Professional Documents
Culture Documents
F
ir
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t
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This card certifies that the above individual has successfully completed the objectives
and skills evaluations in accordance with the curriculum of the AHA Heartsaver First Aid
CPR AED Program. Optional completed modules are those NOT marked out:
Child CPR AED
Infant CPR
Written test
Issue Date
Recom
m
ended Renewal Date
H
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Training
TC
ID
#
C
enter N
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TC
TC
Info C
ity, State ZIP
Phone
C
ourse
Location
Instructor
Inst. ID
#
N
am
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H
olders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1815
Cont ent s
i
Preface ii
General Information 1
Security Features 1
Guidelines for Card Completion 2
Front of Card, 2006 and Later 2
Back of Card, 2006-2010 3
Back of Card, 2011 and Later 3
Duplication/Replacement of Lost Cards 3
Course Card Tip Sheets and Templates 3
Military Training Network 4
BLS HCP 6
BLS National Faculty 6
BLS Regional Faculty 6
BLS Training Center Faculty 7
BLS Instructor 7
BLS Healthcare Provider 8
Heartsaver 9
Heartsaver Instructor 9
Heartsaver Skills Evaluator 10
Heartsaver CPR AED 10
Heartsaver First Aid 11
Heartsaver First Aid CPR AED 12
Heartsaver Pediatric First Aid CPR AED 13
Heartsaver Pediatric First Aid 13
Heartsaver CPR AED in Schools 14
Heartsaver CPR in Schools 14
ACLS 15
ACLS National Faculty 15
ACLS Regional Faculty 15
ACLS Training Center Faculty 16
ACLS Instructor 16
ACLS Provider 17
ACLS EP 18
ACLS EP Training Center Faculty 18
ACLS EP Instructor 18
ACLS Experienced Provider 19
PALS 20
PALS National Faculty 20
PALS Regional Faculty 20
PALS Training Center Faculty 21
PALS Instructor 21
PALS Provider 22
PEARS 23
PEARS Instructor 23
PEARS Provider 23
Course Card Index 24
International 25
Spanish 25
Portuguese 25
Irish Heart Foundation 26
Council on Resuscitation of Southern Africa 26
Heart and Stroke Foundation of Canada 27
International Course Card Index 28
2013 American Heart Association
Pr ef ace
ii
Preface
The Emergency Cardiovascular Care Course Card Reference Guide is a quality control tool to be used
with American Heart Association (AHA) course cards. It is not a policy document. See the 2012
Emergency Cardiovascular Care Program Administration Manual: Guidelines for Program Administration
and Training (PAM), both US and international versions, for specifc criteria, guidelines, and policy
for issuing course cards. The PAMs are available on the AHA Instructor Network website at
www.ahainstructornetwork.org and are for Training Centers (TCs) and instructors.
AHA Emergency Cardiovascular Care (ECC) course cards are described throughout this Guide. This
Guide includes samples of available cards for each discipline. Quality Control Checkpoints aid the user by
providing the date the card was introduced, the date the card was withdrawn from use, and how long the
card is recognized.
Course cards are available only to authorized TCs with a confdential security code issued by AHA National
Center ECC Programs. Each student who successfully completes an AHA ECC credentialed course must be
issued the appropriate course card, which bears an AHA logo. The TC conducting the course is responsible
for card issuance and security through its instructors and Training Sites. Each TC must document how
it maintains card security and accountability. Duplicate course cards are managed by the TC issuing the
original card.
For clarifcation on issues addressed in this Guide or to verify the status of the TC that issued a card,
please contact the ECC Customer Support Center at 1-877-242-4277, option 4.
Gener al I nf or mat i on
General Information
This section describes cards issued for courses that use criteria and materials from the 2010 American Heart
Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. The 2010
cards include BLS Instructor and BLS Healthcare Provider, March 2011; Heartsaver
Instructor, Heartsaver
CPR AED, Heartsaver First Aid, and Heartsaver First Aid CPR AED, April 2011; ACLS Instructor and ACLS
Provider, May 2011; PALS Instructor and PALS Provider, October 2011; PEARS
Heartsaver Instructor
Heartsaver Instructors teach lifesaving CPR, AED, and frst aid courses for the nonmedical community.
Heartsaver Instructors are not required to have a medical background to teach. Instructor cards are available
exclusively to authorized TCs for issuance in accordance with AHA policy.
