2022 International Program Administration Manual PAM

Emergency Cardiovascular Care
Program Administration Manual

Guidelines for Program Administration and Training
Interna�onal Version
Effective April 1, 2022
© 2022 American Heart Association

Contents
Preface ......................................................................................................................................................................1
1—ITC Organization ...................................................................................................................................................2
Structure of the International AHA Training Network .................................................................................................... 2
The Role of the ITC .......................................................................................................................................................... 2
Laws, Rules, and Regulations .......................................................................................................................................... 2
ITC Criteria ....................................................................................................................................................................... 3
Faculty ............................................................................................................................................................................. 3
Regional Faculty .............................................................................................................................................................. 5
2—ITC Policies and Procedures ...................................................................................................................................6
Renewing an ITC Agreement ........................................................................................................................................... 6
Following AHA Policies and Procedures .......................................................................................................................... 8
Managing Records ........................................................................................................................................................... 9
Interfacing With Instructors .......................................................................................................................................... 12
AHA Platforms ............................................................................................................................................................... 13
Course Completion Card Management......................................................................................................................... 13
Course Fees, Materials, and Equipment ....................................................................................................................... 16
Copyright of AHA Materials .......................................................................................................................................... 17
Quality Assurance Plan.................................................................................................................................................. 18
3—Instructor Alignment ...........................................................................................................................................19
Requirements for Instructor Alignment ........................................................................................................................ 19
4—Training Sites ......................................................................................................................................................21
TS Responsibilities ......................................................................................................................................................... 21
Management of TS ........................................................................................................................................................ 21
5—Boundaries and Recognition of Status .................................................................................................................22
Training Boundaries ...................................................................................................................................................... 22
Recognition of Status .................................................................................................................................................... 23
6—Course Information .............................................................................................................................................25
General Information...................................................................................................................................................... 25
Provider Courses ........................................................................................................................................................... 27
Provider Course Student Assessment ........................................................................................................................... 29
Instructor Essentials Courses ........................................................................................................................................ 31
Virtual Training Options for AHA Provider Courses ...................................................................................................... 34
Course Director Orientation.......................................................................................................................................... 35
7—Conflict of Interest and Ethics Policies .................................................................................................................36
Conflict of Interest ........................................................................................................................................................ 36
Ethics/Code of Conduct................................................................................................................................................. 36
8—Legal Aspects ......................................................................................................................................................38
Americans With Disabilities Act .................................................................................................................................... 38
Trademarks ................................................................................................................................................................... 38
Dispute Resolution/Disciplinary Action......................................................................................................................... 39
9—Reference and Resources ....................................................................................................................................41
AHA Program Administration Manual: International Version, 2022

Preface
Welcome to the eighth edition of the Program Administration Manual (PAM). This latest edition of the PAM
reflects the recent changes of the Emergency Cardiovascular Care (ECC) Programs.
This manual includes sections that will help the American Heart Association (AHA) manage ECC Programs. The
manual has been organized to give the user concise access to rules affecting the ECC Training Network,
International Training Centers (ITCs), volunteer organization and management, ethics, and dispute resolution
procedures.
Specifically, this manual includes information for
• ECC operations and ITC administration for ITCs outside of the 50 US states and District of Columbia (US
territories, such as Puerto Rico, Guam, and American Samoa, fall under the International PAM)
• ECC courses
• Organizational ethics and legal considerations
The PAM is intended to augment other ECC information and training materials, not replace them. Because of
the rapid pace at which course improvements and changes may occur, this manual will never be able to
answer all questions that may arise about ECC Program Administration. New policies and changes in the
current PAM policies are announced in training bulletins. Training bulletins issued after the effective date of
this manual supersede the related information in this manual and become the new policy. Training Memos
clarify current policies and introduce new educational materials and programs and changes to existing
programs. For the most current information on ECC Program Administration, please visit Atlas at
atlas.heart.org. The PAM is updated as needed.
AHA Program Administration Manual: International Version, 2022 1

1—ITC Organization
Structure of the International AHA Training Network
The International AHA Training Network includes International Training Centers (ITCs) Regional Faculty (RF),
Training Sites (TSs), ITC Coordinators (TCCs), ITC Faculty (TCF), Training Center Administrators (TCAs), Training
Site Administrators (TSAs), and instructors. Figure 1 represents the structure of the International AHA Training
Network.
Figure 1. International AHA Training Network structure.
The Role of the ITC

ITCs are responsible for
• The administration and quality of all ECC courses delivered by the ITC or aligned TSs and instructors,
regardless of the course location
• Providing aligned instructors and TSs with consistent and timely communication of any new or updated
information about International, Regional, or ITC policies, procedures, course content, or course
administration that could potentially affect an instructor in carrying out their responsibilities
• Serving as the principal resource for information, support, and quality control for all AHA ECC Instructors
aligned with the ITC
• The day-to-day management of the ITC, TSs, and instructors
• Providing TS information on the AHA Platforms
Laws, Rules, and Regulations

Each ITC is responsible for complying with all applicable laws, rules, and regulations. In particular, each ITC
must comply with data privacy laws that apply to their activities based on students’ legal domicile, nationality,
and place of instruction. The AHA cannot provide legal advice to ITCs, their staff, or instructors.

ITC Criteria
New ITC Application
TC applications are available for
• New organizations that wish to become an ITC and that meet the criteria below
• Established ITCs that wish to add discipline(s)
New ITC Application Criteria

Establishment and renewal of ITC Agreements are at the sole discretion of the AHA. The AHA makes these
decisions on the basis of its ability to support all ITCs effectively and efficiently.
The AHA considers each of these factors when approving or renewing an ITC contract:
• The establishment of an ITC supports the AHA mission.

• The training needs of a given area are based on geography, population, corporate/community needs, and
the healthcare environment.
• The relationship of the ITC with the AHA does not place the AHA in a conflict of interest or materially
damage the reputation of the AHA or AHA’s mission as a publicly supported charitable organization.
• The ITC’s aligned instructors meet the established criteria and are eligible to fulfill the role.
• The ITC meets the general liability insurance requirements outlined in the Liability Insurance for ITCs
section of this manual.
• The ITC maintains internet access and a current active email address.
• Each region may have different requirements or criteria for establishing an ITC.
Faculty
ITC Coordinator
The TCC
• Represents the ITC and is selected by the ITC

• Serves as the primary contact between the ITC and AHA ECC Programs
• Is ideally an AHA ECC Instructor
• Has an understanding of ECC Programs
• Is responsible for submitting midyear and year-end reports of training conducted in the ITC
• Handles the management and storage of ITC records
• Is responsible for the security and distribution of course completion cards
• Is responsible for the security and distribution of exams to instructors and TSs
• Is responsible for all instructors, whether directly affiliated with the TC or through their TSs
• Manages instructor alignment on the AHA Platforms
• Manages instructors and rosters on the AHA Platforms
• Identifies and is responsible for the training and management of all ITC Faculty (TCF) for the ITC

• Ensures that instructors are current with information from the AHA, including science updates, training
memos, and bulletins
Upon a change in TCC, ITC Administration should notify ECC International Operations with the Training Center
Update Form by using the email [email protected].
ITC Faculty
AHA TCF
• Conducts Instructor Essentials courses and monitors, updates, renews, and coaches instructors
• Serves as quality assurance and educational leadership for the ITC
• Ensures that the ITC can conduct quality Instructor Essentials courses, course monitoring, and instructor
updates within the ITC
Each ITC must appoint at least one TCF in each discipline it teaches. Basic Life Support (BLS) TCF can support
both BLS Instructors and Heartsaver® Instructors; likewise, Pediatric Advanced Life Support (PALS) TCF can
support both PALS and Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS®) Instructors.
The recommended ratio is at least one TCF per 8 instructors (in the same discipline) or at least one TCF per TS
if the instructor numbers are fewer than 12.
Potential TCF candidates must complete the TCF program which is designed to prepare to implement
instructor development within their ITC, conduct instructor renewal and collaborate with the TCC to ensure
the highest quality training for the ITC in accordance with the guidelines of the AHA and concepts from
“Resuscitation Education Science: Educational Strategies to Improve Outcomes From Cardiac Arrest.”
TCF candidates must meet certain requirements before taking the TCF course:
• Be at least 21 years old

• Completed the AHA discipline–specific Instructor Essentials online course
• Have a current AHA discipline–specific instructor card and be an active instructor
• Taught at least 8 courses within the past 2 years as Lead Instructor in the discipline for which they apply
• Complete the AHA discipline–specific TCF Candidate Application
• Successfully complete the AHA discipline–specific TCF process:
− Complete a TCF course in the discipline for which they apply
− Successfully be monitored by a RF teaching an instructor course within 6 months of completing the TCF
course
− Successfully be monitored by RF while monitoring an instructor candidate who is teaching a provider
course
TCF status is a TCC appointment and an internal position to that ITC. TCF status can be transferred to other
ITCs if the TCF has completed the AHA TCF program. The other ITCs are not obligated to accept the TCF
position and may require a meeting with or monitoring of the TCF applicant before acceptance. When a TCF
member transfers to another ITC, it is as an instructor, not as a TCF, unless the new ITC accepts the TCF’s
transfer.

