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  • ECC

    Emergency Cardiovascular Care

    Course Card Reference Guide

    90-1801 3

    /11

    This card c

    ontains uniq

    ue security

    features to

    protect aga

    inst forgery.

    PEEL

    HERE

    Healthcar

    e

    Provider

    This card c

    ertifies that

    the above

    individual h

    as success

    fully

    completed

    the cognitiv

    e and skills

    evaluations

    in accorda

    nce with

    the curriculu

    m of the A

    merican He

    art Associa

    tion BLS fo

    r Healthcar

    e

    Providers

    (CPR and

    AED) Progr

    am.

    Issue Date

    Recomme

    nded Rene

    wal Date

    H E AL T H

    C A RE P

    R OV I D

    E RH E A

    L T HC A R

    E PR O

    V I DE R

    Training

    TC ID #

    Center Nam

    e

    TC

    TC

    Info

    City, State

    ZIP

    Phone

    Course

    Location

    Instructor

    Inst. ID #

    Name

    Holders

    Signature

    2011 Am

    erican Hear

    t Associatio

    n Tampe

    ring with thi

    s card will a

    lter its appe

    arance. 9

    0-1801

    90-1806 3/11

    This card contains unique security features to protect against forgery.

    PEELHERE

    ACLSProviderThis 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 SUPPORTADVANCED CARDIOVASCULAR LIFE SUPPORT

    Training

    TC ID #

    Center NameTC

    TC

    Info City, State ZIP Phone

    CourseLocationInstructor

    Inst. ID #

    Name

    HoldersSignature 2011 American Heart Association Tampering with this card will alter its appearance. 90-1806

    September 2011

    90-1817 3

    /11

    This card c

    ontains uniq

    ue security

    features to

    protect aga

    inst forgery.

    PEEL

    HERE

    TC

    TC ID #

    Alignment

    TC

    TC

    Address

    Phone

    TCCity,

    State

    ZIP

    Instructor

    ID #

    Holders

    Signature

    2011 Am

    erican Hear

    t Associatio

    n Tampe

    ring with thi

    s card will a

    lter its appe

    arance. 9

    0-1817

    This card c

    ertifies that

    the above

    individual i

    s an Americ

    an Heart

    Association

    Pediatric A

    dvanced Lif

    e Support (

    PALS) Instr

    uctor.

    Issue Date

    Expiration

    Date

    P AL S

    I NS T

    R UC T

    O R

    PALS Inst

    ructor

    P AL S

    I NS T

    R UC T

    O R

    90-1815 3/11

    Strike through the modules NOT completed.

    This card contains unique security features to protect against forgery.

    PEELHERE

    Heartsaver First Aid CPR AEDThis 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

    Recommended Renewal Date

    HEARTSAVER FIRST AID CPR AEDHEARTSAVER FIRST AID CPR AED

    Training

    TC ID #

    Center NameTC

    TC

    Info City, State ZIP Phone

    CourseLocationInstructor

    Inst. ID #

    Name

    HoldersSignature 2011 American Heart Association Tampering with this card will alter its appearance. 90-1815

  • Contents

    i

    Preface iii

    Card Format 1Security Features 1Guidelines for Card Completion 2

    Front of Card, 2000 and Later 2Back of Card, 2000-2010 3Back of Card, 2011 and Later 3Duplication/Replacement of Lost Cards 3

    BLS 5BLS National Faculty 5BLS Regional Faculty 5BLS Training Center Faculty 6BLS Instructor 6BLS Healthcare Provider 7

    Heartsaver 9Heartsaver Instructor 9Heartsaver Skills Evaluator 9Heartsaver First Aid Instructor 10Heartsaver CPR AED 10Heartsaver CPR 11Heartsaver AED 11Heartsaver First Aid 12Heartsaver First Aid CPR AED 13Heartsaver Pediatric First Aid 13Heartsaver CPR AED in Schools 14Heartsaver CPR in Schools 14

    ACLS 15ACLS National Faculty 15ACLS Regional Faculty 15ACLS Training Center Faculty 16ACLS Instructor 16ACLS Provider 17ACLS EP Instructor 17 ACLS Experienced Provider 18

    PALS and PEARS 19PALS National Faculty 19PALS Regional Faculty 19PALS Training Center Faculty 20PALS Instructor 20PALS Provider 21PEARS Provider 22

    Course Card Index 23

    2011 American Heart Association

  • Preface

    iii

    Preface

    The Course Card Reference Guide is a quality control tool to be used with American Heart Association

    (AHA) course cards. The Course Card Reference Guide is not a policy document. See the Program

    Administration Manual: Guidelines for Program Administration and Training, third and fourth editions,*

    for specific criteria, guidelines, and policy for issuing course cards.

    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 Training Centers with a confidential 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 Training Center

    conducting the course is responsible for card issuance and security through its instructors and training

    sites. Each Training Center must document how it maintains card security and accountability. Duplicate

    course cards are managed by the Training Center issuing the original card.

    For clarification on issues addressed in this Guide or to verify the status of the Training Center that

    issued a card, please contact the ECC Customer Support Center at 1-888-CPR-LINE.

    * Program Administration Manual, third edition, July 2004, pages 77-79; Program Administration Manual, fourth edition, March 2008, pages 19-20.

  • Card Format

    Card Format

    This section describes cards issued for courses that use criteria and materials from the 2000, 2005, and 2010

    American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular

    Care. These cards have issue dates beginning March 5, 2001, for Basic Life Support (BLS); May 2001 for

    Advanced Cardiovascular Life Support (ACLS); January 21, 2002, for Pediatric Advanced Life Support

    (PALS); November 29, 2007, for Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS);

    and March 5, 2001, for Heartsaver CPR and Heartsaver AED, January 2003 for Heartsaver First Aid,

    May 31, 2006, for Heartsaver Pediatric First Aid, April 2006 for Heartsaver CPR in Schools, and Spring 2009

    for Heartsaver Skills Evaluator. The 2011 cards begin with 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; and PALS Instructor and PALS

    Provider, October 2011.