80-1205 R1/08
Training Center
Alignment
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 80-1205
Hear t saver I nst r uct or
This card certifies that the above individual has successfully
completed the objectives and skills evaluations in accordance
with the curriculum of the American Heart Association for the
Heartsaver Instructor Program.
Issue Date Expiration Date
PEEL
HERE
This card contains unique security features to protect against forgery.
90-1816 3/11
This card contains unique security features to protect against forgery.
PEEL
HERE
TC TC ID #
Alignment
TC TC
Address Phone
TC
City, State ZIP
Instructor
ID #
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1816
This card certifies that the above individual is an American Heart
Association Heartsaver Instructor.
Issue Date Expiration Date
Hear t saver
I nst r uct or
HEARTSAVER INSTRUCTOR HEARTSAVER INSTRUCTOR
Quality Control Checkpoints
Issue date beginning April 26, 2011
Valid until further notice
Expiration date 2 years from month of issue
This card supersedes cards 80-1205 and 80-1213
Associated Materials for Instructors
Heartsaver First Aid CPR AED Instructor Manual
Heartsaver Pediatric First Aid CPR AED Instructor Manual
Heartsaver First Aid, CPR AED, First Aid CPR AED, and
Pediatric First Aid CPR AED Student Workbooks
Quality Control Checkpoints
Issue date beginning May 2002
Valid through July 31, 2013
Not valid for issue after July 31, 2011
80-1205 3-card 80-1213 2-card self-mailer
90-1816 3-card
Quality Control Checkpoints
Issue date beginning spring 2009
Discontinued May 7, 2013
Not valid after August 30, 2013
Heartsaver Skills Evaluator
Alan Carrington, MD
Term: July 2009 June 2010
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Heartsaver Skills Evaluator
Alan Carrington, MD
Term: July 2009 June 2010
Heartsaver Skills Evaluator
Alan Carrington, MD
Term: July 2009 June 2010
John Doe
HEARTSAVER
Skills Evaluator
has completed the national cognitive and skills objectives of the
American Heart Association Heartsaver Skills Evaluator program.
Term: MMMM YYYYMMMM YYYY ID#: 1234567890
Authorizing Training Center: Heartland ECC Training, Dallas TX
TC ID: AAA1234 Phone: 214-706-1717
John Doe
HEARTSAVER
Skills Evaluator
has completed the national cognitive and skills objectives of the
American Heart Association Heartsaver Skills Evaluator program.
Term: MMMM YYYYMMMM YYYY ID#: 1234567890
Authorizing Training Center: Heartland ECC Training, Dallas TX
TC ID: AAA1234 Phone: 214-706-1717
HEARTSAVER
Skills Evaluator
John Doe
has completed the national cognitive and skills objectives of the
American Heart Association Heartsaver Skills Evaluator program.
Term: MMMM YYYYMMMM YYYY ID#: 1234567890
Authorizing Training Center: Heartland ECC Training, Dallas TX
TC ID: AAA1234 Phone: 214-706-1717
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80-1216 3-card
Heartsaver CPR AED
Heartsaver CPR AED is a course that teaches adult CPR and AED use, as well as how to relieve choking in an
adult. This course teaches skills with the AHAs research-proven practice-while-watching technique, which
allows instructors to observe the students, provide feedback, and guide the students learning of skills. Infant
and child modules are optional. Provider cards are available exclusively to authorized TCs for issuance in
accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning April 26, 2011
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes cards 80-1203 and 80-1211
Strike through modules NOT completed
Completed modules are unmarked and visible
Adult CPR AED must be taught if child CPR AED is taught
90-1813 3/11
PEEL
HERE
Hear t saver
CPR AED
This card certifies that the above individual has successfully completed the objectives
and skills evaluations in accordance with the curriculum of the AHA Heartsaver CPR AED
Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR Written test
Issue Date Recommended Renewal Date
HEART SAVER CPR AED
HEART SAVER CPR AED
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1813
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
90-1813 3-card 90-1810 2-card self-mailer
Hear t saver
10
Heartsaver Skills Evaluator
This card has been discontinued and is no longer available. It will not be valid after August 30, 2013. The roles
and responsibilities have been transferred to Heartsaver Instructor or BLS Instructor status.
Quality Control Checkpoints
Issue date beginning October 2011
Discontinued May 7, 2013
Not valid after August 30, 2013
90-1822 9/11
This card contains unique security features to protect against forgery.