Regional Faculty
AHA RFs are appointed volunteers and serve as science and curriculum experts to ITCs and instructors. The
AHA reviews RF assignments to avoid conflict of interest. AHA has final authority in the decision of
assignment.
AHA RF
• Conducts course monitoring on a routine basis and as requested by the AHA

• May monitor, update, coach, and mentor TCF and instructors upon request of the assigned ITC
• May conduct science and training updates in the region, as requested by AHA International
An RF member cannot
• Conduct course monitoring for any ITC they are aligned with as an instructor or an ITC that may be
perceived as a competitor because of conflict of interest
• Receive payment for monitoring or mentoring activities while acting in the role of RF
• Hold a paid position within the AHA

2—ITC Policies and Procedures
Renewing an ITC Agreement
ITC Agreement Renewal Process
The TCC will work with the AHA Regional Director to complete the renewal application. Renewal of the ITC will
be based on compliance with AHA policies and procedures, which includes the results of ITC administrative
reviews, and course monitoring, timely submission of required updated insurance and requirement of
indemnity clauses mentioning bodily injury and third-party liability, training reports, and submission of a
quality assurance plan.
Course Monitoring
Course monitoring is part of the AHA’s quality review process and may be announced or unannounced. An
ITC’s refusal to cooperate with or allow course monitoring is grounds for termination of the ITC Agreement.
Course monitoring is conducted by an assigned RF or AHA staff member, who reports the Course Monitoring
to the AHA. The TCC must be available during a scheduled ITC course monitoring to answer any questions
from reviewers and to ensure that the requirements are understood. Participation by TCF is encouraged.
An unscheduled course monitoring may be conducted at the discretion of AHA Administration.
Transfer of ITC Agreement

Status as an ITC may not be assigned, sold, licensed, sublicensed, or transferred without the prior written
consent of the AHA.
Adding a Discipline
ITCs that wish to add or reinstate a discipline need to submit an application with appropriate attachments to
their Regional Director.
Deleting a Discipline
The procedure for deleting a discipline is the same as for terminating an ITC Agreement.
Terminating an ITC Agreement

ITCs may be closed in 1 of 4 ways:
• Either party may, at its discretion, terminate the ITC Agreement by providing the other party with 60
calendar days’ notice without further explanation or justification.
• Either party is free to choose not to renew the ITC Agreement at renewal without giving advance notice,
further explanation, or justification to the other party.
• Either party may terminate the ITC Agreement if the other party breaches the ITC Agreement and does not
cure the breach within 10 business days after receiving written notice of the breach.
• The AHA may terminate the agreement and close an ITC without any prior written notice if it determines,
in its sole discretion, that the ITC performs any activities that pose a legal or business risk to the AHA.

• If the TC is requesting to terminate the agreement, they must submit the request on company letterhead
and ensure that it is signed by the TC’s signing authority
An ITC must perform the steps in Table 1 within 30 calendar days before the expiration or termination of the
ITC Agreement unless indicated otherwise:
Table 1. Steps for Terminating an ITC Agreement

Step Action
1 The ITC notifies all instructors in writing of the ITC closing
• At least 30 calendar days before the scheduled closing date
or
• Immediately if the agreement expires and either party chooses not to renew it
or
• Immediately upon termination due to failure to cure to breach upon 10 days’ written notice or any
immediate termination by the AHA
2 Instructors access Atlas (atlas.heart.org) for a current list of other ITCs in the area.
3 The ITC ensures that its records are updated and complete and that all pending cards have been issued.
Refer to the ITC Agreement for more details.
4 eCards and course completion cards are not transferable. Upon closure of the ITC, all unissued eCards will
be unavailable to the ITC.
The ITC returns all blank AHA course completion cards to AHA International. Only course completion cards
purchased from an authorized AHA distributor will be considered for reimbursement.
5 The ITC offers to either
• Hold instructor records (including course rosters and monitor forms) until new ITCs have been
designated
or
• Inform instructors that their records are being sent to the AHA
Records must be sent to the new ITC or to AHA International within 30 calendar days after the ITC
Agreement termination date. Instructor records may not be sent to individual instructors.
Transitioning an ITC to a TS
To transition from an ITC to a TS, the ITC needs to complete the steps in Table 2 at least 30 calendar days
before the transition.
Table 2. Steps for Transitioning an ITC to a TS

Step Action
1 The TCC identifies an ITC that will accept the transitioning ITC and its instructors as a TS. Instructors may
select their own ITC.
2 The ITC notifies all instructors aligned with the ITC that is closing or transitioning at least 30 calendar days
before the scheduled date. If an instructor wishes to align with another ITC, the transitioning ITC will
transfer the instructor’s records to the requested ITC on receipt of a completed Instructor Records Transfer
Request.

Step Action
3 The transitioning ITC ensures that all course and instructor records are updated and complete and that
pending cards have been issued.
4 eCards and course completion cards are not transferable. Upon closure of the ITC, all unissued eCards will
be unavailable to the ITC.
Following AHA Policies and Procedures

Overview
The ITC must perform its duties in a manner consistent with the AHA mission and guidelines. This includes the
following:
• The ITC must use the current AHA ECC training materials in its courses and ensure that course participants
have the most current course materials for use. For more information, please refer to Use of AHA
Materials.
• A training organization cannot operate as an ITC until it has submitted the appropriate information and
documentation to the AHA and has been officially approved as an ITC.
• In support of the AHA ECC mission, the ITC provides instructors with resources for obtaining equipment,
marketing, or organizational support for courses.
• The ITC conducts Instructor Essentials courses and provides updates to its instructors and TSs with the
latest information on AHA courses, science guidelines, policies and procedures, training bulletins and
memos, or other communications. All updates must meet the timing requirements defined with each
product or materials release.
• ITC policies and procedures for instructors and administration of TSs cannot contradict AHA guidelines and
policies as listed in the PAM.
• ITCs must prohibit smoking in classrooms and training facilities during all AHA ECC training programs.
• The AHA requires all ITCs to maintain internet access and an email address for the TCC.
• ITCs should communicate any changes in management, TCC, and contact details to
[email protected].
• Failure to maintain internet access and an active email address could be grounds for termination.
• To ensure that each ITC is meeting its contractual obligations, the AHA will conduct periodic reviews. All
ITCs should adhere to the terms of the agreement and AHA guidelines outlined in the PAM.
• The AHA is an independent entity from any TC or TS. No TCC, TC, instructor, or other affiliated individual
(employees, volunteers, or representatives) of a TC or TS may represent themselves as an employee of the
AHA.
• TCs are responsible for ensuring that affiliated individuals do not misrepresent themselves as AHA
employees (eg, in their curriculum vitae or LinkedIn profiles).
Liability Insurance for ITCs

For the duration of its term as an ITC, an ITC must obtain and maintain (at its expense) general liability
insurance. This policy shall not be modified or canceled except after 30 days’ prior written notice to the AHA.

ITCs should contact their Regional Director or [email protected] for specific liability insurance
requirements for AHA ITCs. In addition, ITCs should send their Regional Director a copy of their liability
insurance policy each time it is renewed.
Managing Records
Overview
ITCs may maintain hard copy or electronic records if all required records are available and can be provided to
the AHA upon request. If the ITC uses electronic records, it is recommended to back up the data with a data
recovery system in case of a catastrophic loss of the hard drive. ITCs must be able to print all electronic files.
Managing Records: Document Retention

• ITCs must keep all required documents (either hard copy or electronic) for at least 3 years after the date of
action; for example, maintain records for 3 years past the last day of the course.
• An ITC may store records at a TS as long as the records are available to the ITC and accessible as requested
by the AHA.
• ITCs need to be aware of and comply with local regulations for document retention.
ITC Documents
The ITC must maintain the following required documents according to the retention policy stated above or its
own retention schedule if longer:
• An original or a copy of the current, signed ITC Agreement

• Documentation that the ITC has the appropriate minimum general liability insurance coverage or waiver as
stated in the ITC Agreement
• Documentation of any issues identified during an ITC Quality Assurance Review and steps taken to resolve
the issues(s)
• Agenda for each course provided by the ITC
• The following written policies and procedures:
− Equipment/manikin maintenance and decontamination
− Quality assurance plan (updated annually)
− Internal ITC dispute resolution policy
− TS management/relations
− Card maintenance and issuance
• Documentation of compliance with all laws that regulate data collected and processed as part of the ITC’s
training activities including necessary consents, as applicable.
Course Files
ITCs must maintain the following course records, in either hard copy or electronic format:
Provider Courses
• Completed course rosters
• All AHA course testing documents (skills sheets, exams)

• Documentation related to dispute resolution (attach to course roster as indicated)
• Originals or a summary of course evaluations (used by students to rate the course and instructor)
− Note: For ITCs using eCards, the AHA no longer requires that course evaluations be on paper. Students
can complete an online course evaluation when accessing their eCard. For ITCs currently issuing paper
course completion cards, the AHA still requires paper course evaluations.
• Original evaluations if there were problems with the course
• Evidence of use of the AHA course fee disclaimer for courses in which fees are charged
• Skills session paperwork for eLearning courses, including roster, certificate of completion for the online
portion, and original or summary of course evaluations for the hands-on session
• Rosters from all AHA courses need to be entered into AHA Platforms.
− Note: It is recommended that Course documents be kept within the ITC at least until the ITC’s next
renewal admin review is completed.
Instructor Essentials Courses
• Instructor Candidate Applications for all candidates in the course documenting that the candidate will align
with an ITC
• Documentation related to dispute resolution (attach to course roster as indicated)
• Originals or summary of course evaluations (used by candidates to rate the course and TCF)
• Original evaluations if there were problems with the course
• Evidence of use of the AHA course fee disclaimer for courses in which fees are charged
• All monitoring forms from the first class the candidate taught, which documents that they completed all
the requirements for becoming an instructor
• All paperwork completed by a secondary ITC must be sent to the primary ITC. This is the instructor’s
responsibility.
TCF Courses
• Potential TCF Faculty Evaluations forms completed by the ITC
• All documentation that TCF prerequisites were met (courses as lead, current instructor cards, etc)
• TCF applications forms for all candidates in the course documenting that the candidate will hold that
position within the ITC
• Documentation related to dispute resolution (attach course roster as indicated)
• Originals or summary of course evaluations (used by TCF candidates to rate RF or AHA staff)
• All monitoring forms indicating all requirements for becoming a TCF were completed
Instructor and TCF Records (All Disciplines)