    Security Features

    Cardlayout: Each sheet of cards is formatted for printing both sides at the same time. The completed card can be peeled from the sheet and folded to form a 338 218-inch card.

    Colordesignation:Each discipline is designated by a color stripe at the top edge of both sides. BLS and Heartsaver are blue, ACLS is red, and PALS and PEARS are purple. The 2005 cards also have a red stripe along the left front edge.

    Copyright:The cards have copyright years that begin with 2000.

    Highlightedpersonalization: The cards have highlighted areas for the name, issue date, and renewal date.

    Lamination: Some professional-level course cards (provider and instructor cards for BLS, ACLS, PALS, and PEARS) are laminated with a matte finish on both sides. A phase-out of this lamination began in 2005. Cards produced in 2006 and later have a lamination film on the back of the card only. Cards produced in 2011 and later do not have a laminated finish on either side.

    Print-sidefinish: Tampering with printing on laminated cards (cards produced in 2011 do not have a laminated finish) may dissolve the matte finish, leaving behind a noticeably shiny surface. Tampering with this card will alter its appearance is printed on each card.

    1

    90-1801 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    HealthcareProv ider

    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 BLS for Healthcare Providers (CPR and AED) Program.

    Issue Date Recommended Renewal Date

    H E A L T H C A R E P R O V I D E R H E A L T H C A R E P R O V I D E R

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1801

    90-1801 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    HealthcareProv ider

    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 BLS for Healthcare Providers (CPR and AED) Program.

    Issue Date Recommended Renewal Date

    H E A L T H C A R E P R O V I D E R H E A L T H C A R E P R O V I D E R

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1801

  • Watermark:All laminated cards have the AHA Heart and Torch logo watermark in light gray on the front and back.

    Microprint:All cards with a copyright year of 2006 or later use security microprinting for the information lines. For cards produced in 2006 through 2010, each line is the repeated text AMERICANHEARTASSOCIATION. For cards produced in 2011 and later, the card name in the top bar is the repeated text. For example, the microprint on the BLS Instructor card is BLSINSTRUCTORBLSINSTRUCTOR (see Figure 1).

    Viewingmicroprint: The microprint can be viewed with a loupe or magnifying glass, such as that in Figure 2.

    Guidelines for Card Completion

    The AHA recommends that course cards be stamped, typed, or computer generated to reduce the risk of cards being altered. All AHA cards that are issued must be complete and legible. The content of AHA course cards cannot be altered in any way.

    AHA course cards must be completed as follows:

    FrontofCard,2000andLater

    Thecoursenameispreprintedonthecard.

    Indicatethestudentsname(firstname,middleinitial,and last name).

    StrikethroughorfillinthecirclesformodulesNOTcompleted, if applicable.

    Indicatetheissuedateasa2-digitmonthand4-digityear (01/2011) or a 2-digit month and day and 4-digit year (01/15/2011).

    Indicatetherecommendedrenewal/expirationdate,2years from the issue date (2-digit month and 4-digit year only, no exceptions).

    Figure 1. Security microprint. Figure 2. A loupe or a magnifying glass can be used to view the security microprint.

    90-1800 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    TC TC ID #Alignment

    TC TCAddress Phone

    TCCity, State ZIP

    InstructorID #

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1800

    This card certifies that the above individual is an American Heart Association Basic Life Support (BLS) Instructor.

    Issue Date Expiration Date

    B L S I N S T R U C T O R

    BLSInstructor

    B L S I N S T R U C T O R

    BLSINSTRUCTORBLSINSTRUCTORBLSINSTRUCTOR

    2

    90-1815 3/11

    Strike through the modules NOT completed.

    This card contains unique security features to protect against forgery.

    PEELHERE

    Heartsaver

    First Aid 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 First Aid CPR AED Program. Optional completed modules are those NOT marked out:

    Child CPR AED Infant CPR Written test

    Issue Date Recommended Renewal Date

    HEARTSAVER FIRST AID CPR AED HEARTSAVER FIRST AID CPR AED

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1815

    Card Format

    Program Administration Manual, fourth edition, March 2008, page 20.

  • Card FormatBackofCard,2000-2010

    IndicatethenameoftheTrainingCenter(TC).

    IndicatetheTCsaddressandcontactinformation.

    Indicatethelocationofthecourse.

    IndicatethefirstandlastnameoftheCourseDirector/LeadInstructor(mustbelegible).

    Thestudentmustsignhisorhernameinblackorblueink.

    BackofCard,2011andLater

    All of the following items are required unless otherwise noted:

    IndicatethenameoftheTC.

    IndicatetheTCsAHAidentificationnumber.

    IndicatetheTCsaddressandcontactinformation.

    Indicatethelocationofthecourse.Provideageneraldescriptionofwherethecoursewasconducted.

    IndicatethefirstandlastnameoftheCourseDirector/LeadInstructor(mustbelegible).

    IndicatetheDirectors/InstructorsAHAidentificationnumber.

    Oninstructorcards,indicatethereceivinginstructorsAHAInstructorNetworkidentificationnumber(requiredbyJanuary 1, 2012).

    Thestudentorinstructormustsignhisorhernameinblackorblueink.Amissingsignaturedoesnotinvalidatethe card.

    Duplication/ReplacementofLostCards

    It is the responsibility of the TC to issue a duplicate card if a card is lost, is mutilated, or otherwise becomes unus-able. In such cases the Course Director or Lead Instructor may advise the student to contact the TC that issued the original card, or the Instructor may do so. The TC may set a fee for reissuing a card.