PEEL
HERE
TC TC ID #
Alignment
TC TC
Address Phone
TC
City, State ZIP
Instructor
ID #
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1822
This card certifies that the above individual is an American Heart
Association Heartsaver Skills Evaluator.
Issue Date Expiration Date
Hear t saver
Fi r st Ai d
This card certifies that the above individual has successfully completed
the objectives and skills evaluations in accordance with the curriculum of
the AHA Heartsaver First Aid Program.
Optional Module completed if NOT marked out: Written test
Issue Date Recommended Renewal Date
HEARTSAVER FI RST AI D HEARTSAVER FI RST AI D
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1814
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
90-1814 3-card 90-1809 2-card self-mailer
The previous Heartsaver First Aid course taught rescuers to effectively recognize and treat adult emergencies
in the critical frst minutes until EMS personnel arrive. The course covered general principles of basic frst aid,
medical emergencies, and injury emergencies. Optional modules included environmental emergencies, adult
and child CPR and AED, and infant CPR.
Quality Control Checkpoints
Issue date beginning January 2003
Valid through July 31, 2013
Not valid for issue after July 31, 2011
Renewal date 2 years from month of issue
Modules NOT completed are shaded
Completed modules are unmarked and visible
AAdult First Aid
BEnvironmental Emergencies
CAdult/Child CPR With Mask
DAdult/Child AED
EInfant CPR With Mask
Training
Center
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2006 American Heart Association Tampering with this card will alter its appearance. 80-1202
Hear t saver
Fi r st Ai d
This card certifies that the above individual has successfully completed the
objectives and skills evaluations in accordance with the curriculum of the AHA
for Heartsaver First Aid Program.
Modules Completed: A B C D E
Issue Date Recommended Renewal Date
80-1202 R3/08
PEEL
HERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.
80-1202 3-card 80-1208 2-card self-mailer
Heartsaver First Aid CPR AED
Heartsaver First Aid CPR AED is a course that teaches students critical skills needed to respond to and manage
a frst aid, choking, or sudden cardiac arrest emergency in the frst few minutes until EMS arrives. Students
learn skills such as how to treat bleeding, sprains, broken bones, shock, and other frst aid emergencies. This
course also teaches adult CPR and AED use. Infant and child modules are optional. Provider cards are available
exclusively to authorized TCs for issuance in accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning April 26, 2011
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes cards 80-1202 and 80-1208
Strike through modules NOT completed
Completed modules are unmarked and visible
90-1815 3/11
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
PEEL
HERE
Hear t saver
CPR in Schools
This card certifies that the above individual has successfully completed the
objectives and skills evaluations in accordance with the curriculum of the AHA
for Heartsaver CPR in Schools Program.
Modules Completed: A B C D E
Issue Date Recommended Renewal Date
80-1200 R12/08
PEEL
HERE
Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.
80-1200 3-card
14
Hear t saver
Heartsaver CPR AED in Schools
Heartsaver CPR AED in Schools uses the Heartsaver First Aid CPR AED course to teach middle and high
school students critical skills needed to respond to and manage a sudden cardiac arrest, choking, or frst aid
emergency in the frst few minutes until EMS arrives. This course teaches adult CPR and AED use. Infant and
child modules are optional. Students may also learn skills such as how to treat bleeding, sprains, broken bones,
shock, and other frst aid emergencies. The course is presented in several modules, giving schools and AHA
Instructors the fexibility to teach the course over several class periods. Provider cards are available exclusively
to authorized TCs for issuance in accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning September 8, 2011
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes card 80-1200
Strike through modules NOT completed
Completed modules are unmarked and visible
90-1821 8/11
PEEL
HERE
Hear t saver
CPR AED
i n School s
This card certifies that the above individual has successfully completed the objectives
and skills evaluations in accordance with the curriculum of the AHA Heartsaver CPR AED
Program. Optional completed modules are those NOT marked out:
Child CPR AED Infant CPR First Aid Written test
Issue Date Recommended Renewal Date
HEARTSAVER CPR AED IN SCHOOLS HEARTSAVER CPR AED IN SCHOOLS
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1821
Strike through the modules NOT completed.
This card contains unique security features to protect against forgery.
