1. CALS Instructor Review Course
2016
Evolution of the
CALS Program
Darrell Carter MD
CALS Program Director
2016
CALS

2. Objectives for this session
Review the CALS Mission and teaching principles
Discuss the current distribution of CALS training
Describe the support of the CALS Program by national organizations (ACEP, AAFP)
Discuss new initiatives of the CALS Program
2016
CALS

3. The Mission of CALS
To improve patient care by providing advanced life support education to rural health care providers
2016
CALS

4. CALS Educational Content
What we teach is based on the following principles:
- Content is based on the best available evidence
- Medical literature is often inconclusive and open to interpretation
- There may be more than one acceptable approach to a given clinical situation but we need to teach the “CALS approach”
Our intent is to provide practical, consensus-based recommendations generally consistent with published guidelines
While there are more than one acceptable approach to many clinical situations, we need to teach the “CALS Approach” so as to have a functional team at work when the care providers are in their own clinical setting.
2016
CALS

5. Essential Components of CALS Training
Team Concept
Universal Approach
Rural Focus [Rural Emergency Medical Education]
Resuscitation Diamond
2016
CALS

6. CALS Resuscitation Diamond
2016
CALS

7. Key Elements of the CALS Resuscitation Diamond
Teaching of Essential Emergency Skills and Knowledge
Development and use of Effective Provider Teams with the utilization of the CALS Universal Approach
2016
CALS

8. Key Elements of the CALS Resuscitation Diamond
Instruction in the proper use of essential Equipment
Teaching of Emergency Care based on a Systems Approach centered on the needs of the patient, rather than an assumed diagnosis
2016
CALS

9. Growth and Distribution of CALS Training
2016
CALS

10. Location of CALS Training In the United States
California
Iowa
Michigan
Minnesota
Missouri
Montana
Nebraska
Oklahoma
Texas
Wisconsin
AAFP Annual Assembly in Orlando
AAFP – 2 modified Provider Courses (40 participants)
2016
CALS

11. Current or Developing CALS Training Internationally
- Canada (3 Providences) - Global CALS development * Africa (Kenya) * Haiti * Viet Nam - US Department of State (Embassy Medical Personnel) * Austria * Germany * Italy * Panama * South Africa * Thailand
2016
CALS

12. Distribution of CALS Training - MN
Provider Courses:
FY15-16 = 24(487 participants)
Total Courses = 339 (7,173 participants)
Benchmark Labs : FY15-16 = 18 labs
Total = > 500 (>2000 participants)
Trauma Module: FY15-16 = 25 (404 participant)
Total Courses =159 (2,163 participants)
2016
CALS

13. Distribution of CALS Training - WI
Provider Courses: FY = 4 (56 participants)
Total = 29 (730 participants)
Trauma Modules: FY = 4 (58 participants)
Total = 16 (230 Participants)
Benchmark Labs = 6 total
2016
CALS

14. Distribution of CALS Training Total Courses
Provider Courses – ( 10,392 participants)
Benchmark Lab > 500 labs ( > 2000 participants)
Trauma Modules – ( 2,719 participants)
2016
CALS

15. Endorsement of the CALS Program
2016
CALS

16. Endorsement of CALS by AAFP
In 2013, the AAFP Congress of Delegates passed a resolution endorsing CALS training for rural emergency care training.
July 2014 meeting of the AAFP Commission on Education recommended and the Board of Directors approved the following:
“The CALS Curriculum as an equally acceptable alternative to other advanced life support and/or trauma life support and/or emergency response training courses and because the CALS Curriculum is more comprehensive, there may be additional benefit to physicians in rural practice.”
2016
CALS

17. Endorsement of CALS by ACEP
The American College of Emergency Physicians (ACEP) believes that the Comprehensive Advanced Life Support (CALS) course is a valuable educational experience and is an equally acceptable alternative to other advanced life support or trauma life support courses.
CALS may be of particular value to physicians who practice rural emergency medicine because it is more comprehensive than other life support courses. [Ann Emerg Med. 2015;66:446]
2016
CALS

18. New Initiatives of the CALS Program
CALS Toolbox for the development of new CALS Programs.
CALS training licenses
Suggested standardized ED training for rural ED providers
Development of e-learning materials
Develop a toolbox for ACEP Chapters to use to promote CALS as a replacement for the triplicate certifications (ACLS, PALS, ATLS) for those providers who are required to take them.
2016
CALS

19. New Initiatives of the CALS Program
Cardiostart
Viet Nam CALS training
Alaska CALS training program with telemedicine
Advances in CALS Web site
2016
CALS

20. New CALS Initiatives (cont)
Development of CALS Essentials
Development of the Haiti CALS Program
Development of the Kenya CALS Program
2016
CALS

21. Challenges Ahead
Help generate an acceptance of CALS training in place of other ALS training for rural providers.
Find ways to help fund CALS training
Emergency Skills Training – maintain the Benchmark Lab &/or develop more life-like mannequins.
Further development of the Global CALS Program
2016
CALS

22. Challenges Ahead
Develop State and Regional CALS Programs with local instructors to teach local providers.
Seek State Trauma Committee acceptance of CALS as appropriate rural emergency trauma training in other states
2016
CALS

23. How can you be involved? Teach CALS Courses
Volunteer – Serve on a CALS committee!
Most have teleconferencing opportunities
Make a real impact on the growth of CALS
Advocate – Recruit others to become involved with CALS
Help with the many projects and activities of CALS
2016
CALS

24. Conclusion
Teamwork is the fuel that allows common people to attain uncommon results. (Author Unknown)
2016
CALS

25. Your Thoughts and Questions!
Contact information:
* Kari Lappe RN
CALS Executive Director
*Darrell Carter MD
CALS Program Director
2016
CALS

26. 2016
CALS

27. Development of the International CALS Program
Establishment of a Global CALS Committee/Division to work on the modification of the current CALS material into a form useful to the medically developing world.
Phase I – development of “CALS Essentials” – the written material and curriculum for the teaching of the initial phase of Global CALS at a useful level for the providers and their team working in their environment.
Translation of the CALS material into French for Haiti.
The first CALS Essentials class has been conducted in Haiti and another is in planning.
Work in progress on a CALS Essentials Course in Kenya.
2016
CALS