    3

  • BLS

    BLS (Basic Life Support)

    BLS National FacultyBLS National Faculty (NF) members are BLS Instructors appointed by their respective National ECC

    Committees. BLS NF members are responsible for quality assurance and are the educational leadership

    fortheBLSProgramwithintheirregionsinstructornetwork.NFmembersarekeyresourcesforthe Regional ECC Committee. The NF status 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

    IssuedatebeginningJuly 2007 Termofappointment Carddesignvaliduntilfurthernotice

    Back of Card

    AHAECCmissionstatement SignatureofappointedNFmember(inink)

    BLS National Faculty

    John DoeTerm: July 2011 June 2012

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    John Doehas been appointed as a Basic Life Support National Faculty

    for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    BLS NationalFaculty

    BLS National Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Basic Life Support National Faculty

    for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    BLS NationalFaculty

    BLS National Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Basic Life Support National Faculty

    for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    BLS NationalFaculty

    KJ0462

    R4/10

    KJ0462

    R4/10

    KJ0462

    R4/10

    BLS Regional FacultyBLS Regional Faculty (RF) members are BLS Instructors appointed by their respective Regional ECC

    Committees. BLS RF members are responsible for quality assurance and are the educational leadership

    fortheBLSProgramwithintheirregionsinstructornetwork.RFmembersarekeyresourcesforthe regionsTrainingCenters.TheRFstatusisnottransferablebetweenregionsorstates.Thiscardisnot an acceptable substitute for an instructor card and does not verify instructor status dates.

    BLS Regional Faculty

    John DoeTerm: July 2011 June 2012

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    John Doehas been appointed as a Basic Life Support Regional Faculty

    for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    BLS RegionalFaculty

    BLS Regional Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Basic Life Support Regional Faculty

    for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    BLS RegionalFaculty

    BLS Regional Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Basic Life Support Regional Faculty

    for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    BLS RegionalFaculty

    KJ0562

    R4/10

    KJ0562

    R4/10

    KJ0562

    R4/10

    Quality Control Checkpoints

    IssuedatebeginningJuly 2007 Carddesignvaliduntilfurthernotice Termofappointment

    Back of Card

    AHAECCmissionstatement SignatureofappointedRFmember(inink)

    5

    National Faculty cards produced and distributed by AHA National Center

    Regional Faculty cards produced and distributed by AHA National Center

  • BLS

    6

    BLS Training Center FacultyBLS Training Center Faculty (TCF) members are appointed by their respective Training Centers. BLS TCF

    members are responsible for quality assurance and are the educational leadership for all BLS courses within

    their Training Center network. TCF members conduct instructor courses, monitor new and renewing instructors,

    andconductupdatesfortheTrainingCentersinstructors.Thiscardisnotanacceptablesubstituteforan instructor card and does not verify instructor status.

    Quality Control Checkpoints

    IssuedatesbeginningJune 2010 Carddesignvaliduntilfurthernotice NameoftheappointingTrainingCenter Monthandyearofappointment Dateforreappointment(monthandyear) TrainingCenteralignment TrainingCenteraddressandcontactinformation FirstandlastnameoftheTrainingCenterCoordinator

    (must be legible)

    BLS Training Center Faculty

    has been appointed as a Basic Life Support Training Center Faculty

    for the American Heart Association.

    TC Name TC Coordinator

    Term RegionKJ0835 BLS 6/10

    BLS InstructorBLS Instructors teach lifesaving CPR, AED, and first aid courses for the medical and nonmedical communities.

    Although BLS Instructors are not required to have a medical background to teach, most instructors are in a

    healthcare field.

    90-1800 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    TC TC ID #Alignment

    TC TCAddress Phone

    TCCity, State ZIP

    InstructorID #

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1800

    This card certifies that the above individual is an American Heart Association Basic Life Support (BLS) Instructor.

    Issue Date Expiration Date

    B L S I N S T R U C T O R

    BLSInstructor

    B L S I N S T R U C T O R

    Quality Control Checkpoints

    IssuedatebeginningMarch 23, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescards70-2916and70-2904

    Associated Materials for Instructors

    BLSforHealthcareProvidersInstructorManual BLSforHealthcareProvidersStudentManual 2010HandbookofEmergencyCardiovascularCare forHealthcareProviders

    HeartsaverFirstAidCPRAEDInstructorManual HeartsaverFirstAid,CPRAED,andFirstAidCPRAED StudentWorkbooks

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 CarddesignvalidthroughJune30,2013 Not valid for issue after June 30, 2011, and is

    superseded by cards 90-1800 and 90-1807 Expirationdate2yearsfrommonthofissue

    Associated Materials for Instructors

    BLSforHealthcareProvidersInstructorManual BLSforHealthcareProvidersStudentManual HeartsaverFirstAidCPRAEDInstructorManual HeartsaverFirstAid,CPR,andAEDStudent Workbooks

    90-1800 3-card 90-1807 2-card self-mailer

    TCF certificate and card printed by Training Center Coordinator using template available on AHA Instructor Network

    70-2916 R12/08

    Training CenterAlignment

    TC AddressContact Info

    CourseLocation

    TCCoordinator

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2916

    BLS Instructor

    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 Basic Life Support (CPR/AED) Instructor Program.

    Issue Date Expiration Date

    70-2916 3-card 70-2904 2-card self-mailer

    BLS

  • 7BLS

    BLS Healthcare ProviderThe BLS for Healthcare Providers Course teaches both single-rescuer and team basic life support skills for

    application in both in- and out-of-hospital settings. This course trains participants to promptly recognize

    several life-threatening emergencies, give high-quality chest compressions, deliver appropriate ventilations,

    and provide early use of an AED. It includes adult, child, and infant rescue techniques.

