ACLS & PALS Program Administrator Training

1. ACLS & PALS Program Administrator Training SFC Stephen Dohn HM2 (SW) David Baumbach TSgt Tuyen Tran

2. MTN STAFF - Lt Col Linda Hogan, NC, Director MTN 301-295-0964 - SMSgt Sandra Scott, Superintendant/ATLS 301-295-1468 - SFC Stephen Dohn, NCOIC/ACLS 301-295-1476 - HM1 Joe Monsivais, Outgoing Navy BLS 301-295-1479 - TSgt Tuyen Tran, Outgoing PALS 301-295-1473 - HM1 Brian Politi, Army BLS 301-295-1478 - TSgt Trina Myers, Incoming Navy BLS 301-295-1479 - HM1(SW/AW) Ruben Valenzuela Air Force BLS 301-295-1492 - SSgt Katina James, IT 301-295-1484 - HM2 (SW) David Baumbach, Incoming PALS 301-295-1473 - Ms. Ruth Sullivan, Program Assistant 301-295-0964

3. OVERVIEW • - PA Nomination • - PD Nomination • - Annual Reports/ Re-Affiliation • - Agenda’s • Post Course Reports (PCR) • Delinquency Policy • - Program Resources

4. PROGRAM ADMINISTRATOR NOMINATION - For PA nomination, send in the PA nomination form signed by PD. - Send within 10 days of personnel change (request at least 4-6 wks prior) - Must complete PA Orientation

5. PA Form

6. PROGRAM DIRECTOR NOMINATION • - PD nomination form • TSF nomination form • Do not sign the bottom block • - Curriculum vitae or Bio • - Copy of Instructor card/ TSF card • Copy of Core Instructor Course (CIC) • - Send within 4-6 weeks of personnel change

7. PD Checklist

8. PD Form

9. CORE INSTRUCTOR COURSE(CIC) - MTN Handbook 2-27 - All new BLS instructors are required to complete the AHA CIC before completing the instructor course. - Who needs the CIC: All instructors trained after 1 Oct 06 Are adding discipline Becoming TSF/PD National Faculty

10. Annual Checklist

11. Check Appropriate Program For Report Unit Name Unit Commander Phone # N/A for site code Your Unit Address APO/APE Current PD Info Your phone # Email Address Current PA Info Your phone # Email Address # of students estimated to train in next FY Check YES or NO For CME/CNE Type in Commanding Officers Name Signature / Date here

12. List of all courses/type you are planning to teach nextFY. EXAMPLES: ACLS Inst.- 15 DEC 2010 PALS Renewal -20 FEB 2011 PALS 2 Day Provider –15-16 MAR 2011 PALS Instructor-4 APR 2011 PEARS -13 AUG 2011

13. Date List all your current Instructors names. If Instructor is Deployed/TDY, Pease type it next to the name & note “I will send Financial Disclosure (FD) with next PCR”.

15. Unit Name here List Satellites if any. (Not your Command)

16. Must have last 8 classes taught including 1 Instructor course New Curriculum Vitae (CV) for current PD only

17. Year Here Unit Name Current total Cards on Hand Provider Cards Issued/Destroyed # Students first time trained # Students Re-trained # Instructor Cards Issued/Destroyed # New Instructors trained # Renewal Instructors TSF cards issued TSF cards destroyed Year here Projected # cards you will issue Typed PD & PA Names with signatures Dates here

18. Year here Unit Name Location Courses that you completed this FY___ Examples: YES or NO Was a PCR sent to MTN. (SEND WITH REPORT IF NO) PEARS 15 JUNE 2010 # First time students # Students Re-trained # Re-newal instructors(If applicable) ACLS –Instructor 16 JUNE 2010 # Students Trained in this course # Re-newal Instructors

19. Check One ACLS/PALS Date here Ensure that either box is checked Print/Type Instructor name here Instructor role in unit Instructor Signature Date here NOTE: Must be signed annually. One per Instructor if unit request CME/CNE/CEU.

