Keep up ACLS?

[daisyausoleil]

I got my ACLS certification in school and have renewed it once already and it’s going to be due again in November. I’m working in urgent care and don’t really anticipate switching to an ER or inpatient setting anytime soon (though you never know what can happen). ACLS isn’t required for my current job so they don’t cover the costs. I’m wondering if it’s worth the day and $120 or so to recert. Is it harder to get it back if you let it lapse? Trying to figure out if it’s worth my time and money!

Thanks

[beattie228]

I'm always of the mindset of keep all of your credentials up to date because you never know if you'll need them in the future. If anything, it counts as Cat 1 CME so it's still fruitful for you.

[UGoLong]

I’d keep it up. Required or not. One of our PA students had to help work a code in an urgent care on her rotation (just her and her precepting PA.)

You never know when you might put it to good use.


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[EMEDPA]

keep it. it is easy cat 1 cme and you may need it someday if you want to switch jobs. most UC positions I know of require it. If you let it lapse you have to take the full 2 day course, instead of the 1 day refresher. Also, working with patients who may mistriage themselves to UC when they should be at the ER, you could potentially open yourself to liability by not having it. A lawyer would eat you alive if you treated someone with chest pain who had a bad outcome later, whether or not it was your fault.

Lawyer: Do you know of any coursework that covers emergency situations and the most up to date treatment of heart attacks?

You: yes, the ACLS class

Lawyer: Do you have a curent ACLS certification?

You: No

Lawyer: Do patients having heart attacks ever go to urgent care centers?

You: yes

Lawyer: So you know people with heart attacks could come to your facility and intentionally avoided taking a simple course that lasts 8 hours that could have saved this patient's life. is that why you told this 34 yr old mother of 5 who volunteers at church and works at a soup kitchen that her chest pain was probably a muscle strain? Did you not know the new algorithm taught in acls for the evaluation of chest pain? Is this why you didn't give her aspirin? Is this why she called 911 10 min after leaving your clinic and was found dead by paramedics on their arrival? autopsy showed a massive MI.  ladies and gentleman of the jury I submit that this was gross negligence not in kline with the standard of care, etc

Verdict for the plaintiff for your savings, you house, your car, your future.....

if you worked in derm I would say it is ok to let it go, but not in UC, which is really just ER-lite

[surgblumm]

I had my first ACLS four decades ago and have re-taken the certification every two years since. I did five years in Urgent Care when I hit sixty as it was less chaotic than /emergency medicine and had at least 8 occasions to use my ACLS basically by myself with an NA until the FD ambulance came.

[EMEDPA]

8 minutes ago, surgblumm said:

I had my first ACLS four decades ago and have re-taken the certification every two years since. I did five years in Urgent Care when I hit sixty as it was less chaotic than /emergency medicine and had at least 8 occasions to use my ACLS basically by myself with an NA until the FD ambulance came.

yup, UC is em-lite. I have intubated, cardioverted, delivered babies, etc at UCs

[sas5814]

well...I'll take a differing point of view. Our UC doesn't have any ACLS meds or anything beyond an automatic defibrillator so I let my ACLS go years ago. In 6 clinics we had one code in 4 years.

Now people do walk in with any number of things that don't belong here from stab wounds to chest pain. We eval, stabilize as best we can and transfer.

[EMEDPA]

39 minutes ago, sas5814 said:

well...I'll take a differing point of view. Our UC doesn't have any ACLS meds or anything beyond an automatic defibrillator so I let my ACLS go years ago. In 6 clinics we had one code in 4 years.

Now people do walk in with any number of things that don't belong here from stab wounds to chest pain. We eval, stabilize as best we can and transfer.

Scott- if you were on that one code and it went badly see my post above. It is the standard of care....

[sas5814]

I take your point but if there are no ACLS meds what would being ACLS certified bring to the table? Without the tools the certification doesn't add much to the mix. You are still doing BLS.

My wife has a favorite expression.... pick a side and get on it. The powers that be have decided to remove all the ACLS tools from the urgent care clinics so requiring everyone to be certified went away about 18 months ago. For the longest time they required ACLS and ATLS but evaluation of the numbers didn't justify the time and expense.