The ITC maintains files and documentation for all course activities for aligned instructors.
The forms listed below can be found on Atlas or requested from the regional office.
• Instructor/TCF Candidate Applications for all instructors aligned with that ITC

• Instructor Monitor Tool
• Instructor/TCF Renewal Checklist
• Instructor Records Transfer Requests
• Instructor Course Completion Notice to Primary TC
• TCF Monitoring Tool (available to RF or AHA staff)
• Documentation of administrative or disciplinary actions taken
Note: Instructors are responsible for submitting proof of training to their primary ITC.
Instructor Records Transfer

Instructor status may be freely transferred from one ITC to another upon the instructor’s request.
Records must be transferred as requested, and the original ITC must also retain copies for the required 3-year
period to document training activities through the ITC.
The original ITC is required to notify the instructor of the process as listed below and to send whatever is on
file in the instructor records.
Note: Instructor records may not be sent to individual instructors.
The steps to transfer instructor records from one ITC to another are as shown in Table 3:
Table 3. Steps to Transfer Instructor Records

Step Action
1 The instructor completes an Instructor Records Transfer Request, obtained from the regional office.
2 The TCC of the ITC where the instructor is transferring signs the request and sends it to the
instructor’s original ITC. Alternatively, the instructor may send the request to the original ITC.
3 The original ITC sends complete, up-to-date instructor files, instructor records, or a list of all courses
taught to the other ITC within 30 calendar days after receiving the Instructor Records Transfer
Request.
Instructor records include
• Instructor/TCF Candidate Applications for all instructors aligned with that ITC
• Instructor Monitor Tool
• Instructor/TCF Renewal Checklist
• Instructor Records Transfer Requests
• Instructor Essentials Course Completion Notice to Primary ITC
• Documentation of administrative or disciplinary actions taken
• Initial application form
• Course monitoring
• Renewal forms
• List of the dates of the courses conducted (within the 3-year retention window for instructor
records)
Copies or originals are acceptable.
4 Once the original ITC has sent requested instructor files, the accepting ITC must verify that the
instructor has been removed from the original ITC Instructor List on the AHA Platforms. The

Step Action
accepting ITC will need to advise the instructor on how to complete alignment with their center on
the AHA Platforms.
5 Upon verifying receipt of instructor records and that the instructor has completed all necessary
steps to hold current instructor status, the new ITC adds the instructor on the AHA Platforms.
6 Accepting ITC must
• Complete a skills check
• Conduct course monitoring
• Verify required courses taught
• Review any documentation related to administrative and disciplinary actions taken
• Retain a copy of the Instructor Records Transfer Request
The new ITC may renew the instructor card if the instructor has met the renewal criteria or maintain the
current instructor card and issue a new card on renewal date.
Reporting
ITCs are required to submit 2 training reports each year: a mid-year report and an end-of-year report. Failure
to submit the required ITC Activity Report by the deadline is considered a breach of the ITC Agreement and
cause for the AHA to terminate the ITC Agreement.
Interfacing With Instructors

Responsibilities of ITCs to Instructors
The AHA recommends that ITCs have written Alignment Agreements that ensure instructors meet all
requirements. This might include, but is not limited to, having instructors sign a contract. At a minimum, each
ITC is responsible for
• Ensuring that all instructors are aligned with the ITC on the AHA Platforms
• Providing guidance and assistance to instructors as needed
• Maintaining a current list of instructor ID numbers from AHA Platforms
• Providing instructors with notification of all ECC training bulletins, training memos, or other official
communications from the AHA update courses as needed
• Maintaining complete and accurate instructor records
• Transferring instructor records to a new ITC within 30 days after receiving an Instructor Records Transfer
Request
• Ensuring that instructors use all current course materials
• Ensuring that all instructors actively use the AHA Platforms and that all rosters are entered into the system
in a timely manner.
TCCs must inform their instructors of the requirement to comply with all AHA policies and Ethics/Code of
Conduct. TCCs must also provide first-line support to their instructors.

AHA Platforms
All ITCs should fully use the AHA Platforms for maintaining course records, managing instructors, and
accessing course information and exams. Users have the following access, depending on their role:
• TCC: One TCC account is created by the AHA for each ITC. The TCC can add, edit, and deactivate
administrators, TSCs, TSAs, TCF, and instructors.
• TCA: The TCA can add, edit, and deactivate TSCs, TSAs, TCF, and instructors.
• TSC: One TSC account is created by the TCC or TCA. The TSC can add and deactivate instructors and
manage rosters for their site, but they cannot access rosters and instructors that are not associated with
their TS.
• TSA: The TSA can add and deactivate instructors and manage rosters for their site, but they cannot access
rosters and instructors that are not associated with their TS.
• Instructors: Their access allows them to add or edit rosters for classes in which they are aligned as well as
accessing course resources.
• Faculty: Can teach instructors
Course Completion Card Management

Ordering Course Completion Cards
Only a TCC (or another authorized ITC representative designated by the TCC) can use the confidential security
code to order eCards or course completion cards for approved disciplines.
The TCC must keep this code confidential. The TCC has final responsibility to the AHA for the security code.
The TCC must notify the AHA immediately if the security code is suspected of being lost, stolen, disclosed, or
used without authorization.
The AHA may change the code if deemed necessary to maintain the confidentiality of the code.
Misuse of the confidential security code could result in termination of the ITC Agreement.
Issuing Course Completion Cards and Security

• AHA eCards and course completion cards contain security features and have the AHA logo. For more
information, please refer to the Course Card Reference Guide located on Atlas.
• To verify an eCard issued internationally, go to https://ecards.heart.org/international and enter the eCard
code or scan the QR code on the student eCard.
• For administrative reasons, the TCC may allow a TS to issue eCards or course completion cards. However,
the TCC has final responsibility to the AHA for all eCards or course completion cards, including those issued
to a TS. Before a course completion card is distributed to a TS or instructor, the name of the ITC must
always be printed on the course completion card. ITCs may not release blank cards that do not contain the
ITC name to a TS or instructors.
• Each student who successfully completes an AHA ECC course must be issued the appropriate course
completion card unless prohibited by local or state statutes or regulations.

• The ITC of the instructor who conducts the provider course is responsible for card issuance and security. If
an instructor is invited to teach at a second ITC or with an instructor from another ITC (the sponsoring ITC),
the course completion cards are issued by that sponsoring ITC.
• Each ITC must be able to document how it maintains card security and accountability. Only the TCC and
persons they designate may have access to blank AHA course completion cards.
• All course completion cards must be in students’ hands as quickly as possible. ITCs must issue eCards or
course completion cards within 20 business days after receipt of completed paperwork.
• ITCs must never allow a course roster to be given to a provider in place of a course completion card.
Course rosters contain personal data of providers and must be protected.
• The instructor’s ID number assigned by Atlas must be included on all provider cards.
• ITCs cannot sell or give course completion cards to other ITCs or non-AHA organizations.
• ITCs can only issue eCards or course completion cards to students who have successfully completed an
AHA course through that ITC.
• If a provider receives remediation, the course completion card will have the remediation date for the issue
date.
• ITCs may choose whether to allow individual instructors to issue eCards on the AHA Platforms. ITCs which
allow individual instructors to issue eCards through the AHA Platforms must develop policies to control the
security of the eCards.
• Advisor: BLS course completion cards accommodate students who pass the cognitive portion of the
HeartCode® BLS Provider Course but cannot perform the physical skills of cardiopulmonary resuscitation
(CPR). By successfully advising others how to perform CPR and use an AED, HeartCode BLS students with
disabilities can receive an Advisor: BLS card. Students should check to make sure their workplaces will
accept these cards. Advisor: BLS cards are available exclusively to authorized TCs for issuance in
accordance with AHA policy.
For more information on course completion cards, refer to the Course Card Reference Guide, the Resource tab
on Atlas, or ask your Regional Director.
Rerouting of Cards
An eCard that has been issued to a student but has not been claimed by that student may not be reclaimed by
the TC or instructor and reissued to another student. Once issued to a student, the eCard must remain
available to that student who successfully completed the course, even if they do not claim it. The student may
claim their eCard anytime during the 2-year period after successful completion of their course. Any TC or
instructor who reclaims a student’s eCard and reissues that eCard to another student is out of compliance.
Filling Out Course Completion Cards

The information to complete the eCard must include all information in the required fields (ITC name,
instructor ID number. For paper cards, the ITC must use the eCard template to fill out the card.
Atlas provides the instructor ID number required on course completion cards. In countries where General Data
Protection Regulation applies, contact the Regional Director for this information. All instructors must have
only one instructor ID number.

Refer to the Course Card Reference Guide for further details on how to complete AHA course completion
cards.
Course Completion Card Validity Period

All AHA course completion cards are valid for 2 years through the end of the month in which the course
completion card was issued.
The only exception is the Heartsaver Bloodborne Pathogens Course participation card. Per the Occupational
Safety and Health Administration, this course participation card is valid for only one year.
If a government statute or requirement mandates a period other than 2 years, contact ECC International at
[email protected] for assistance and guidance.
Written Exams and Skills Tests

Only current written exams and skills tests issued by the AHA are used to determine successful course
completion. Use of any other written exam to determine a student’s completion of an AHA ECC course will
jeopardize the ITC Agreement, the instructor’s status, or both.
Note: Not all AHA courses require a written exam. It is the instructor’s responsibility to determine this by
consulting the instructor manual for that course or the TCC or TCF.
Exam Security
To prevent possible compromise of exam contents, the AHA will only issue an exam to the TCC listed on AHA
records when the class is created. TCCs are ultimately responsible for the security of the exams.
The ITC, through the TCC, is responsible for
• Ensuring that instructors use current versions of each exam as appropriate

• Maintaining exam security within the ITC records and through all instructors who issue exams
Each exam should be accounted for and returned to the instructor at the end of the exam. Exams should be
stored in a securely locked location and should not be distributed without a clear set of guidelines for their
use.
If a TCC sends exams electronically to an instructor, the TCC must protect the security of the exams by sending
to an email address that is accessible only by that instructor.
• The AHA produces written exams in the languages in which materials are produced, as well as some other
languages. Any ITC can use AHA translated exams in disciplines that they are approved to teach. The
course language selected in Atlas determines in which language the exam will be issued.
• The ITC is responsible for ensuring that the exams are not altered and that only AHA-translated exams are
used. AHA ECC course exams may not be posted to any internet or intranet site. ITCs may distribute the
exams through a learning management system (LMS) for the purpose of testing students in an ECC course
after permission has been granted by AHA International. Failure to obtain permission from the AHA may
result in termination of the ITC Agreement.