    70-2915 R1/08

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2915

    Healthcare Provider

    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 BLS for Healthcare Providers (CPR & AED) Program.

    Issue Date Recommended Renewal Date

    90-1801 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    HealthcareProv ider

    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 BLS for Healthcare Providers (CPR and AED) Program.

    Issue Date Recommended Renewal Date

    H E A L T H C A R E P R O V I D E R H E A L T H C A R E P R O V I D E R

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1801

    Quality Control Checkpoints

    IssuedatebeginningMarch 23, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards70-2915and70-2903

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 ValidthroughJune30,2013 Not valid for issue after June 30, 2011, and is

    superseded by cards 90-1801 and 90-1802 Renewaldate2yearsfrommonthofissue

    70-2915 3-card 70-2903 2-card self-mailer

    90-1801 3-card 90-1802 2-card self-mailer

  • Hear tsaver

  • 9Hear tsaver

    Heartsaver

    Heartsaver InstructorHeartsaver Instructors teach lifesaving CPR, AED, and first aid courses for the nonmedical community.

    Heartsaver Instructors are not required to have a medical background to teach.

    80-1205 R1/08

    Training CenterAlignment

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 80-1205

    Heartsaver Instructor

    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

    PEELHERE

    This card contains unique security features to protect against forgery.

    90-1816 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    TC TC ID #Alignment

    TC TCAddress Phone

    TCCity, State ZIP

    InstructorID #

    HoldersSignature

    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

    Heartsaver

    Instructor

    HEARTSAVER INSTRUCTOR HEARTSAVER INSTRUCTOR

    Quality Control Checkpoints

    IssuedatebeginningApril 26, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescards80-1205and80-1213

    Associated Materials for Instructors

    HeartsaverFirstAidCPRAEDInstructorManual HeartsaverFirstAid,CPRAED,andFirstAidCPRAED StudentWorkbooks

    Quality Control Checkpoints

    IssuedatebeginningMay 2002 CarddesignvalidthroughJuly31,2013 Not valid for issue after July 31, 2011, and is

    superseded by card 90-1816 Expirationdate2yearsfrommonthofissue

    Associated Materials for Instructors

    HeartsaverInstructorManual HeartsaverFirstAid,CPR,andAEDStudentWorkbooks

    80-1205 3-card 80-1213 2-card self-mailer

    90-1816 3-card

    Heartsaver Skills EvaluatorThis course provides training where the Skills Evaluator learns to appropriately evaluate the psychomotor

    skills performed in Heartsaver skills practice and skills testing sessions by following a self-directed online

    learning course. The role of the Heartsaver Skills Evaluator is to coach, if needed, during skills practice and

    evaluate psychomotor skills during skills testing. The course does not provide training for instructing

    Heartsaver classroom courses.

    Quality Control Checkpoints

    IssuedatebeginningOctober 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescard80-1216

    90-1822 9/11This card contains unique security features to protect against forgery.

    PEELHERE

    TC TC ID #Alignment

    TC TCAddress Phone

    TCCity, State ZIP

    InstructorID #

    HoldersSignature

    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

    Heartsaver

    Skil ls Evaluator

    HEARTSAVER SKILLS EVALUATOR HEARTSAVER SKILLS EVALUATOR

    90-1822 3-card

  • Quality Control Checkpoints

    IssuedatebeginningSpring 2009 CarddesignvalidthroughNovember30,2013 Not valid for issue after November 30, 2011, and is

    superseded by card 90-1822 Expirationdate2yearsfrommonthofissue

    Associated Materials for Skills Evaluators

    HeartsaverSkillsEvaluatorManual

    Heartsaver Skills Evaluator

    Alan Carrington, MDTerm: July 2009 June 2010

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Heartsaver Skills Evaluator

    Alan Carrington, MDTerm: July 2009 June 2010

    Heartsaver Skills Evaluator

    Alan Carrington, MDTerm: 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#: 1234567890Authorizing Training Center: Heartland ECC Training, Dallas TXTC 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#: 1234567890Authorizing Training Center: Heartland ECC Training, Dallas TXTC ID: AAA1234 Phone: 214-706-1717

    Heartsaver skills evaluator

    John Doehas completed the national cognitive and skills objectives of the American Heart Association Heartsaver Skills Evaluator program.

    Term: MMMM YYYYMMMM YYYY ID#: 1234567890Authorizing Training Center: Heartland ECC Training, Dallas TXTC ID: AAA1234 Phone: 214-706-1717

    80-1216 R

    4/10

    80-1216 R

    4/10

    80-1216 R

    4/10

    80-1216 3-card

    Hear tsaver

    Heartsaver First Aid InstructorThis card has been discontinued and is no longer valid or available. A phase-out of this position began

    on May 1, 2006. The roles and responsibilities have been transferred to BLS Instructor and Heartsaver

    Instructor status.

    Quality Control Checkpoints

    IssuedatebeginningMay 2002 NotvalidafterMay31,2008

    70-2965 11-02

    AHARegion

    CommunityTraining Center

    TrainingSite

    Instructor

    HoldersSignature2000 American Heart Association Tampering with this card will alter its appearance. 70-2965

    Heartsaver First Aid InstructorThis 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 Heartsaver First Aid Instructor Program.

    Issue Date Expiration Date

    70-2965 3-card 70-2964 2-card self-mailer

    Heartsaver CPR AEDHeartsaver CPR AED is a classroom, video-based, instructor-led course that teaches adult CPR and AED

    use,aswellashowtorelievechokinginanadult.ThiscourseteachesskillswiththeAHAsresearch-proven practice-while-watching technique, which allows instructors to observe the students, provide feedback, and

    guidethestudentslearningofskills.Infantandchildmodulesareoptional.