Beyond that it is a personal choice and if I thought I might be looking for work somewhere that it would be required or valuable I probably would have kept it up.

[mgriffiths]

43 minutes ago, sas5814 said:

I take your point but if there are no ACLS meds what would being ACLS certified bring to the table? Without the tools the certification doesn't add much to the mix. You are still doing BLS.

 

53 minutes ago, EMEDPA said:

Scott- if you were on that one code and it went badly see my post above. It is the standard of care....

This is exactly why my FP clinic got rid of ACLS meds.  With or without ACLS - nobody in our clinic has been part of running a code for many years.  It is a bit different being FP and not an UC or ED, but the administration decided it was better from a legal perspective to not even have the capability of doing a code properly than have the capability and do it wrong.  They figured if we don't have the meds then they can't sue.  Yes we have a defibrillator and nitro, but that's it - and everyone is required to have BLS/CPR.

I'm not sure I like the idea of making a decision in that manner, but definitely don't feel equipped to perform a code and my ACLS is still valid - but almost due for renew.

[surgblumm]

If a Clinic holds itself out to be an Urgent Care Clinic then the community is going to expect Urgent Care. Did the owners ever hear about the Golden Hour of Trauma which is taught at every ATLS program? Your community is losing precious time waiting for you to triage them or stabilize them as nothing replaces a chest tube, the proper medications, a rapid blood transfusion, an appropriate surgical clamp. This clinic by all rights is slightly different then Minute Clinic.

[sas5814]

Bob I have worked in many urgent care clinics that offer varying degrees of services from the simple to the fairly complex. While I take your point thinking a surgical clamp, chest tube, or blood transfusion in an urgent care is just outdated thinking..... Nobody and I mean nobody in the urgent care business in this state offers that kind of service. What you are describing is an emergency room.

[surgblumm]

No question SAS, you are correct and I did not mean to lead anyone into thinking this is something that should be done or eqiipment that is needed in an UCC, but on the contrary, only in an ER. My premise is that this clinic should not hold themselves out to be able to care for these types of emergencies. This is a strongly debate argument concerning the definition of urgent care and the ignorance of the public in coming to an UCC instead of dialing 911 and going to an ER. If you are rural, than it's the best care that can be given and you probably need a helicopter evacuation. Sorry if I was not clear. My wife says that WHEN I SPEAK I SEEM TO HAVE A SUPPOSITION THAT I HAVE BEEN CLEAR TO EVERYONE. Indeed, I do not.

[sas5814]

LOL! It is an ongoing issue. Every day we send people out by EMS because they don't understand the difference between UC and ER. My personal record is 7 in 10 hours all with chest pain.

Sorry if I snapped....

[Cideous]

23 hours ago, sas5814 said:

I take your point but if there are no ACLS meds what would being ACLS certified bring to the table? Without the tools the certification doesn't add much to the mix. You are still doing BLS.

My wife has a favorite expression.... pick a side and get on it. The powers that be have decided to remove all the ACLS tools from the urgent care clinics so requiring everyone to be certified went away about 18 months ago. For the longest time they required ACLS and ATLS but evaluation of the numbers didn't justify the time and expense.

Beyond that it is a personal choice and if I thought I might be looking for work somewhere that it would be required or valuable I probably would have kept it up.

 

 

Completely agree here.

And I LOVE that saying....pick a side and get on it.

The last urgent care I was in that had a real crash cart was 15 years ago and they got rid of it after 6 months.  If it is there you are expected to use it.  If all you have is an AED, some 02 and maybe ASA and nitro, that is all you can be expected to use.  None of which requires ACLS.  

I have shocked people (1 actually) back to life from Vfib in an Urgent Care with an AED so it does happen but without the tools to run a full code, ACLS is not helpful.  Also EMS in my area is freakishly fast.

My take...if your company requires ACLS then get it.  If not and you plan to be there awhile and not do ED work, then stick with BLS.

Edited August 8, 2018 by Cideous

[classof2018]

Text Peter

[dfw6er]

As said many times above....take it.  In addition, present the receipt to your accountant for use as a deduction.  Tomorrow I will do the 1 day renewal....it will be, I believe, the 11th time I've taken it.