90-1821 3-card
ACLS
ACLS (Advanced Cardiovascular Life Support)
ACLS National Faculty
ACLS National Faculty (NF) members are ACLS Instructors appointed by their respective National ECC
Committees. ACLS NF members are responsible for quality assurance and are the educational leadership
for the ACLS Program within their regions instructor network. NF members are key resources for the Regional
ECC Committee. The NF status is a region-specifc volunteer appointment and is not transferable between
regions or states. This card is not an acceptable substitute for an instructor card and does not verify instructor
status dates.
Quality Control Checkpoints
Issue date beginning July 2007
Term of appointment
Valid until further notice
Cards are hard plastic
Back of Card
AHA ECC mission statement
Signature of appointed NF member (in ink)
N
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ACLS National Faculty
John Doe
Term: July 2011 June 2012
N
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C
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John Doe
has been appointed as an Advanced Cardiovascular Life Support
National Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe PROAD Chair
ACLS
National
Faculty
ACLS National Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as an Advanced Cardiovascular Life Support
National Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe PROAD Chair
ACLS
National
Faculty
ACLS National Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as an Advanced Cardiovascular Life Support
National Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe PROAD Chair
ACLS
National
Faculty
K
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ACLS Regional Faculty
ACLS Regional Faculty (RF) members are ACLS Instructors appointed by their respective Regional ECC
Committees. ACLS RF members are responsible for quality assurance and are the educational leadership
for the ACLS Program within their regions instructor network. RF members are key resources for the regions
TCs. The RF status is a region-specifc volunteer appointment and is not transferable between regions or states.
This card is not an acceptable substitute for an instructor card and does not verify instructor status dates.
N
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ACLS Regional Faculty
John Doe
Term: July 2011 June 2012
N
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7
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2
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9
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John Doe
has been appointed as an Advanced Cardiovascular Life Support
Regional Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe, ECC Regional Committee Chair
ACLS
Regional
Faculty
ACLS Regional Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as an Advanced Cardiovascular Life Support
Regional Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe, ECC Regional Committee Chair
ACLS
Regional
Faculty
ACLS Regional Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as an Advanced Cardiovascular Life Support
Regional Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe, ECC Regional Committee Chair
ACLS
Regional
Faculty
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Quality Control Checkpoints
Issue date beginning July 2007
Valid until further notice
Term of appointment
Cards are hard plastic
Back of Card
AHA ECC mission statement
Signature of appointed RF member (in ink)
15
National Faculty cards produced and distributed by AHA National Center
Regional Faculty cards produced and distributed by AHA National Center
ACLS Training Center Faculty
ACLS Training Center Faculty (TCF) members are appointed by their respective TCs. ACLS TCF members are
responsible for quality assurance and are the educational leadership for all ACLS courses within their TC network.
TCF members conduct instructor courses, monitor new and renewing instructors, and conduct updates for the
TCs instructors. The ACLS TCF card and certifcate are not an acceptable substitute for an instructor card and
do not verify instructor status. The TCF certifcate/card template that TCs use when appointing TCF members
in their respective disciplines is accessible on the Instructor Network to TCCs only. The TCF document is set up
to auto-populate the card template at the bottom of the certifcate. You will only need to complete the certifcate
portion and then print and place it in the instructors record. You may issue the auto-populated card to the TCF.
Quality Control Checkpoints
Issue dates beginning June 2010
Valid until further notice
Name of the appointing TC
Term of the appointment (eg, 1/2010-1/2012)
First and last name of the TCC
Name of region
Important Reminders
TCF cards are not a replacement for AHA Instructor cards. If an
instructor is appointed as a TCF by the TCC, he or she is to be
issued a current instructor card, and it must be kept in the TCs
records.
The designation of TCF is not transferable to other TCs.
ACLS Instructor
ACLS Instructors teach the ACLS Provider Course. Instructor cards are available exclusively to authorized
TCs for issuance in accordance with AHA policy.
90-1804 3/11
This card contains unique security features to protect against forgery.
PEEL
HERE
This card certifies that the above individual is an American Heart
Association Advanced Cardiovascular Life Support (ACLS) Instructor.
Issue Date Expiration Date
A C L S I N S T R U C T O R
ACLS
I nst r uct or
A C L S I N S T R U C T O R
TC TC ID #
Alignment
TC TC
Address Phone
TC
City, State ZIP
Instructor
ID #
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1804
Quality Control Checkpoints
Issue date beginning May 10, 2011
Valid until further notice
Expiration date 2 years from month of issue
This card supersedes cards 70-2909 and 70-2921
Associated Materials for Instructors
Advanced Cardiovascular Life Support Instructor Manual
Advanced Cardiovascular Life Support Provider Manual
2010 Handbook of Emergency Cardiovascular Care
for Healthcare Providers
90-1804 3-card 90-1803 2-card self-mailer
TCF certifcate, card, and template are available only
to TCCs, through the AHA Instructor Network.