    Quality Control Checkpoints

    IssuedatebeginningApril 26, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards80-1203and80-1211 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible AdultCPRAEDmustbetaughtifchildCPRAEDistaught

    90-1813 3/11

    PEELHERE

    Heartsaver

    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

    H E A R T S AV E R C P R A E D H E A R T S AV E R C P R A E DTraining TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    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

    10

    Hear tsaver

  • 11

    Hear tsaver

    Heartsaver CPRThis course card and course curriculum were discontinued as of April 26, 2011. Heartsaver CPR was a modular

    course that taught lay rescuers how to recognize and treat life-threatening emergencies, including cardiac arrest

    and choking for adult, child, and infant victims. Students also learned to recognize the warning signs of heart

    attack and stroke in adults and breathing difficulties in children.

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 ValidthroughApril30,2013 Not valid for issue after April 26, 2011, and is

    superseded by cards 90-1810 and 90-1813 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible Fourallowedcoursecombinations:

    Adult/Child CPR and Choking Infant CPR and Choking Adult/Child CPR With Mask Infant CPR With Mask

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2006 American Heart Association Tampering with this card will alter its appearance. 80-1204

    Heartsaver CPR

    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 Program.Modules Completed: A B C D

    Issue Date Recommended Renewal Date

    80-1204 R1/08

    PEELHERE

    Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1204 3-card 80-1210 2-card self-mailer

    Heartsaver AEDHeartsaver AED taught the basic techniques of adult CPR and use of an AED. Pediatric CPR skills could be

    taught if students lived or worked in a setting where children were present. Students also learned to use

    barrier devices in CPR and give first aid for choking. The course taught how to recognize the signs of 4 major

    emergencies: heart attack, stroke, cardiac arrest, and foreign-body airway obstruction.

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 ValidthroughApril30,2013 Not valid for issue after April 26, 2011, and is

    superseded by cards 90-1810 and 90-1813 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible AdultCPR&AEDwasrequiredtobetaughtifchild CPR&AEDwastaught

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2006 American Heart Association Tampering with this card will alter its appearance. 80-1203

    Heartsaver AED

    80-1203 R1/08

    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 AED Program.Modules Completed: A B C

    Issue Date Recommended Renewal Date

    PEELHERE

    Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1203 3-card 80-1211 2-card self-mailer

  • Hear tsaver

    12

    Heartsaver First AidHeartsaver First Aid is a classroom, video-based, instructor-led course that teaches students critical skills

    to respond to and manage an emergency in the first few minutes until emergency medical services (EMS)

    arrives. Students learn skills such as how to treat bleeding, sprains, broken bones, shock, and other first

    aid emergencies.

    Quality Control Checkpoints

    IssuedatebeginningApril 26, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards80-1202and80-1208 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible ThiscourseisforFirstAidonlyanddoesnotinclude

    CPR AED

    90-1814 3/11

    PEELHERE

    Heartsaver

    F i rst A id

    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 F IRST A ID HEARTSAVER F IRST A ID

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    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 first minutes until EMS personnel arrive. The course covered general principles of basic first aid,

    medical emergencies, and injury emergencies. Optional modules included environmental emergencies, adult

    and child CPR and AED, and infant CPR.

    Quality Control Checkpoints

    IssuedatebeginningJanuary 2003 ValidthroughJuly31,2013 Not valid for issue after July 31, 2011, and is

    superseded by cards 90-1809 and 90-1814 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible AdultCPRwasrequiredifchildCPRwastaught AdultCPR&AEDwasrequiredifchildCPR&AEDwastaught InfantCPRwasnottaughtwithoutadultandchildCPR

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2006 American Heart Association Tampering with this card will alter its appearance. 80-1202

    Heartsaver Firs t Aid

    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

    PEELHERE

    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

    Hear tsaver

  • Heartsaver First Aid CPR AEDHeartsaver First Aid CPR AED is a classroom, video-based, instructor-led course that teaches students critical

    skills needed to respond to and manage a first aid, choking, or sudden cardiac arrest emergency in the first

    few minutes until EMS arrives. Students learn skills such as how to treat bleeding, sprains, broken bones,

    shock, and other first aid emergencies. This course also teaches adult CPR and AED use. Infant and child

    modules are optional.

    Quality Control Checkpoints

    IssuedatebeginningApril 26, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards80-1202and80-1208 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible

    90-1815 3/11

    Strike through the modules NOT completed.

    This card contains unique security features to protect against forgery.

    PEELHERE

    Heartsaver

    First Aid 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 First Aid CPR AED Program. Optional completed modules are those NOT marked out:

    Child CPR AED Infant CPR Written test

    Issue Date Recommended Renewal Date

    HEARTSAVER FIRST AID CPR AED HEARTSAVER FIRST AID CPR AED

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1815

    90-1815 3-card 90-1820 2-card self-mailer

    13

    Hear tsaver

    Heartsaver Pediatric First AidHeartsaver Pediatric First Aid is a modular course for the child care industry and others requiring a credential in

    pediatric first aid. Students learn how to manage illness and injuries in a child in the first few minutes until

    professional help arrives. The course covers first aid basics and medical, injury, and environmental emergencies.

    Quality Control Checkpoints

    IssuedatebeginningMay 31, 2006 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2006 American Heart Association Tampering with this card will alter its appearance. 80-1201

    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 Pediatric First Aid Program.Modules Completed: A B C D E F

    Issue Date Recommended Renewal Date

    80-1201 R3/08

    PEELHERE

    Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.