• All requests to make exams available through an LMS or to use them in a similar manner should be
requested by contacting [email protected].
Skills Tests for AHA eLearning or Classroom Course Completion

Skills tests are a key way to measure the student’s mastery of material. The instructor will
• Ensure that the student has completed the eLearning online portion of the course for which the student
will be tested
• Ensure that a skills practice session has been conducted and that both the student and instructor feel
confident that the student is ready for testing before skills testing begins
• Administer skills tests as designed and outlined in the applicable curriculum without prompting the
student; prompting and coaching students during testing weakens the purpose of the test and the
student’s confidence in their ability to perform the required skill
• Use the skills testing sheets, critical skills description sheets, and lesson plans as described in the
curriculum; completed skills testing sheets for students who have not yet succeeded in performing the skill
will be kept in the course file
Course Fees, Materials, and Equipment

Course Fees
The AHA does not set or receive fees for courses offered by ITCs or instructors. It is the responsibility of the
ITC and/or instructor to determine what fees, if any, to charge for their courses and to ensure that their billing
practices comply with applicable laws.
The following disclaimer must be printed on all ITC promotional brochures, announcements, agendas, or other
materials distributed to students in courses for which fees are charged:
The American Heart Association strongly promotes knowledge and proficiency in all AHA courses and has
developed instructional materials for this purpose. Use of these materials in an educational course does not
represent course sponsorship by the AHA. Any fees charged for such a course, except for a portion of fees
needed for AHA course materials, do not represent income to the AHA.
Use of AHA Materials

Textbook or Student Manual
Each student must have the current, appropriate course textbook of their own readily available for use before,
during, and after the course.
Textbooks are designed for individual use and are an integral part of the student’s education. Students may
reuse their textbooks during renewals or updates until new science guidelines are published.
The AHA designs our resuscitation courses by using the most current educational design concepts. To
maximize the students’ learning potential and keep course length manageable, we have designed the
classroom courses with the intent that students will have the opportunity to study the course materials

outside of the class. Students must have access to student manuals before, during, and after each course,
especially if the students are less familiar with the skills.
We have taken steps to increase availability of our student materials by
• Increasing the number of distributors that we have worldwide

• Producing an eBook that can be easily purchased and accessed
• Posting precourse materials online for free for some courses
AHA ITCs must have a policy to ensure that each student has their own manual for each course. The ITC’s
internal process should ensure that students receive the manuals according to the recommendation in the
discipline specific instructor manual lesson plan to study before the course. ITCs and their sites should not
maintain libraries of AHA manuals to rent or loan out to students.
ITCs that fail to comply with the requirements may not issue eCards or course completion cards.
Core Curriculum
Each AHA course must follow the guidelines and core curriculum in the most current editions of the course
textbook or instructor manual. Current editions of AHA course materials must serve as the primary training
resource during the course.
Instructor Material Requirements

All AHA Instructors are required to have their own current instructor manual, provider manual or student
workbook, and course videos for each discipline they teach.
Managing Equipment
It is the responsibility of the ITC to ensure that
• Instructors follow the appropriate decontamination of equipment according to the manufacturer’s

instructions
• Instructors verify that the course equipment is clean and in working condition before the course
• Appropriate equipment is available in sufficient quantities (as outlined in the instructor manual) and in
good working order at each course conducted by the ITC and/or its TSs or instructors
Copyright of AHA Materials

Copyright/Copying of AHA Material
The AHA owns the copyrights of AHA textbooks, manuals, and other ECC training materials. These materials
may not be copied, in whole or in part, without the prior written consent of the AHA.
To request permission to reprint, copy, or use portions of ECC textbooks or materials, submit a written request
to the AHA.
For more information, see the copyright information page.

Quality Assurance Plan
Quality Assurance
Quality assurance is the key to an effective ECC training program. The ITC is solely responsible for
• The quality of the courses it provides and its compliance with AHA policies and guidelines
• A written quality assurance plan that can be produced upon request and that complies with AHA policies
and procedures
Quality Assurance Plan

An ITC quality assurance plan should include the following points:
• Current AHA exams are used in all courses that require testing for issuance of a course completion card.
• The ITC ensures that each student has the current appropriate textbook readily available for use before,
during, and after the course.
• The ITC has a written policy for developing, monitoring, and updating TCFs and instructors and for
renewing TCF and instructor status.
• Every AHA course conducted by the ITC uses the AHA core content and AHA-developed materials.
• Course completion cards and written exams are stored securely in a locked location.
• The ITC has adequate resources to complete the contracted program requirements, including staff,
equipment, and location.
• The appropriate course completion card is issued to every student who meets the completion
requirements.
• The ITC has written internal dispute resolution policies and procedures that each instructor receives.
• The ITC monitors equipment used in all AHA courses to ensure that it is clean and works properly.
• ITC records are complete and filed properly.
• The ITC has a written policy detailing how TCF and instructors receive training for their roles and are
actively involved in the quality assurance/continuous quality improvement process to ensure providers are
able to perform quality CPR.
• The ITC has a written policy detailing how courses and skills sessions conducted by its instructors and TSs
will be monitored.
• The ITC has a written policy detailing how to evaluate its courses, instructors, and program administration.
It is highly recommended that the ITC have a program that monitors growth and improvement in its
performance. To do this, the following indicators could be monitored:
• Increased training numbers

• Participation in Chain of Survival activities in the community
• Improved course evaluations as a result of documented corrections
• Expansion of the ITC Training Network (new instructors and new TSs participating in the quality assurance
programs as applicable)

3—Instructor Alignment
Requirements for Instructor Alignment
An instructor candidate must complete all requirements and align with an approved primary AHA ITC that is
authorized by the AHA to teach in that territory before teaching a course other than the initial monitored
course. Only instructors aligned with an ITC are authorized to teach courses and issue course completion cards
through the TCC.
The following are requirements for instructor alignment:
• No fees are paid to the AHA for this alignment. Any fees charged for instructor alignment are solely at the
discretion of the ITC.
• The TCC may require a meeting with or monitoring of the instructor applicant before acceptance. The
course monitoring will be done by designated TCF. The TCC decides whether to accept the instructor for
alignment. This decision is final.
• ITCs may revoke the alignment privilege of any instructor who fails to act in accordance with AHA course
policy or ITC policy.
• ITCs are not obligated to accept all instructors who apply for alignment. The ITC has the sole right to
determine which instructors to keep on its roster based on its criteria.
• The ITC listed as the instructor’s primary ITC on Atlas is responsible for instructors’ adherence to AHA
guidelines. This includes instructors with multiple alignments.
Responsibilities of ITCs to Instructors

The AHA also encourages ITCs to provide excellent experiences for their students in not only the quality of
instruction but also the environment in which classes are conducted. Students should feel safe, secure, and
comfortable. To ensure a safe and secure environment for students and instructors, each ITC is expected to
establish guidelines or requirements for its instructors to address these concerns. Such guidelines may include
restrictions on location, time, and attendance, in addition to environmental concerns, such as being smoke-
free or managing heating, air conditioning, lighting, and odors.
Requirement examples include
• A smoke-free facility, including surrounding grounds, parking lots, and entrances

• A nonresidential facility, unless held in a public common area, such as a fitness room of an apartment
complex
• No fewer than 3 students in attendance at any given time
• A secure facility with sufficient restriction to access to prevent outside intrusions
• Heat and air conditioning set at a comfortable temperature in consideration of the physical activities
involved in the class
• Clean tables, chairs, and floor conducive to learning and comfort
• Start and end times scheduled and adhered to consistent with local workday and after-hour activity times
• Adequate lighting to facilitate the learning experience

• Absence of noises, odors, nonparticipants, and other disturbances/distractions that may negatively impact
the students
• Respect for local customs
Instructor Status Revocation

Revocation of instructor status means the privilege of claiming instructor status, aligning with an ITC, and
issuing AHA course completion cards is no longer allowed.
The following are key points on instructor status revocation:
• If the instructor is no longer aligned with an ITC and has an eCard, the ITC must officially communicate to
the instructor that he may no longer use the instructor eCard with the ITC information.
• The ITC must then report its decision to de-align the instructor to AHA International by submitting the
information via the AHA International Program Development Department at [email protected].
• The AHA will review information and determine whether the instructor is eligible for active status or if they
should have their instructor status revoked. Instructor records cannot be transferred until a final decision
is made.
• Once the AHA finalizes its decision to revoke an instructor’s status, the instructor card must be returned to
the issuing ITC or the AHA.
• Instructor status revocation does not revoke provider card status.
Reasons for Instructor Revocation

The following list includes some but not all reasons that can result in revocation:
• Falsification of class records

• Nonadherence to AHA guidelines and curricula
• Producing or issuing non-AHA course completion cards
• Continued instruction that is inconsistent with AHA standards for the course/program after remediation by
the TCC, TCF, ECC staff, or RF
• Using non-AHA exams or breaching security of AHA exams
• Inappropriate activities, language, harassment, or conduct during courses or directed toward other
instructors, students, ECC staff, or volunteers