ACLS
Training Center Faculty
has been appointed as an
Advanced Cardiovascular Life Support Training Center Faculty
for the American Heart Association.
TC Name TC Coordinator
Term Region
KJ1048 ACLS 3/13
ACLS
16
ACLS
17
ACLS Provider
The ACLS Provider Course is designed to teach providers the knowledge and skills needed to evaluate and
manage cardiovascular emergencies, stroke, and respiratory arrest. Provider cards are available exclusively to
authorized TCs for issuance in accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning May 10, 2011
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes cards 70-2908 and 70-2920
Quality Control Checkpoints
Issue date beginning May 2001
Valid through June 30, 2013
Not valid for issue after June 30, 2011
70-2920 R1/08
Training
Center
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2920
ACLS Pr ovi der
This card certifies that the above individual has successfully
completed the national cognitive and skills evaluations in
accordance with the curriculum of the American Heart Association
for the Advanced Cardiovascular Life Support Program.
Issue Date Recommended Renewal Date
70-2920 3-card 70-2908 2-card self-mailer
90-1806 3-card 90-1805 2-card self-mailer
90-1806 3/11
This card contains unique security features to protect against forgery.
PEEL
HERE
ACLS
Provi der
This card certifies that the above individual has successfully
completed the cognitive and skills evaluations in accordance
with the curriculum of the American Heart Association Advanced
Cardiovascular Life Support (ACLS) Program.
Issue Date Recommended Renewal Date
ADVANCED CARDIOVASCULAR LIFE SUPPORT ADVANCED CARDIOVASCULAR LIFE SUPPORT
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1806
Quality Control Checkpoints
Issue date beginning March 2001
Valid through June 30, 2013
Not valid for issue after June 30, 2011
70-2921 R12/08
Training Center
Alignment
TC Address
Contact Info
Course
Location
TC
Coordinator
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2921
ACLS I nst r uct or
This card certifies that the above individual has successfully
completed the national cognitive and skills evaluations in
accordance with the curriculum of the American Heart Association
for the Advanced Cardiovascular Life Support Instructor Program.
Issue Date Expiration Date
70-2921 3-card 70-2909 2-card self-mailer
ACLS EP (ACLS for Experienced Providers)
ACLS EP Training Center Faculty
ACLS EP Training Center Faculty (TCF) members are appointed by their respective TCs. ACLS EP TCF members
are responsible for quality assurance and are the educational leadership for all ACLS EP courses within their TC
network. TCF members conduct instructor courses, monitor new and renewing instructors, and conduct updates
for the TCs instructors. The ACLS EP TCF card and certifcate are not an acceptable substitute for an instruc-
tor card and do not verify instructor status. The TCF certifcate/card template that TCs use when appointing TCF
members in their respective disciplines is accessible on the Instructor Network to TCCs only. The TCF document
is set up to auto-populate the card template at the bottom of the certifcate. You will only need to complete the
certifcate portion and then print and place it in the instructors record. You may issue the auto-populated card to
the TCF.
Quality Control Checkpoints
Issue dates beginning April 17, 2013
Valid until further notice
Name of the appointing TC
Term of the appointment (eg, 1/2010-1/2012)
First and last name of the TCC
Name of region
Important Reminders
TCF cards are not a replacement for AHA Instructor cards. If an
instructor is appointed as a TCF by the TCC, he or she is to be
issued a current instructor card, and it must be kept in the TCs
records.
The designation of TCF is not transferable to other TCs.
TCF certifcate, card, and template are available only
to TCCs, through the AHA Instructor Network.
ACLS EP
Training Center Faculty
has been appointed as an
ACLS for Experienced Providers Training Center Faculty
for the American Heart Association.
TC Name TC Coordinator
Term Region
KJ1048 ACLS EP 3/13
ACLS EP Instructor
ACLS EP Instructors teach the ACLS EP Course. Instructor cards are available exclusively to authorized TCs
for issuance in accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning April 17, 2013
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes card 70-2923
Associated Materials for Instructors
ACLS for Experienced Providers DVD Set which includes
ACLS for Experienced Providers Instructor Manual
ACLS for Experienced Providers Manual and Resource Text
Advanced Cardiovascular Life Support Instructor Manual
Advanced Cardiovascular Life Support Provider Manual
2010 Handbook of Emergency Cardiovascular Care
for Healthcare Providers
90-1811 4/13
This card contains unique security features to protect against forgery.