20. - Reportsdue to the MTN NLT 30 September Date never changes - Packages need to be complete and accurate - If you can turn your packages in early please do so starting on 1 September - Packages submitted late; TS are at risk for being placed on hold & unauthorized to train

21. MTN Delinquency Policy - < 15 Days – PA and or PD is notified - 15-20 Senior Leadership is notified - 25-30 TS is placed in abeyance - 30-45 TS is terminated - Exceptions on case by case basis with prior coordination

22. AGENDAS EX: ACLS- Instructor Agenda PALS- Renewal Agenda PEARS Agenda NOTE: All agendas must meet MTN/AHA minimum time & course requirements (also found in Instructor Manual, Ch. 2 & at www.usuhs.mil/mtn ) Please fax your request to DSN 295-1717 OR COMM 301-295-1717. MTN main number: DSN 295-0964 or COMM 301-295-0964 NOTE: You must separate programs and submit one report per program. ( ACLS or PALS)

23. POST COURSE REPORTS(PCR) - PCR cover page - Course Grade Report - MTN Course Evaluation Form - FY approved agendas for courses taught - CE will not be authorized for PCR submitted late or incomplete

24. ACLS/PALS

25. Course conducted: EX- PALS – Provider 2 days Date of class Your unit name Course location: EX: 109 P St., LAFB, TX Dates start/ completed: EX: 2-3 Feb 2011 Total # of students enrolled # of students retrain Total # of cards issued Provider/ Instructor # of instructor renewal Lead instructor’s info and signature: EX: LT Joe Smith, Phone 222-222-2222 Email- jsmith@joo.com Program Administrator info Program Director & Administrator signatures Type names of all instructor , include leader instructor Professional Licensure: EX: MD, RN, EMT Instructor/TSF card Exp date: EX: Feb 2012 Enter What level: EX: PD, TSF or Instructor Renewing Instructor: Yes or No NOTE: At the end of all lists entry “ LAST ENTRY”

26. Course date Student Name: EX: Capt Joe Smith Professional Licensure: EX: MD, RN, EMT Date of BLS Exp: EX: Mar 2011 Core Tests: Annotate only C for completed Or U for unsuccessful Input grade: EX: 96% CPR-D Skills: Annotate only C for completed Or U for unsuccessful First time student Yes or No Annotate only C for completed Or U for unsuccessful Or IP for Instructor- Potential NOTE: At the end of all lists entry “ LAST ENTRY”

27. Course date Student Name: EX: Capt Joe Smith Professional Licensure: EX: MD, RN, EMT Date of BLS Exp: EX: Mar 2011 Megacode: Annotate only C for completed Or U for unsuccessful Input grade: EX: 96% CPR Skills: Annotate only C for completed Or U for unsuccessful First time student Yes or No Annotate only C for completed Or U for unsuccessful Or IP for Instructor- Potential NOTE: At the end of all lists entry “ LAST ENTRY”

28. Input lead instructor, unit name, date(s) of course Please average the # MTN only need Summary of the evaluation

31. Input lead instructor, unit name, date(s) of course Please average the # MTN only need Summary of the evaluation

34. INSTRUCTOR FOLDERS • Left Side • Teaching History • MTN CV for PD and TSF • Equipment training & disinfection memo • Any additional licensures & certificates • Financial Disclosures

35. INSTRUCTOR FOLDERS • Right Side • MTN TSF and PD appointment forms • Instructor Renewal Checklist • Instructor Monitoring Forms • Instructor Candidate Form • Copy of signed wallet card (front and back) • Core Instructor Course certificate

36. PROGRAM RESOURCES - Instructor/ Student Handbooks - Military Training Network Handbook - Military Training Network Website (www.usuhs.mil/mtn) - Military Training Network Program Managers - Admin Review Checklist

37. SUMMARY • - Program Administrator Nomination • - Program Director Nomination • Instructions on how properly fill out Re-Affiliation /Reports for ACLS/PALS • Delinquency Policy • - Agendas • PCR reports • Instructor Folders • - Program Resources

38. QUESTIONS SFC Stephen Dohn ACLS Program Manager HM2 (SW) David Baumbach PALS Program Manager TSgt Tuyen Tran PALS Program Manager