for the umpteenth time, but certainly not for most people, and certainly not as an initial course.

This is more of that feel-good crap that they did to CPR. You know, don't worry about proper hand position anymore, just plop down in the centre of the chest somewhere. Same thing with ACLS. If you screw up, hey no problem, just ask another team member. It's not even a test anymore. It's just a "final exercise." No losers. Everybody is a winner. Except for the patient.

You will still find locations teaching a real ACLS course, complete with in-depth cardiology and pharmacology lectures and one-on-one megacode. I see them in hospitals, run by physicians still. But I long ago learned to never get my recerts or continuing ed from EMS organisations if I can possibly avoid it. The majority of them are into the lowest common denominator school of education, hoping to get you out of class a few hours early with your shiny new card, but no new knowledge.

I don't even want to talk about it anymore. It's too depressing. But I'm sure Rid will have something to add.

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This is more of that feel-good crap that they did to CPR. You know, don't worry about proper hand position anymore, just plop down in the centre of the chest somewhere. Same thing with ACLS. If you screw up, hey no problem, just ask another team member. It's not even a test anymore. It's just a "final exercise." No losers. Everybody is a winner. Except for the patient.

Not the way I saw it. We spent a God awful amount of time on CPR, and the focus of the class was team related, but you had better know the ACLS material before class. I can't remember if we even touched on it before practicing and testing.

We had to run through dynamic cardiology with the team, but if anyone was seen coaching you, it was considered a fail. And yeah, I caused on of my buddies to fail, so I know they weren't kidding. (Each person got two attempts)

At the end of the day...a pretty long day...I think only two or three of us got to leave. I heard later that the others were kept another four hours for remediation and retesting.

I can't say how it compares to the way it used to be (all the nurses failed at least the first time through) but I found that I didn't really need a review on CPR, I liked the concepts of teamwork and have seen them being applied in the field, But am pretty dang glad I knew my ACLS going in...

Dwayne

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Good deal. That's how the better classes have always been run, and will continue to be. But the new "official" style of the AHA is to ASSume that you already know everything in the book, quickly gloss over the algorithm for each dysrhythmia, and then do an informal, group participation megacode-lite scenario and leave. Of course, the vast majority of the students are perfectly happy with that. In fact, a great many people would gladly just pay for their entire paramedic diploma and leave the same day, if they could. In all my years of teaching, I can count the number of students who complained about the course being too easy or ending too early on one hand. But everybody complains if it's too difficult, or if you actually make them stay the full scheduled class time. So again, what we see is most instructors catering to the lowest common denominator, and the students love them for it. And, of course, they still get paid the same and get to go home earlier themselves.

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Yeah, I hear ya.

It seems to me that that is pretty much what everyone expected going in. There were some majorly pissed of people staying at the end of the day!

Maybe the difference was that ours what taught by an M.D. She is funny, and sweet...an amazing teacher! But it's in your best interest to remember that she's a teacher first...Cause Homey don't play no "Take your cert so I can go home early" games...

And that "give it to me easy" attitude doesn't seem to be only EMS...It seemd to be pervasive throughout by entire college experience. In any given class (Usually 15-30 people) you could count on 3-5 people that wanted to attack the material...really digest it. The rest were irritated if the class had a maximum number of days you could miss without being dropped...Pretty sad.

Dwayne

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I can agree with the simplification of CPR, since it is intended to result in more people being willing to do "something" when it is needed. Previous incarnations tended to intimidate the lay public with detail where the current seems to encourage action.

For ACLS, I HATE the way it is being taught now. No stress, no critical thinking, no knowledge of anything beyond the magical algorithm is utter garbage. This is an advanced course in name only. The target audience is healthcare professionals that are responsible for patients that just might need them to know something. This is not a time for kinder and gentler.

I do agree with expecting the participants to come to class knowing the information. The instructors should only be expanding on what is readily available to them. Our job should be refining the content to help with the critical thinking. Instead, we are introducing the concepts.

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We did ACLS megacode individual testing style. No one was allowed to help you. The wrong drug, dosage, use of electricity and doseage were all critical fails, as were doing anything that could potentially harm the patient, yourself or your team. It was a must pass for our paramedic course too. Anyone that failed was out. It was an intense week and I can't believe that others have watered it down. I was very proud of myself when I passed.

PS.. the testing took a week. Our cardiology stuff was about 9 weeks and ACLS specific was 50 hours.

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AHA ACLS no longer has any credibility. Rather, they have placed their attention into making separate classes for ACLS and placing their intent in pacifying participants in lieu of assuring that candidates truly understood ACLS procedures and emergency cardiac care.

Should people fail such type of courses alike the older version or style of ACLS? YES! Believe it or not, not all participants are smart enough, or prepared to pass such courses. Not all people can perform emergency cardiac care, which is okay by eliminating them. Emergency cardiac care is very serious business and should be performed by those that are actually informed, educated and tactfully skilled in providing such care.

I do wish NREMT would eliminate AHA ACLS requirement for Paramedic level. It is a waste of time and has no value to it any more. It is a shame that no other organization has attempted to challenge AHA and develop a true program similar to the older ACLS programs, where one had successfully passed, one could be assured that they were aware of emergency cardiac care. Definitely not the way it is by today standards.

R/r 911

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Took my first ACLS class in 1982. Tested by ED physicians that you were going to have to call for orders. If you didn't know the information all the way down to mixing a drug and knowing the concentration, dosage and drip rate, you failed. Forget to check a pulse after defib....you failed. Not know the dosage limits and side effects for calcium...failed. To pass the course then you had to pretty much be able to run a mega-code in your sleep. Now you just show up and learn how to provide positive feedback. I have no problem with making CPR easier to learn (research will probably show that pumping is all you need anyway) because we need as many people as possible initiating it but ACLS should something that an attendee should know completely. Just my two cents.

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