PEEL
HERE
TC TC ID #
Alignment
TC TC
Address Phone
TC
City, State ZIP
Instructor
ID #
Holders
Signature
2013 American Heart Association Tampering with this card will alter its appearance. 90-1811
This card certifies that the above individual is an American Heart
Association Advanced Cardiovascular Life Support (ACLS) Experienced
Provider (EP) Instructor.
Issue Date Expiration Date
ACL S E P I NST RUCT OR
ACLS EP
I nst r uct or
ACL S E P I NST RUCT OR
90-1811 3-card
ACLS EP
18
ACLS Experienced Provider
The ACLS Experienced Provider Course is designed for seasoned ACLS providers who wish to renew their
provider status. The course provides a stimulus for expert clinicians and scientists to identify and discuss
resuscitation in special circumstances. Provider cards are available exclusively to authorized TCs for issuance in
accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning April 17, 2013
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes card 70-2922
Quality Control Checkpoints
Issue date beginning March 2001
Valid through June 30, 2015
Renewal date 2 years from month of issue
Not valid for issue after June 30, 2013
70-2922 R3/09
Training
Center
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2922
This card certifies that the above individual has successfully
completed the national cognitive and skills evaluations in
accordance with the curriculum of the American Heart Association
for the ACLS Experienced Provider Program.
Issue Date Recommended Renewal Date
ACLS Experienced Provider
70-2922 3-card
90-1812 4/13
This card contains unique security features to protect against forgery.
PEEL
HERE
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2013 American Heart Association Tampering with this card will alter its appearance. 90-1812
ACLS Experienced
Provider
This card certifies that the above individual has successfully
completed the cognitive and skills evaluations in accordance
with the curriculum of the American Heart Association Advanced
Cardiovascular Life Support (ACLS) Experienced Provider Program.
Issue Date Recommended Renewal Date
ACLS EXPERI ENCED PROVI DER ACLS EXPERI ENCED PROVI DER
90-1812 3-card
ACLS EP
19
Quality Control Checkpoints
Issue date beginning March 2001
Valid through June 30, 2015
Expiration date 2 years from month of issue
Not valid for issue after June 30, 2013
70-2923 R10/11
Training Center
Alignment
TC Address
Contact Info
Course
Location
TC
Coordinator
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2923
This card certifies that the above individual has successfully
completed the national cognitive and skills evaluations in
accordance with the curriculum of the American Heart Association
for the ACLS Experienced Provider Instructor Program.
Issue Date Expiration Date
ACLS EP I nst r uct or
70-2923 3-card
PALS
PALS (Pediatric Advanced Life Support)
PALS National Faculty
PALS National Faculty (NF) members are PALS Instructors appointed by their respective National ECC
Committees. PALS NF members are responsible for quality assurance and are the educational leadership
for the PALS Program within their regions instructor network. NF members are key resources for the Regional
ECC Committee. The NF status is a region-specifc volunteer appointment and is not transferable between
regions or states. This card is not an acceptable substitute for an instructor card and does not verify instructor
status dates.
Quality Control Checkpoints
Issue date beginning July 2007
Term of appointment
Valid until further notice
Cards are hard plastic
Back of Card
AHA ECC mission statement
Signature of appointed NF member (in ink)
PALS National Faculty
John Doe
Term: July 2011 June 2012
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John Doe
has been appointed as a Pediatric Advanced Life Support National
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe PROAD Chair
PALS
National
Faculty
PALS National Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as a Pediatric Advanced Life Support National
Faculty for the American Heart Association XXXXXX Region .
Term: July 2011 June 2012
Jane Doe PROAD Chair
PALS
National
Faculty
PALS National Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as a Pediatric Advanced Life Support National
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe PROAD Chair
PALS
National
Faculty
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PALS Regional Faculty
PALS Regional Faculty (RF) members are PALS Instructors appointed by their respective Regional ECC
Committees. PALS RF members are responsible for quality assurance and are the educational leadership
for the PALS Program within their regions instructor network. RF members are key resources for the regions
TCs. The RF status is a region-specifc volunteer appointment and is not transferable between regions or states.