    Heartsaver Pediatric First Aid

    80-1201 3-card 80-1209 2-card self-mailer

  • Hear tsaver

    14

    Heartsaver CPR AED in SchoolsHeartsaver 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 first aid

    emergency in the first 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 first aid emergencies. The course is presented in several modules, giving schools and AHA

    Instructors the flexibility to teach the course over several class periods.

    Quality Control Checkpoints

    IssuedatebeginningSeptember 8, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescard80-1200 StrikethroughmodulesNOTcompleted Completedmodulesareunmarkedandvisible

    90-1821 8/11

    PEELHERE

    Heartsaver

    CPR AED in Schoo lsThis 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 SCHOOLSTraining TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    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

    Heartsaver CPR in SchoolsHeartsaver CPR in Schools is designed to teach middle and high school students lifesaving CPR and AED

    skills. Especially designed with the teen audience in mind, the course appeals to students through a unique

    training video featuring teen interviews and edgy video footage. The course is presented in several modules,

    giving schools the flexibility to teach the course over several class periods.

    Quality Control Checkpoints

    IssuedatebeginningApril 2006 ValidthroughDecember31,2013 Not valid for issue after December 31, 2011,

    and is superseded by card 90-1821 Renewaldate2yearsfrommonthofissue ModulesNOTcompletedareshaded Completedmodulesareunmarkedandvisible

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2006 American Heart Association Tampering with this card will alter its appearance. 80-1200

    Heartsaver 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

    PEELHERE

    Fill in the circles of the modules NOT completed. This card contains unique security features to protect against forgery.80-1200 3-card

  • ACLS

    ACLS (Advanced Cardiovascular Life Support)

    ACLS National FacultyACLS 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

    fortheACLSProgramwithintheirregionsinstructornetwork.NFmembersarekeyresourcesfortheRegionalECC Committee. The NF status 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

    IssuedatebeginningJuly 2007 Termofappointment Carddesignvaliduntilfurthernotice

    Back of Card

    AHAECCmissionstatement SignatureofappointedNFmember(inink)

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    ACLS National Faculty

    John DoeTerm: July 2011 June 2012

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    John Doehas been appointed as an Advanced Cardiovascular Life Support

    National Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    ACLS NationalFaculty

    ACLS National Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as an Advanced Cardiovascular Life Support

    National Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    ACLS NationalFaculty

    ACLS National Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as an Advanced Cardiovascular Life Support

    National Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    ACLS NationalFaculty

    KJ0462

    R4/10

    KJ0462

    R4/10

    KJ0462

    R4/10

    ACLS Regional FacultyACLS 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

    fortheACLSProgramwithintheirregionsinstructornetwork.RFmembersarekeyresourcesfortheregionsTraining Centers. The RF status 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.

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    ACLS Regional Faculty

    John DoeTerm: July 2011 June 2012

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    John Doehas been appointed as an Advanced Cardiovascular Life Support

    Regional Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    ACLS RegionalFaculty

    ACLS Regional Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as an Advanced Cardiovascular Life Support

    Regional Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    ACLS RegionalFaculty

    ACLS Regional Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as an Advanced Cardiovascular Life Support

    Regional Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    ACLS RegionalFaculty

    KJ0562

    R4/10

    KJ0562

    R4/10

    KJ0562

    R4/10

    Quality Control Checkpoints

    IssuedatebeginningJuly 2007 Carddesignvaliduntilfurthernotice Termofappointment

    Back of Card

    AHAECCmissionstatement SignatureofappointedRFmember(inink)

    15

    National Faculty cards produced and distributed by AHA National Center

    Regional Faculty cards produced and distributed by AHA National Center

  • ACLS

    16

    ACLS Training Center FacultyACLS Training Center Faculty (TCF) members are appointed by their respective Training Centers. ACLS TCF

    members are responsible for quality assurance and are the educational leadership for all ACLS courses

    within their Training Center network. TCF members conduct instructor courses, monitor new and renewing

    instructors,andconductupdatesfortheTrainingCentersinstructors.Thiscardisnotanacceptablesubstitutefor an instructor card and does not verify instructor status dates.

    Quality Control Checkpoints

    IssuedatesbeginningJune 30, 2010 Carddesignvaliduntilfurthernotice NameoftheappointingTrainingCenter Monthandyearofappointment Dateforreappointment(monthandyear) TrainingCenteralignment TrainingCenteraddressandcontactinformation FirstandlastnameoftheTrainingCenterCoordinator

    (must be legible)

    ACLS InstructorACLS Instructors teach the ACLS Provider Course.

    90-1804 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    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

    ACLSInstructor

    A C L S I N S T R U C T O RTC TC ID #Alignment

    TC TCAddress Phone

    TCCity, State ZIP

    InstructorID #

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1804

    Quality Control Checkpoints

    IssuedatebeginningMay 10, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescards70-2909and70-2921

    Associated Materials for Instructors

    AdvancedCardiovascularLifeSupportInstructorManual AdvancedCardiovascularLifeSupportProviderManual 2010HandbookofEmergencyCardiovascularCare forHealthcareProviders

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 CarddesignvalidthroughJune30,2013 Not valid for issue after June 30, 2011, and is

    superseded by cards 90-1803 and 90-1804 Expirationdate2yearsfrommonthofissue

    Associated Materials for Instructors

    AdvancedCardiovascularLifeSupportInstructorManual AdvancedCardiovascularLifeSupportProviderManual HandbookofEmergencyCardiovascularCare forHealthcareProviders

    ACLSResourceTextforInstructorsand ExperiencedProviders

    90-1804 3-card 90-1803 2-card self-mailer

    TCF certificate and card printed by Training Center Coordinator using template available on AHA Instructor Network

    70-2921 R12/08

    Training CenterAlignment

    TC AddressContact Info

    CourseLocation

    TCCoordinator

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2921

    ACLS Instructor

    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 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 RegionKJ0835 ACLS 6/10

  • ACLS

    17

    ACLS ProviderThe ACLS Provider Course is designed to teach providers the knowledge and skills needed to evaluate and

    manage cardiovascular emergencies, stroke, and respiratory arrest.