4—Training Sites
TSs are generally training locations that operate under an ITC in separate locations.
An AHA TS operates with the authorization of an AHA ITC and meets the following minimum requirements:
• Has a legal business name

• Teaches AHA courses in accordance with the 2020 AHA Guidelines for CPR and ECC
• Maintains at least 2 AHA Instructors
• Ensures that they have sufficient TCF to manage their instructors and TSs.
• Owns and maintains all equipment needed for teaching AHA courses, including manikins that meet
feedback device requirements
• Meets minimum technical requirements
− Uses latest version of one of the top 3 or 4 internet browsers by market share
− Maintains knowledge of and effectively uses AHA Platforms applications, eCards, eLearning, and
eBooks
TS Responsibilities
A TS must
• Conduct AHA courses by following the guidelines outlined in the PAM and in the instructor manual for
each discipline the TS is approved to teach
• Meet the same standards as ITCs regarding equipment and instructors in each discipline that the TS will
teach
• Maintain course and instructor records meeting the same requirement and standards of the ITC and
submit reports as requested to the ITC
• Appoint a coordinator who meets the defined position requirements and who is approved by the TCC. The
TCC must designate TCF for each discipline taught at the TS so that quality monitoring, mentoring, and
evaluation of instructors will be met
Management of TS
It is the responsibility of the ITC to ensure that its TSs comply with all policies and procedures outlined in this
manual as well as with the ITC’s own policies and procedures and the ITC Agreement. If a TS does not comply
with the policies and procedures outlined in this manual, the ITC Agreement may be terminated.
• The ITC must have a signed letter of agreement/understanding on file with each TS that can be made
available to the AHA upon request.
• The TCC or approved TCF designee visits and monitors each TS at least once every year to ensure that the
site complies with the AHA and ITC policies.
• The ITC maintains documentation of these visits for at least 3 years.
• The TCC ensures that appropriate equipment is available in sufficient quantity (as outlined in the instructor
manual) and in good working order at each course conducted by the ITC and/or its TSs or instructors. This
can be accomplished by visits to each TS and by regular course/skills session monitoring.

5—Boundaries and Recognition of Status
Training Boundaries
ITC Agreement
The ITCs (including all aligned instructors and TSs) may offer their AHA courses only in the geographic territory
defined in their ITC Agreement.
Training Outside of Home Country

The information here provides a process by which AHA Instructors can conduct courses and issue AHA cards
outside of the country where their ITC is based.
The AHA acknowledges that many AHA Instructors and ITCs have ongoing relationships within the
international medical and safety communities. Often, these contacts request training outside of the country
where the ITC is located. Generally, an ITC is approved to offer AHA training in only its country of
incorporation. This will outline the process of obtaining permission for these courses and ensure the quality of
international training.
Provider Training
The AHA’s preference is to direct training to local ITCs whenever possible. A local ITC can follow up with
provider course participants after 2 years to support ongoing training; the local ITC can also select participants
in its provider courses to enroll in future Instructor Essentials courses to further develop the Training Network.
If training is requested where there is a local ITC, the AHA will direct training to a local ITC unless there is a
compelling reason that the local ITC cannot support the training. If there is no local ITC, instructors can travel
from an ITC in a different country to offer provider training after they have obtained approval from AHA’s ECC
International Department.
To obtain approval, an applicant must submit an International Training Application. The application must be
filled out completely and submitted at least 6 weeks before the start of the proposed training. Approval is not
automatic. The applicant must also submit a letter of support from their ITC as well as copies of the AHA
instructor cards of all instructors participating in the training.
The International Training Application can be found on the AHA website.
AHA Instructors must comply with the standards in the current Program Administration Manual—
International Version as well as the discipline-specific instructor manual, regardless of where the course is
taught.
Instructor Training
Approval for instructor training follows the same process as approval for provider training, but with additional
requirements. Because all AHA Instructors must be aligned with a local ITC to be active as an instructor, any
ITC applying to offer instructor training in a different country must have a plan for the potential instructors to
align with a local ITC before the training can be approved.

If the ITC plans to provide instructor training to an organization abroad that is applying for ITC status, the
organization must submit the application and receive initial approval before the instructor training can be
approved. It is important that the ITC planning to provide the training and the ITC applicant be in contact with
the AHA throughout the process. If you have questions about offering instructor training to a potential ITC,
please contact AHA’s ECC International Department at [email protected].
Prohibited Countries List

As a US corporation, the AHA abides by the US government’s rules and regulations that prohibit or restrict
conducting business transactions with certain countries, individuals, and entities. All AHA US TCs, ITCs, and
their sites must abide by the US government’s directives on such transactions, including
• Terrorist Designations and State Sponsors of Terrorism

• Foreign Corrupt Practices Act
• Lists of Parties of Concern
• Sanctions Programs and Country Information
If you have questions, please contact AHA’s ECC International Department at [email protected].
Recognition of Status
Overview
The AHA’s ECC Programs recognizes the mobility of its providers and instructors and encourages them to
remain active in the ECC Training Network wherever they move.
Within the AHA

Table 4 details recognition of status in the ECC Training Network in the United States and internationally.
Table 4. Description of Status Recognition for AHA

Status Description of recognition
Provider • Providers are recognized by all AHA ITCs worldwide.
Instructor • Instructors are recognized nationally and internationally.
• An instructor card supersedes a provider card. Provider status (for the same discipline) is deemed
current if the instructor card remains valid. The AHA does not require an instructor to have a valid
provider card. However, policies from different agencies or regulatory bodies may make it a
requirement.
TCF • TCF status can be transferred to other ITCs granted that the TCF has undergone the official TCF
program.
• When a TCF member transfers to another ITC, it is as an instructor, not as a TCF, unless accepted by
the ITC.
• The ITCs are not obligated to accept the TCF position and may require a meeting with or monitoring
of the TCF applicant before acceptance.
RF • An RF appointment is not transferable outside of the region or state where it was issued.
• An RF member who moves to another region should contact AHA International for specific
information about applying for RF appointment in the new region.

Heart and Stroke Foundation of Canada
The Heart and Stroke Foundation of Canada (HSFC) works closely with AHA ECC. AHA ITCs and instructors are
not permitted to teach in Canada unless they are aligned with an HSFC training program. Table 5 details
recognition with the HSFC in the United States.
Table 5. Description of Status Recognition for HSFC

Status Description of recognition
HSFC provider card • Recognized by the AHA
• Can be used for admission to an AHA provider renewal or Instructor Essentials course in
the same discipline
HSFC instructor card • Recognized by an AHA ITC in the same way as an instructor card issued by any AHA ITC
International TCs
The role of the ITC and the US TC is the same. The AHA seeks consistency in training in all ITCs, both in the
United States and globally.
AHA course completion cards issued by any AHA ITC should be considered equivalent, regardless of their
country of origin.
Contact ECC International for questions about international recognition at [email protected].
Recognition of Other Organizations Not Listed

For questions about AHA recognition of other organizations not listed above, contact the ECC Customer
Support Center.
For questions about international organizations not listed, contact [email protected].

6—Course Information
For specific course information, please refer to the appropriate instructor manual.
General Information
AHA ECC Classroom-Based Course Criteria
An AHA ECC classroom-based course must meet the following criteria before a course completion card may be
issued and the course is referred to as an AHA course. The intent of this policy is to ensure consistent quality
in AHA courses wherever they are taught.
The course instructor(s) must be a current AHA-recognized instructor. Specialty Faculty with expertise in a
particular content area may assist AHA Instructors in advanced life support courses. Specialty Faculty do not
count in the required student-to-instructor ratio as outlined in the appropriate instructor manual.
The course must be taught according to the guidelines and core curriculum set forth in the current editions of
the AHA course textbook(s) and/or instructor manual(s). An instructor can add topics before or after the AHA
core curriculum, so long as the addition of these topics does not interrupt the flow of the course or impact the
instructional design of the course.
Each student must have the current appropriate course textbook readily available for use before, during, and
after the course. Textbooks are designed for individual use and are an integral part of the student’s education
before, during, and after the course. Students may reuse their textbooks during renewals until new science
guidelines are published. See Use of AHA Materials.
The current edition of AHA course materials, DVDs or streaming videos, and exams must be used. Using the
course DVDs or streaming videos is mandatory in classroom-based courses.
A course evaluation form must be used in each ECC course to obtain feedback from students on course
content and instructors. The AHA strongly encourages the use of the AHA Course Evaluation Form on the AHA
Platforms. If an ITC elects to use its own evaluation form, the form must contain all the information on the
AHA Course Evaluation form. Note: For ITCs using eCards, course evaluations are no longer required to be on
paper.
After successful course completion, the appropriate AHA course completion card must be issued. The course
completion card must meet all AHA card issuance requirements.
Any changes or deletions to items set out in the core curriculum of each AHA course instructor manual should
be considered fundamental changes to the course and may not be made in a course for which an AHA course
completion card is issued.
Validation
After a student completes the online portion of an AHA eLearning course, an instructor can conduct the skills
practice and testing.
To validate students’ completion certificates,

1. Go to https://ecards.heart.org/international
2. Enter the eCard code and click Submit
Continuing Medical Education/Continuing Education Units

Some AHA classroom courses provide continuing education (CE) credit. ITCs are encouraged to offer CE credit
whenever possible for ECC courses.
Some online AHA courses do qualify for CE, CE units (CEUs), or continuing medical education (CME) credit for
doctors, nurses, and EMS professionals. Access OnlineAHA.org for continuing education opportunities and
www.learn.heart.org for additional professional education opportunities.
The AHA is contracted to offer EMS students Continuing Education Hours (CEHs) through the Commission on
Accreditation for Pre-Hospital Continuing Education (CAPCE)* for several disciplines:
• ACLS
• ACLS for Experienced Providers (ACLS EP)
• BLS
• Heartsaver
• PALS
• PEARS
*CAPCE accreditation does not represent that the content conforms to any national, state, or local standard or
best practice of any nature.
Note: EMS CE through CAPCE is required to be issued only for the US market; it is optional outside of the
United States.
The AHA does not require the student to accept the CE offering. The AHA recognizes that not all students will
need the credit, and not all of their licensing agencies will accept the credit. However, when a provider
completes one of these courses, the ITC will report the credits to make them available to that provider,
whether the provider needs them or not.
When a provider completes one of these courses, the ITC will make these credits available to that provider.
Course Equipment
Equipment required for each course is listed in the course-specific instructor manual. All equipment used must
be in proper working order and good repair.
The AHA requires the use of an instrumented directive feedback device or manikin in all AHA courses that
teach the skills of adult cardiopulmonary resuscitation. Feedback devices are recommended for child and
infant training. Specifically, an instrumented directive feedback device or manikin is one that, at a minimum,
provides audio or visual (or both) feedback on the rate and depth of compressions during CPR training. This
requirement will impact BLS, ACLS, ACLS EP, and Heartsaver courses.
With the increase in popularity and functionality of electronic tablets in the past few years, there has been a
surge in development and use of tablet-based monitor/defibrillator applications.

