Those of you who follow the Paramedicine 101 Facebook fan page may have noticed a discussion, after this post was shared on the wall. A follower mentioned the AHA Learn: Rapid STEMI ID course, and how it could be a solution. Myself, and Tom B then casually shared some choice opinions about video-based AHA courses. I recently received an email from the commenter, who happens to be affiliated with the AHA. He humbly asked if he could call me regarding my ideas. I suggested a conference call with Tom, and he suggested a conference call with the people whom make decisions at AHA. If we do get them to take interest, I would like to be able to provide a lot of insight. I have many ideas, but would like to solicit some more from our faithful readers.
How do you feel AHA courses could improve?
- ACLS
- CPR
- PALS
- Rapid STEMI ID
Please provide any suggestions. This is our chance to make a difference. RM, don't hold back.
Maybe they could put some medical content back into the medical courses. I know that the AHA is all about good CPR and early electricity, but that shouldn't be the main emphasis of an ACLS course.
ReplyDeleteOh, and even more importantly, give some discretion back to the instructors instead of making them well animated CPR mannequins.
The Learn STEMI Course seemed to do a good job at identifying "home run" STEMIs. I would have liked more subtle STEMIs and mimics. The online format was good though. Maybe an interactive CD-ROM or DVD so you don't need internet access to do it. Maybe add a more advanced follow-up course.
ReplyDeleteI've only done the ACLS & PALS refreshers over the past few years, so I don't know how the initial courses are now. Video driven courses allow an organization to make sure everybody gets the same information, but that obviously doesn't translate to real life (prehospital vs ED vs floor of a hospital & what we need to know).
It will be interesting to see what they change for 2011.
Thanks for the input so far. You guys make some good points.
ReplyDeleteTOTWTYTR, I think that there should be stricter guidelines to being an instructor and required continuing education. This is one of the suggestions that I brought up.
Geoff, you can actually see what they are going to change if you look at their research worksheets. www.americanheart.org/ilcor
Tom has made a few good points that it is more a paramedic curriculum problem, and EMS agency problem than it is AHA's problem. I completely agree.
Geoff -
ReplyDeleteI agree with this comment:
"Video driven courses allow an organization to make sure everybody gets the same information, but that obviously doesn't translate to real life (prehospital vs ED vs floor of a hospital & what we need to know)."
On the other hand, one has to wonder why a floor nurse is required to possess an ACLS card if s/he isn't expected to master the content of the ACLS textbook.
Is it just so the hospital can say the nurses are "Advanced Cardiac Life Support certified"? What's wrong with BLS for Healthcare Provider with AED? It's a great course.
The AHA shouldn't pass out ACLS cards to people who aren't particularly good at cardiac rhythm analysis, can't read 12-lead ECGs, have no idea how to operate a transcutaneous pacer (let alone verify capture), and can't make nuanced decisions about the various treatment modalities.
Would you give a drivers license to someone who can't drive a car?
ACLS should be a 40-hour course at a minimum (80-hours would be better for initial certification) and possessing an ACLS card should mean that you've mastered the content of the ACLS textbook, within your scope of practice (e.g., a paramedic isn't expected to insert central line catheters).
The standard excuse is that ACLS cards are given to people who might need to function as part of an ACLS team. Well, that's ridiculous. There's no reason that someone certified to the BLS for Healthcare Provider level couldn't function as part of an ACLS team.
What we're seeing now is top performing EMS systems abandoning the AHA's ACLS and PALS certifications in favor of home-grown courses that are based on their actual (evidence-based) protocols.
In my opinion, it's time better spent.
Tom