    Quality Control Checkpoints

    IssuedatebeginningMay 10, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards70-2908and70-2920

    Quality Control Checkpoints

    IssuedatebeginningMay 2001 ValidthroughJune30,2013 Not valid for issue after June 30, 2011, and is

    superseded by cards 90-1805 and 90-1806 Renewaldate2yearsfrommonthofissue

    ACLS EP InstructorACLS Experienced Provider (EP) Instructors teach the ACLS Experienced Provider Course.

    70-2920 R1/08

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2920

    ACLS Provider

    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

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 Validuntilfurthernotice Expirationdate2yearsfrommonthofissue

    70-2920 3-card 70-2908 2-card self-mailer

    90-1806 3-card 90-1805 2-card self-mailer

    70-2923 12/00

    AHARegion

    CommunityTraining Center

    TrainingSite

    Instructor

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2923

    ACLS EP InstructorThis 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

    70-2923 3-card

    90-1806 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    ACLSProvider

    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 TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1806

  • ACLSACLS Experienced ProviderThe 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.

    Quality Control Checkpoints

    IssuedatebeginningMarch 5, 2001 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue

    70-2922 R3/09

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    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

    18

  • PALS and PEARS

    PALS and PEARS(Pediatric Advanced Life Support and Pediatric Emergency Assessment, Recognition, and Stabilization)

    PALS National FacultyPALS 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

    forthePALSProgramwithintheirregionsinstructornetwork.NFmembersarekeyresourcesfortheRegionalECC Committee. The NF status 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

    IssuedatebeginningJuly 2007 Termofappointment Carddesignvaliduntilfurthernotice

    Back of Card

    AHAECCmissionstatement SignatureofappointedNFmember(inink)

    PALS National Faculty

    John DoeTerm: July 2011 June 2012

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    John Doehas been appointed as a Pediatric Advanced Life Support National

    Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    PALS NationalFaculty

    PALS National Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Pediatric Advanced Life Support National

    Faculty for the American Heart Association XXXXXX Region .

    Term: July 2011 June 2012Jane Doe PROAD Chair

    PALS NationalFaculty

    PALS National Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Pediatric Advanced Life Support National

    Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe PROAD Chair

    PALS NationalFaculty

    KJ0462

    R4/10

    KJ0462

    R4/10

    KJ0462

    R4/10

    PALS Regional FacultyPALS 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

    forthePALSProgramwithintheirregionsinstructornetwork.RFmembersarekeyresourcesfortheregionsTraining Centers. The RF status 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 DoeTerm: July 2011 June 2012

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    Natio

    nal Center

    EC

    C P

    rograms

    7272 Greenville A

    ve.D

    allas, TX 75231-4596

    John Doehas been appointed as a Pediatric Advanced Life Support Regional

    Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    PALS RegionalFaculty

    PALS Regional Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Pediatric Advanced Life Support Regional

    Faculty for the American Heart Association XXXXXX Region .

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    PALS RegionalFaculty

    PALS Regional Faculty

    John DoeTerm: July 2011 June 2012

    John Doehas been appointed as a Pediatric Advanced Life Support Regional

    Faculty for the American Heart Association XXXXXX Region.

    Term: July 2011 June 2012Jane Doe, ECC Regional Committee Chair

    PALS RegionalFaculty

    KJ0562

    R4/10

    KJ0562

    R4/10

    KJ0562

    R4/10

    Quality Control Checkpoints

    IssuedatebeginningJuly 2007 Carddesignvaliduntilfurthernotice Termofappointment

    Back of Card

    AHAECCmissionstatement SignatureofappointedRFmember(inink)

    19

    National Faculty cards produced and distributed by AHA National Center

    Regional Faculty cards produced and distributed by AHA National Center

  • PALS and PEARS

    20

    PALS Training Center FacultyPALS Training Center Faculty (TCF) members are appointed by their respective Training Centers. PALS TCF

    members are responsible for quality assurance and are the educational leadership for all PALS courses

    within their Training Center network. TCF members conduct instructor courses, monitor new and renewing

    instructors,andconductupdatesfortheTrainingCentersinstructors.Thiscardisnotanacceptablesubstitutefor an instructor card and does not verify instructor status dates.

    Quality Control Checkpoints

    IssuedatesbeginningJune 30, 2010 Carddesignvaliduntilfurthernotice NameoftheappointingTrainingCenter Monthandyearofappointment Dateforreappointment(monthandyear) TrainingCenteralignment TrainingCenteraddressandcontactinformation FirstandlastnameoftheTrainingCenterCoordinator

    (must be legible)

    PALS InstructorPALS Instructors teach the PALS Provider Course and the PEARS Provider Course.

    90-1817 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    TC TC ID #Alignment

    TC TCAddress Phone

    TCCity, State ZIP

    InstructorID #

    HoldersSignature

    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 Instructor

    P A L S I N S T R U C T O R Quality Control Checkpoints

    IssuedatebeginningOctober 12, 2011 Carddesignvaliduntilfurthernotice Expirationdate2yearsfrommonthofissue Thiscardsupersedescard70-2919

    Associated Materials for Instructors

    PediatricAdvancedLifeSupportInstructorManual PediatricAdvancedLifeSupportProviderManual PediatricEmergencyAssessment,Recognition, andStabilizationInstructorManual

    PediatricEmergencyAssessment,Recognition, andStabilizationProviderManual

    2010HandbookofEmergencyCardiovascularCare forHealthcareProviders

    90-1817 3-card

    TCF certificate and card printed by Training Center Coordinator using template available on 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 RegionKJ0835 PALS 6/10

  • PALS and PEARS

    21

    PALS ProviderThe 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.