Some of these tablet applications have the functionality of a monitor in which students can demonstrate that
they know how to defibrillate, pace, or cardiovert by pushing the correct buttons.
For the tablet-based monitor simulator to be used as a monitor/defibrillator in advanced AHA courses, the
student must be able to do the following with the tablet-based monitor:
• See the rhythm running on the monitor on the tablet screen

• Connect the tablet to the simulated patient with electrodes and defibrillator/pacing pads
• Physically push a button to charge and shock and sync, if applicable
• Physically push buttons to set the rate and output while pacing
For the tablet-based monitor to be used as an automated external defibrillator (AED) trainer in AHA courses, it
must meet the following requirements:
• The student must be able to connect the tablet to the simulated patient with defibrillator pads.
• The student must be able to physically push a button to charge and shock.
• The device must give the student step-by-step instructions consistent with standard AEDs and AED
trainers.
Use of Healthcare Provider Term in Advanced Courses

The AHA uses the terminology of “any current, active healthcare provider” to be inclusive of any potential
member of a resuscitation team. Because the AHA’s course materials are translated and used globally, the
terminology is also broad enough to include certain professions outside of the United States that do not
require the same level of licensure as is required in the United States.
Examples of “any current, active healthcare provider” include but are not limited to physicians, nurses,
paramedics, physician assistants, nurse practitioners, advanced practice nurses, dentists, respiratory
therapists, pharmacists, and any other provider who may be part of a resuscitation team. Therefore, there is
no limitation for current, active healthcare providers to attend AHA advanced courses or to be considered as
instructors for AHA advanced courses.
Likewise, there is no limitation for any AHA Instructor to apply for RF status based on their level of licensure.
For example, a respiratory therapist who applies to become RF will not be denied status solely based on their
level of licensure.
Provider Courses
For descriptions of specific AHA provider courses, see the AHA website or the instructor manual for that
course.
Several of the provider courses have prerequisites. For more information, instructors should refer to the
discipline-specific instructor manual.
eLearning
The AHA eLearning programs offer instructors maximum flexibility in educating and training healthcare
professionals and lay responders. The AHA offers a variety of web-based and personal kit programs.

• Instructors will perform skills practice and testing to complete the course as indicated.
• Instructors may offer remediation.
• These products may also provide CE opportunities for physicians, pharmacists, nurses, and EMS personnel.
Documenting course completion card issuance requires copies of the completion certificate for the online
course, the eLearning Skills Session Course Evaluation, skills testing checklists, and course roster to be
completed and filed with the ITC. Use the same procedures to file online course paperwork as for classroom-
based courses.
For more information about AHA eLearning programs, visit OnlineAHA.org.
Provider Course Director

The following guidelines apply to Course Directors in provider courses:
• For instructor-led courses, each advanced life support provider course (ACLS, ACLS EP, PALS, and PEARS)
must have a Course Director physically present on-site throughout the course. For courses using blended
learning, a Course Director is not a requirement. ITCs can require Course Directors for blended-learning
skills stations, if they choose.
• A Course Director for advanced courses must be appointed by the TCC. The Course Director may also fill
the role of instructor in the course.
Provider Course Instructors and Specialty Faculty

The following guidelines apply to provider course instructors:
• AHA courses must be taught by AHA Instructors with current instructor status in their specific discipline.
• A Lead Instructor for nonadvanced courses must be assigned by the TCC.
• Course Directors are responsible for monitoring Specialty Faculty (eg, an anesthesiologist who teaches
airway management) in every course they teach to ensure that they follow AHA guidelines.
• Specialty Faculty may assist in teaching advanced-level courses at the discretion of the ITC and with the
prior approval of the Course Director. Specialty Faculty must adhere to the core content.
• The total number of Specialty Faculty instructors may not exceed 50% of the total instructor staff.
Specialty Faculty do not count in the required student-to-instructor ratio as outlined in the appropriate
instructor manual.
• An AHA Instructor of the appropriate discipline must do the formal assessment or testing of students.
Provider Course Lead Instructor

The following guidelines apply to Lead Instructors for provider courses:
• Each BLS Provider Course must have a Lead Instructor physically present on-site throughout the course.
• The Lead Instructor can also fill the role of instructor in the course.
• The Lead Instructor is responsible for course logistics and quality assurance.
• The Lead Instructor is assigned by the TCC.

Provider Course Structure
The following guidelines apply to provider course length, lesson plans, agenda, and student-to-instructor
ratios:
• The course educational objectives must be met according to the current guidelines in the course instructor
manual or the AHA website. All core course content must be included.
• The focus is on interactive learning and evaluation. Course materials allow maximum time for hands-on
manikin skills practice and skills evaluation.
• All students will have an opportunity to practice their skills under the supervision of an instructor who will
provide ongoing feedback on their competency. For students who are enrolled in the AHA’s Resuscitation
Quality Improvement® (RQI®) program, the learning program will monitor their performance and provide
real-time feedback.
• The course must adhere to the student-to-instructor and student-to-manikin ratios outlined in the specific
instructor manual. Participants must attend all course sessions as established by the agenda for successful
completion of the course.
• Failure by either an ITC or an instructor to follow these policies may be cause for termination of the ITC
Agreement or revocation of instructor status.
Provider Course Completion

To receive a course completion card, the student must complete the following as indicated in the course-
specific instructor manual:
• Attend and participate in the entire course

• Pass required skills tests
• Pass required exams
The Course Director or Lead Instructor is responsible for verifying that the student has met all requirements
for course completion.
Provider Course Student Assessment

Provider Course Exam
The following rules apply to the exam:
• The current version of the exam for an AHA course must be used.
• Exams are copyrighted; therefore, ITCs may not alter them in any way or post them to any internet or
intranet sites. This includes precourse self-assessments.
• Use of an altered exam or another exam in a course in which AHA course completion cards are issued is
not permitted and will jeopardize the AHA ITC Agreement and the status of all involved Faculty and
instructors.
• Requests to administer the exam via an online education platform should be sent to
[email protected].

• When an instructor administers the exam, the exam is administered in a proctored setting. In some self-
directed eLearning courses, the exam is included in the software program, according to the policy for that
individual course.
• As part of education methodologies, the AHA uses an open-resource policy for exams administered online
through an eLearning course and in a classroom-based course. Open resource means that students may
use resources as reference while completing the exam. Resources could include the provider manual,
either in printed form or as an eBook on personal devices; any notes the student took during the provider
course; the 2020 Handbook of ECC for Healthcare Providers; the 2020 AHA Guidelines for CPR and ECC; and
posters. Open resource does not include open discussion with other students or the instructor.
Provider Course Skills Testing

Instructors of the appropriate discipline will evaluate each student for their knowledge and proficiency in all
core psychomotor skills of the course.
Students may use the 2020 Handbook of ECC for Healthcare Providers and ECC algorithms for the Megacode
Skills Test in the ACLS Course and the case scenarios in PALS Course at the discretion of the Course Director.
No AHA course completion card is issued without hands-on manikin skills testing by either an AHA Instructor
for that discipline or an AHA-approved computerized manikin in an AHA eLearning course.
Students in advanced life support courses are not required by the AHA to have a current BLS Provider card,
but they are expected to be proficient in BLS skills. ITCs have the option to require a current BLS card.
The AHA no longer offers a “challenge” option, where students may complete course testing requirements
without participating in an AHA instructor-led training or blended-learning course. To demonstrate proficiency
in knowledge and skills, all students must complete a provider course every 2 years to maintain their course
completion card (unless they are enrolled in the AHA’s RQI program). Students who believe they have mastery
of knowledge may wish to complete the blended-learning version of the provider course or, for ACLS and PALS
Courses, attend an instructor-led update version of the course.
For blended-learning students who come to the hands-on session prepared to demonstrate mastery of the
skills associated with high-quality CPR and ACLS, instructors may use the Accelerated HeartCode® BLS and
ACLS Competency Agendas. These agendas offer greater flexibility in the requirements to complete the
instructor-led hands-on session and allow a learner to immediately demonstrate their mastery and thus
potentially shorten the time required to complete the hands-on session. The adaptable design allows
instructors and students an opportunity to demonstrate competency in a strategic learning environment that
is adjustable to all learners. Those students who demonstrate skills well in practice immediately move into
skills testing, and those who may still require additional knowledge have an opportunity to review cognitive
content before moving into skills testing. When using the competency agenda, the instructor must ensure that
the student is demonstrating performance at the required level by using an instrumented directive feedback
device or manikin during the instructor-led, high-quality BLS skills lesson and testing.
Instructors are permitted additional flexibility options in the hands-on sessions, including
• Breaking up the hands-on session agenda into subsets of (whole) lessons for shorter time segments