This card is not an acceptable substitute for an instructor card and does not verify instructor status dates.
PALS Regional Faculty
John Doe
Term: July 2011 June 2012
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John Doe
has been appointed as a Pediatric Advanced Life Support Regional
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe, ECC Regional Committee Chair
PALS
Regional
Faculty
PALS Regional Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as a Pediatric Advanced Life Support Regional
Faculty for the American Heart Association XXXXXX Region .
Term: July 2011 June 2012
Jane Doe, ECC Regional Committee Chair
PALS
Regional
Faculty
PALS Regional Faculty
John Doe
Term: July 2011 June 2012
John Doe
has been appointed as a Pediatric Advanced Life Support Regional
Faculty for the American Heart Association XXXXXX Region.
Term: July 2011 June 2012
Jane Doe, ECC Regional Committee Chair
PALS
Regional
Faculty
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Quality Control Checkpoints
Issue date beginning July 2007
Valid until further notice
Term of appointment
Cards are hard plastic
Back of Card
AHA ECC mission statement
Signature of appointed RF member (in ink)
20
National Faculty cards produced and distributed by AHA National Center
Regional Faculty cards produced and distributed by AHA National Center
PALS Training Center Faculty
PALS Training Center Faculty (TCF) members are appointed by their respective TCs. PALS TCF members are
responsible for quality assurance and are the educational leadership for all PALS courses within their TC network.
TCF members conduct instructor courses, monitor new and renewing instructors, and conduct updates for the
TCs instructors. The PALS TCF card and certifcate are not an acceptable substitute for an instructor card and
do not verify instructor status. The TCF certifcate/card template that TCs use when appointing TCF members
in their respective disciplines is accessible on the Instructor Network to TCCs only. The TCF document is set up
to auto-populate the card template at the bottom of the certifcate. You will only need to complete the certifcate
portion and then print and place it in the instructors record. You may issue the auto-populated card to the TCF.
Quality Control Checkpoints
Issue dates beginning June 2010
Valid until further notice
Name of the appointing TC
Term of the appointment (eg, 1/2010-1/2012)
First and last name of the TCC
Name of region
Important Reminders
TCF cards are not a replacement for AHA Instructor cards. If an
instructor is appointed as a TCF by the TCC, he or she is to be
issued a current instructor card, and it must be kept in the TCs
records.
The designation of TCF is not transferable to other TCs.
PALS Instructor
PALS Instructors teach the PALS Provider Course and the PEARS Provider Course. Instructor cards are
available exclusively to authorized TCs for issuance in accordance with AHA policy.
90-1817 3/11
This card contains unique security features to protect against forgery.
PEEL
HERE
TC TC ID #
Alignment
TC TC
Address Phone
TC
City, State ZIP
Instructor
ID #
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1817
This card certifies that the above individual is an American Heart
Association Pediatric Advanced Life Support (PALS) Instructor.
Issue Date Expiration Date
P A L S I N S T R U C T O R
PALS I nst r uct or
P A L S I N S T R U C T O R
Quality Control Checkpoints
Issue date beginning October 12, 2011
Valid until further notice
Expiration date 2 years from month of issue
This card supersedes card 70-2919
Associated Materials for Instructors
Pediatric Advanced Life Support Instructor Manual
Pediatric Advanced Life Support Provider Manual
Pediatric Emergency Assessment, Recognition,
and Stabilization Instructor Manual
Pediatric Emergency Assessment, Recognition,
and Stabilization Provider Manual
2010 Handbook of Emergency Cardiovascular Care
for Healthcare Providers
90-1817 3-card
TCF certifcate, card, and template are available only
to TCCs, through the AHA Instructor Network.
PALS
Training Center Faculty
has been appointed as a
Pediatric Advanced Life Support Training Center Faculty
for the American Heart Association.
TC Name TC Coordinator
Term Region
KJ1048 PALS 3/13
PALS
21
PALS
22
PALS Provider
The PALS Provider Course teaches students how to recognize infants and children at risk of cardiopulmonary arrest,
provides students with strategies for preventing cardiopulmonary arrest in infants and children, and teaches how
to perform the cognitive and psychomotor skills for resuscitating and stabilizing infants and children in respiratory
failure, shock, or cardiopulmonary arrest. Provider cards are available exclusively to authorized TCs for issuance
in accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning October 12, 2011
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes cards 70-2906 and 70-2918
Quality Control Checkpoints
Issue date beginning January 2002
Valid through December 31, 2013
Not valid for issue after December 31, 2011
Renewal date 2 years from month of issue
70-2918 R1/08
Training
Center
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2918
PALS Pr ovi der
This card certifies that the above individual has successfully
completed the national cognitive and skills evaluations in
accordance with the curriculum of the American Heart Association
for the Pediatric Advanced Life Support Program.