    Quality Control Checkpoints

    IssuedatebeginningOctober 12, 2011 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Thiscardsupersedescards70-2906and70-2918

    Quality Control Checkpoints

    IssuedatebeginningJanuary 21, 2002 ValidthroughDecember31,2013 Not valid for issue after December 31, 2011, and

    is superseded by cards 90-1808 and 90-1818 Renewaldate2yearsfrommonthofissue

    70-2918 R1/08

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2918

    PALS Provider

    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 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    PALS Prov ider

    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

    P E D I AT R I C A D VA N C E D L I F E S U P P O R T P E D I AT R I C A D VA N C E D L I F E S U P P O R T

    Training TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1818

    Quality Control Checkpoints

    IssuedatebeginningJanuary 21, 2002 CarddesignvalidthroughDecember31,2013 Not valid for issue after December 31, 2011, and

    is superseded by card 90-1817 Expirationdate2yearsfrommonthofissue

    Associated Materials for Instructors

    PediatricAdvancedLifeSupportInstructorManual PediatricAdvancedLifeSupportProviderManual PediatricAdvancedLifeSupportCourseGuide PediatricEmergencyAssessment,Recognition, andStabilizationInstructorManual

    PediatricEmergencyAssessment,Recognition, andStabilizationProviderManual

    HandbookofEmergencyCardiovascularCare forHealthcareProviders

    70-2919 R1/08

    Training CenterAlignment

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2000 American Heart Association Tampering with this card will alter its appearance. 70-2919

    PALS Instructor

    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

  • Quality Control Checkpoints

    IssuedatebeginningNovember 29, 2007 Validuntilfurthernotice Renewaldate2yearsfrommonthofissue Uponrelease,willbesupersededbycard90-1819

    80-1215 8/07

    TrainingCenter

    TC AddressContact Info

    CourseLocation

    Instructor

    HoldersSignature

    2007 American Heart Association Tampering with this card will alter its appearance. 80-1215

    PEARS Provider

    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

    PEELHERE

    This card contains unique security features to protect against forgery.80-1215 3-card

    PALS and PEARS

    22

    PEARS ProviderThe 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.

    Quality Control Checkpoints

    Issuedate:tobereleasedSpring 2012 Uponrelease,validuntilfurthernotice Renewaldate2yearsfrommonthofissue Uponrelease,thiscardsupersedescard80-1215

    90-1819 3/11This card contains unique security features to protect against forgery.

    PEELHERE

    PEARS Prov ider

    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 RTraining TC ID #Center Name

    TC TCInfo City, State ZIP Phone

    CourseLocation

    Instructor Inst. ID #Name

    HoldersSignature

    2011 American Heart Association Tampering with this card will alter its appearance. 90-1819

    90-1819 3-card

  • Course Card Index

    Course Card Index

    Below is a comprehensive list of course cards with product numbers, including 2 different formats for the

    cards: 3-card sheet and 2-card sheet, self-mailer. For cards that list 70-, 80-, and 90- product numbers, the

    90- product number reflects the most current version.

    Only current American Heart Association Training Centers may order course cards.

    Card Description

    Current Version of Card Earlier Version of Card

    3-Card Sheet2-Card Sheet,

    Self-Mailer3-Card Sheet

    2-Card Sheet,Self-Mailer

    BLS

    BLS Instructor 90-1800 90-1807 70-2916 70-2904

    BLS Healthcare Provider 90-1801 90-1802 70-2915 70-2903

    Heartsaver

    Heartsaver Instructor 90-1816 80-1205

    Heartsaver Skills Evaluator 90-1822 80-1216

    Heartsaver First Aid Instructor Discontinued Discontinued 70-2965 70-2964

    Heartsaver CPR AED 90-1813 90-1810 80-1203 80-1211

    Heartsaver CPR Discontinued Discontinued 80-1204 80-1210

    Heartsaver AED Discontinued Discontinued 80-1203 80-1211

    Heartsaver First Aid 90-1814 90-1809 80-1202 80-1208

    Heartsaver First Aid CPR AED 90-1815 90-1820 80-1202 80-1208

    Heartsaver Pediatric First Aid 80-1201 80-1209

    Heartsaver CPR AED in Schools 90-1821 80-1200

    Heartsaver CPR in Schools 80-1200

    ACLS

    ACLS Instructor 90-1804 90-1803 70-2921 70-2909

    ACLS Provider 90-1806 90-1805 70-2920 70-2908

    ACLS EP Instructor 70-2923

    ACLS Experienced Provider 70-2922

    PALS and PEARS

    PALS Instructor 90-1817 70-2919

    PALS Provider 90-1818 90-1808 70-2918 70-2906

    PEARS Provider 90-1819 80-1215

    23

  • ECCTo order, contact one of the following:

    C H A N N I N G B E T E C O M P A N Y

    One Community Place | South Deerfield, MA 01373-0200

    P H O N E : 800-611-6083 | F A X : 800-499-6464aha.channing-bete.com

    L A E R D A L M E D I C A L C O R P O R A T I O N

    167 Myers Corners Road | Wappingers Falls, NY 12590-8840

    P H O N E : 888-562-4242 | F A X : 800-227-1143 laerdal.com

    W O R L D P O I N T E C C , I N C .

    1326 S. Wolf Road | Wheeling, IL 60090

    P H O N E : 888-322-8350 | F A X : 888-281-2627eworldpoint.com

    For more information on other American

    Heart Association programs contact us:

    877-AHA-4CPR

    www.heart.org/cpr

    7272 Greenville AvenueDallas, Texas 75231-4596

    www.heart.orgKJ0916 9/11