• Using a 1:1 student-to-manikin ratio to shorten practice sessions
• Using a 1:1 student-to-instructor ratio to shorten skills testing
• Using mock codes or taking a manikin to the floor to conduct the High-Performance Teams Activity
• Using as few as 2 participants for the High-Performance Teams Activity (only one needs to be a student)
Instructor Essentials Courses

Instructor Candidates
An AHA Instructor Essentials course teaches the methods needed to effectively instruct others in resuscitation
courses.
The AHA requires that instructors be at least 18 years of age for Heartsaver Instructor Essentials and BLS
Instructor Essentials Courses. ACLS, PALS, and PEARS Instructors must be at least 18 years of age and be
licensed or credentialed in a healthcare occupation where the skills are within the provider’s scope of practice.
ITCs should ensure that they comply with local laws regarding the age of instructors and participants.
The AHA has defined these 5 core competencies for all instructor candidates:
• Skills: Instructors need to demonstrate mastery in all skills for the courses they teach. This includes both
cognitive skills as well as psychomotor skills.
• Course delivery: Instructors need to teach AHA materials correctly and as outlined in the appropriate
instructor manual and lesson plans.
• Testing: Instructors must be able to test students effectively.
• Professionalism: Instructors need to maintain a high standard of ethics and professionalism when teaching
AHA courses.
• Program Administration: Instructors need to be able to manage time, space, materials, and paperwork in
compliance with AHA guidelines.
Instructor Essentials Course Prerequisites

The AHA has defined these Instructor Essentials course prerequisite requirements. The instructor candidate
must
• Currently have or obtain a provider card in the discipline(s) for which they are interested in teaching and
be proficient in all skills
• Identify ITCs accepting new instructors before enrolling in an instructor program (The ITC hosting the
course may not necessarily be the same as the primary designated ITC; Instructor Essentials courses and
ITCs can be found on Atlas)
• Complete an Instructor Candidate Application to be on file with the accepting primary ITC
• Successfully complete the appropriate discipline-specific online Instructor Essentials course with a
certificate of completion brought to the classroom for a hands-on session conducted by TCF (An Instructor
Candidate Workbook may be secured from the TCF or from the online Instructor Essentials course at
OnlineAHA.org; Faculty may incorporate the cost of instructor materials into the cost of the course, or the
student may purchase materials separately from one of our authorized distributors)

• Successfully be monitored teaching within 6 months after successful completion of the appropriate
Instructor Essentials course with a course monitor form documented by TCF (ITCs may require additional
monitoring, if needed)
• Be accepted and approved by their primary ITC for registration and issuance of an instructor ID number,
which must be used to issue course completion cards/eCards
Note: The instructor card issued by the primary ITC is valid for 2 years.
Instructor Essentials Course Faculty

AHA Instructor Essentials courses are taught by TCF that have completed the TCF program in that discipline.
TCF members acting as Course Directors must be present throughout the entire Instructor Essentials course.
Additional Instructor Essentials course Faculty members must be, at a minimum, current TCF in the discipline
being taught.
Instructor Essentials Course Completion

Instructor candidates must demonstrate
• Satisfactory performance of the skills listed in the Faculty Guide for the course
• A thorough knowledge of course organization, course content (including appropriate BLS skills), instructor
responsibilities, and the AHA guidelines for the specific discipline
• Mastery of the AHA Instructor core competencies
• Instructor course written exams
− As part of education methodologies, the AHA uses an open-resource policy for exams administered
online through an eLearning course and in a classroom-based course. Open resource means that
instructor candidates may use resources as reference while completing the exam. Resources could
include the provider manual or instructor manual (either in printed form or as an eBook on personal
devices), any notes the instructor candidate took during the provider course, the 2020 Handbook of
ECC for Healthcare Providers, the 2020 AHA Guidelines for CPR and ECC, posters, etc. Open resource
does not include open discussion with other instructor candidates or the instructor.
Instructor Card Issuance Requirements
The instructor manuals explain the requirements for instructor cards for new and renewing instructors. Refer
to the appropriate instructor manual. In addition to those details, the following requirements apply:
• The Instructor Monitor Tool must be submitted within 10 business days after the monitored course.
• If a deficiency is noted during monitoring, the reviewer may conduct remediation by using any one or a
combination of the following:
− For a deficiency in skills performance, the candidate may receive remediation privately and then
allowed to demonstrate and teach the skill successfully during the same course or a future course.
− For a deficiency in content knowledge, the instructor candidate may receive remediation privately or
asked to review the current provider manual and then allowed to teach the content successfully during
the same course or a future course.

− For a deficiency in teaching ability or quality, the instructor candidate may be mentored while teaching
with the Course Director, instructor, or TCF member and then monitored again in a future course. The
instructor candidate may also be required to repeat the Instructor Essentials course before being
monitored again.
− For a deficiency in content knowledge or skills performance, the Course Director, TCF member, or RF
member may require the candidate to take an entire provider or provider renewal course before being
monitored again.
• All instructors should be aligned with a primary ITC on the AHA Platforms.
• Within 10 business days after receiving the completed monitor form, the ITC for the instructor candidate
must issue an instructor card. The issue date of the card is the month and 4-digit year in which the course
monitoring was successfully completed.
• Questions related to the receipt of an instructor card should be directed to the instructor’s primary TCC.
• If the instructor candidate transfers to another ITC before the initial monitoring takes place, the new ITC
may issue the instructor card after monitoring is completed but must have documentation of the
Instructor Essentials course completion and other prerequisites.
Instructor Renewal Criteria

An instructor’s status can be renewed only by TCF or RF. Criteria for renewal varies based on discipline. Refer
to the appropriate instructor manual for the discipline-specific instructor renewal criteria.
Note: An instructor status stays the same regardless of professional status. Some countries and regional states
have scope-of-practice issues that are beyond what the AHA can determine.
The AHA is a global organization and in some countries, local laws apply that are beyond the AHA’s decisions.
Special Exceptions to Teaching Requirements

The requirement for instructors to teach a minimum of 4 courses in 2 years to renew instructor status may be
waived or extended under special circumstances. These circumstances include but are not limited to the
following:
• Illness or injury that has caused the instructor to take a leave from employment or teaching duties
• A limited number of courses offered in an area because of lack of audience or delay of course materials
The TCC, in consultation with AHA staff, may decide to waive the teaching requirements for the discipline in
question. Consideration should be given to the amount of time an instructor is away from normal
employment, the length of delay in release of materials, and the number of courses taught in relation to the
number of teaching opportunities. Documentation supporting the decision must be maintained in the
instructor’s file.
All other requirements for renewal must be met as stated above.

Virtual Training Options for AHA Provider Courses
Purpose
The AHA will allow ITCs to conduct virtual training for provider courses under the following requirements to
ensure consistency and quality in all AHA provider-level courses.
Provider Course Clarification

Virtual training options apply to the following courses: BLS, ACLS, PALS, Heartsaver First Aid CPR AED, and
Heartsaver Pediatric First Aid CPR AED.
Information for ITCs and Instructors

When considering virtual training, please note the following:
• Virtual training for instructor courses requires prior approval from the AHA regional office.
• All other AHA requirements for conducting the training, as described in the course instructor manual and
ITC Agreement, must be fulfilled. Hands-on skills practice and testing are required.
• The instructor conducting the virtual training must be aligned with the ITC and be current in the discipline
being taught and course card being issued.
• Upon request, the ITC must provide course rosters to the AHA for all classes conducted with virtual
training if permitted by applicable law.
• For Heartsaver courses, the student will complete the appropriate Heartsaver online course for the
cognitive work.
• If the student requires the Heartsaver written exam, the Heartsaver written exam is permitted on an LMS.
A second option is for the instructor to deliver the exam verbally with the students. The student would
return the completed exam sheet to the instructor electronically or through the mail.
• For BLS, ACLS, and PALS, the student will complete the appropriate HeartCode course.
• An AHA Instructor will observe skills practice and testing via live video.
• The sound and camera positioning for virtual testing must be adequate for the instructor to accurately
assess elements of high-quality CPR, including feedback from the feedback device, student hand position,
manikin chest rise, and other required skills. Virtual skills testing should not be used if the instructor is
unable to adequately assess high-quality CPR skills performance.
• A sustained loss of internet connection, visibility, and/or audio will require rescheduling the skills practice
and testing. The required skills practice and testing must be completed, or the session will need to be
rescheduled.
• Instructors must adhere to the student-to instructor-ratios in the respective instructor manuals.
• The student must have all the required equipment on-site for the virtual skills practice and testing. It is not
acceptable for the instructor to retain the equipment and ask the student to verbalize the skills.
• It is acceptable for BLS courses to have only one student for activities that normally require 2 or more
students. In this case, the student should be able to verbally provide instruction on what the second
rescuer (or team members) should be doing in the scenario-based learning and testing stations that are
specified in the course lesson plans. For ACLS and PALS, at least 3 students must be in attendance.