Issue Date Recommended Renewal Date
70-2918 3-card 70-2906 2-card self-mailer
90-1818 3-card 90-1808 2-card self-mailer
90-1818 3/11
This card contains unique security features to protect against forgery.
PEEL
HERE
PALS Provi der
This card certifies that the above individual has successfully
completed the cognitive and skills evaluations in accordance with
the curriculum of the American Heart Association Pediatric Advanced
Life Support (PALS) Program.
Issue Date Recommended Renewal Date
PE DI AT RI C ADVANCE D L I F E SUPPORT PE DI AT RI C ADVANCE D L I F E SUPPORT
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2011 American Heart Association Tampering with this card will alter its appearance. 90-1818
Quality Control Checkpoints
Issue date beginning January 2002
Valid through December 31, 2013
Not valid for issue after December 31, 2011
70-2919 R1/08
Training Center
Alignment
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2000 American Heart Association Tampering with this card will alter its appearance. 70-2919
PALS I nst r uct or
This card certifies that the above individual has successfully
completed the national cognitive and skills evaluations in
accordance with the curriculum of the American Heart Association
for the Pediatric Advanced Life Support Instructor Program.
Issue Date Expiration Date
70-2919 3-card
80-1215 8/07
Training
Center
TC Address
Contact Info
Course
Location
Instructor
Holders
Signature
2007 American Heart Association Tampering with this card will alter its appearance. 80-1215
PEARS Pr ovi der
This card certifies that the above individual has successfully
completed the objectives and skills evaluations in accordance
with the curriculum of the American Heart Association Pediatric
Emergency Assessment, Recognition, and Stabilization Course.
Issue Date Recommended Renewal Date
PEEL
HERE
This card contains unique security features to protect against forgery.
80-1215 3-card
PEARS Provider
The PEARS Provider Course is designed to help the basic pediatric healthcare provider develop the knowledge
and skills for emergency assessment and treatment of seriously ill infants and children. Provider cards are
exclusively available to authorized TCs for issuance in accordance with AHA policy.
Quality Control Checkpoints
Issue date beginning June 13, 2012
Valid until further notice
Renewal date 2 years from month of issue
This card supersedes card 80-1215
Quality Control Checkpoints
Issue date beginning November 2007
Valid through August 31, 2014
Not valid for issue after August 31, 2012
Renewal date 2 years from month of issue
90-1819 6/12
This card contains unique security features to protect against forgery.
PEEL
HERE
PEARS
Provi der
This card certifies that the above individual has successfully completed
the cognitive and skills evaluations in accordance with the curriculum
of the American Heart Association Pediatric Emergency
Assessment, Recognition, and Stabilization (PEARS) Program.
Issue Date Recommended Renewal Date
P E A R S P R O V I D E R P E A R S P R O V I D E R
Training TC ID #
Center Name
TC TC
Info City, State ZIP Phone
Course
Location
Instructor Inst. ID #
Name
Holders
Signature
2012 American Heart Association Tampering with this card will alter its appearance. 90-1819
90-1819 3-card
90-1823 3-card
90-1823 6/12
This card contains unique security features to protect against forgery.
PEEL
HERE
TC TC ID #
Alignment
TC TC
Address Phone
TC
City, State ZIP
Instructor
ID #
Holders
Signature
2012 American Heart Association Tampering with this card will alter its appearance. 90-1823
This card certifies that the above individual is an American Heart
Association Pediatric Emergency Assessment, Recognition, and
Stabilization (PEARS) Instructor.
Issue Date Expiration Date
P E A R S I N S T R U C T O R
PEARS
I nst r uct or
P E A R S I N S T R U C T O R
Quality Control Checkpoints
Issue date beginning May 7, 2013
Valid until further notice
Expiration date 2 years from month of issue
Associated Materials for Instructors
Pediatric Emergency Assessment, Recognition,
and Stabilization Instructor Manual
Pediatric Emergency Assessment, Recognition,
and Stabilization Provider Manual
2010 Handbook of Emergency Cardiovascular Care
for Healthcare Providers
PEARS