Quality Control for Virtual Training Options
The AHA may request to participate and/or monitor the live virtual training events or evaluate the students’
feedback.
Course Director Orientation

Purpose
The purpose of the Course Director orientation is to prepare instructors selected by the ITC to plan, organize,
and successfully conduct a provider or provider renewal course.
In addition to helping the instructor conduct a successful course, the goal of orientation is to ensure that the
Course Director can accurately teach, evaluate, monitor, and mentor instructors and instructor candidates in
their teaching and in their proficiency in a particular discipline.
Method
The ITC determines the format of the Course Director orientation. Either the TCC or a TCF can conduct the
orientation. The orientation can be
• A formal presentation
• Self-paced instruction
• Audio or video presentation
• Interactive software
• One-on-one mentoring
• Other alternative formats
Content
The following topics are suggested as content for orientation:
• Review of educational principles outlined in the instructor manual

• Review of course requirements in accordance with the current AHA Guidelines
• Discussion of course format for specific audiences and locations
• Outline of materials and equipment needed to conduct a course
• Discussion of administrative, logistical, and educational problems that can arise during a course and how
to manage them effectively
• Discussion of the Course Director’s quality assurance responsibilities
• Review of methods and skills for monitoring and mentoring instructors
• Development of remediation skills for instructors and providers
• Development of debriefing skills
• Review of the ITC policies and procedures manual, including dispute resolution procedures and
responsibilities
• Review of the PAM
• Course Director competencies

7—Conflict of Interest and Ethics Policies
Conflict of Interest
Conflict of Interest Policy
The AHA has established a Conflict of Interest Policy that applies to all AHA leaders. Throughout the course of
performing duties associated with the ECC leadership role, all ECC leaders must comply with these policies.
The AHA, its affiliates and components, and all officers, directors, delegates, and council and committee
members scrupulously shall avoid any conflict between their own respective personal, professional, or
business interests and the interests of the AHA in any and all actions taken by them on behalf of the AHA in
their respective capacities.
If any officer, director, delegate, council, or committee member of the AHA shall have any direct or indirect
interest in, or relationship with, any individual or organization which proposes to enter into any transaction
with the AHA, including but not limited to transactions involving
• The sale, purchase, lease, or rental of any property or other asset

• Employment, or rendition of services, personal or otherwise
• The award of any grant, contract, or subcontract
• The investment or deposit of any funds of the AHA
such person shall give notice of such interest or relationship and shall thereafter refrain from discussing or
voting on the particular transaction in which they have an interest, or otherwise attempting to exert any
influence on the AHA or its components to affect a decision to participate or not participate in such a
transaction.
Regional Application of the Statement of Conflict of Interest

The expectation is that ECC leaders will conduct themselves with impartiality while performing AHA ECC tasks.
When this is not possible, a statement of conflict of interest must be made and recorded into appropriate
venue minutes, and there may be a need for the leader to excuse themselves from the decision-making
process.
Ethics/Code of Conduct
Overview
The AHA has established an Ethics Policy that applies to all AHA leaders, ITCs, and instructors. These positions
hold a responsibility to exhibit a high standard of conduct.
ECC Leadership Code of Conduct

All persons in AHA ECC leadership are expected to conduct themselves with honesty, integrity, and a
commitment to the goals of the AHA and ECC Programs. This code is intended to provide standards of
professional conduct.

The scope of the standards implied in this code includes activities directly related to the discharge of ECC
leadership functions, such as committee activities and assignments, as well as actions performed with other
AHA programs or activities, such as ECC classes and activities related to AHA affiliate programs. Table 6
describes these conduct elements.
Table 6. Description of Code of Conduct Elements

Conduct Description
Competence ECC leaders must demonstrate a competent knowledge relative to their assigned specific area
of responsibility.
Leaders must maintain all prerequisites for the position and participate in required educational
or informational sessions.
Respect for others ECC leaders must respect and treat others fairly, regardless of race, ancestry, place of origin,
color, ethnic origin, citizenship, religion, gender, sexual orientation, socioeconomic status, age,
disability, or any other basis protected by law.
Additionally, there is no tolerance for sexual harassment, including sexual solicitation, physical
advances, or verbal or nonverbal conduct that is sexual in nature and that is unwelcome,
offensive, or creates a hostile work or classroom environment.
Integrity ECC leaders must conduct themselves with honesty, fairness, and trustworthiness and must not
make statements that are false, misleading, or deceptive.
ECC leaders must adhere to all applicable AHA rules and regulations governing the ECC
Programs, course, and ITC operations as well as all federal, state, and local laws and regulations
in the discharge of their AHA duties.
Neutrality AHA volunteers must maintain neutrality in terms of specific proprietary products or brand
names (eg, drugs, devices, and publications) and in terms of descriptions of other professional
individuals and organizations.
Specifically, whenever possible, generic names for drugs and devices should be used.
While in their volunteer roles, instructors and Faculty must not be advocates for specific brand
names or proprietary products outside of AHA recommendations.
Furthermore, instructors and Faculty, while in their volunteer roles, must use caution when
referring to others, particularly when referring to differences or negative descriptions of other
professional individuals or organizations.

8—Legal Aspects
Americans With Disabilities Act
Each ITC is responsible for complying with all applicable laws, rules, and regulations including, but not limited
to, the Americans With Disabilities Act (ADA) of 1990, as amended, or applicable laws similar to the ADA.
The AHA cannot provide guidance to an ITC or instructor on the specific requirements for providing
accommodation for the disabled. The AHA recommends that ITCs consult an attorney and/or risk manager for
additional information.
The ADA requires that “any private entity that offers examinations or courses related to applications,
licensing, certification, or credentialing for secondary or postsecondary education, professional, or trade
purposes shall offer such examinations or courses in a place and manner accessible to persons with disabilities
or offer alternative accessible arrangements for such individuals.” (ADA Amendments Act of 2008 [P.L. 110-
325])
Whether a person has a disability and the specific steps that must be taken to comply with the law will depend
on the facts and circumstances of each case. Therefore, each ITC should consult its own attorney, architects,
or other professionals for assistance in complying with the law.
ECC leadership, through activities such as course monitoring, may be asked to evaluate programs in which
ADA accommodations have been made. The core curriculum must be examined to ensure that there are no
fundamental changes to core content or educational design that would negate the ability of the ITC to issue a
course completion card.
Note: This law is only applicable to the United States. For ITCs, consider local laws about providing courses to
people with disabilities.
Trademarks
The AHA's stylized name and heart-and-torch logo are trademarks of the American Heart Association, Inc, and
are registered with the US Patent and Trademark Office. Only the AHA may use these trademarks.
The trademarks symbolize the identity of the AHA and, when placed on publications, materials, and other
items, serve to distinctly identify the materials as having originated from the AHA.
The AHA has an ITC seal logo (ITC Seal) that includes the heart-and-torch logo. ITCs may use this ITC Seal logo if
their use of the ITC Seal meets the requirements outlined in the Authorized ITC Seal – Guidelines for Use for
TCCs. The ITC Seal logo application may be requested from the Regional Office and the files are sent to the ITC
once the ITC’s application has been approved. The AHA stylized name and logo may appear on training
materials, including course completion and participation cards and other ECC materials that have been
published by the AHA. No ITC may use any other AHA trademarks without a separate written license from the
AHA.
The AHA’s stylized name and logo may not appear in advertising or announcements for AHA courses
conducted through AHA-designated ITCs unless specifically authorized by the AHA.

Advertising and announcements may state that a specific course is an AHA course if AHA course criteria are
met.
Advertising and announcements may not suggest or imply that the AHA sponsors, owns, or manages the ITC.
Instructors and ECC leaders may not use their AHA Instructor title on business cards or other advertising
materials.
Inclusion of ECC leadership titles in correspondence, appearances, news media, and other venues may only be
done when the individual is acting on an assignment in their ECC leadership role that was issued to them by
the AHA or one of its committees or subcommittees.
The use of AHA letterhead or other uses of the stylized heart-and-torch logo by ECC volunteer leaders is
permitted only when conducting assignments directly associated with the individual’s leadership responsibility
and only with approval of appropriate AHA staff. All correspondence issued on AHA letterhead must be
reviewed by AHA staff before it is sent.
Dispute Resolution/Disciplinary Action

Disputes Involving ITCs, Sites, or Instructors
It is the responsibility of the ITC to manage and resolve any disputes, complaints, or problems that arise from
activities conducted by an ITC’s staff, TS, and aligned instructors. The expectation is that ITCs, sites, and
instructors inform their students of their process and all complaints and/or disputes are managed proactively
by the ITC.
The AHA is not responsible for the day-to-day operations of the ITC or its business practices. The AHA will not
become involved in the resolution of any disputes, complaints, or problems arising from courses taught by the
ITC or activities of the ITC.
The AHA will investigate when one or more of the following is involved:
• Course content/curriculum
• Instructor qualifications
• AHA administrative policies and procedures
• AHA ECC science issues
• AHA ITC Agreement and program guidelines (Note: The AHA is not obligated to use this dispute resolution
process if the ITC is in breach of the ITC Agreement. In that case, the matter is handled according to the
terms of the ITC Agreement.)
AHA Dispute Resolution Process for ITCs, Sites, and Instructors

1. Upon receipt of a written complaint, the appropriate staff will begin an investigation.
2. The ECC Compliance Administrator will contact the TCC, explain the matter, and begin the dispute
resolution process.
3. After the call, an email will be sent to the TCC detailing the issue(s), expectations, and the agreed-upon
timeline for resolution.

4. Within 5 days after receipt of the email, the TCC is required to provide a written action plan that details
the plan to investigate the complaint.
5. Within the defined timeline, the TCC is required to provide a final report that summarizes the investigation
and resolution.
6. If the matter is not resolved by the ITC within the timeline, then the ITC will be considered in breach of the
International Training Agreement and the matter will be escalated to the ECC Quality and Compliance
Manager for further action.
All complaints or problems need to be documented and filed for future reference should other similar
instances occur. If an ITC has a risk manager or legal counsel resource, it is the responsibility of the TCC to
consult that resource.
Disputes About AHA Regional Volunteers

The AHA is ultimately responsible for decisions surrounding its volunteers. The AHA reserves the right to
appoint, not appoint, or remove volunteers at its discretion.
Complaints against AHA RF or other volunteers must be submitted in writing to the AHA International Program
Development department staff.
It is the responsibility of the AHA to manage and resolve any disputes, complaints, or problems that arise from
an issue involving AHA RF or volunteers.
All complaints must contain the following information:
• The name and address of the person making the complaint (“Complainant”); the AHA will not permit the
Complainant to remain anonymous
• The name and address of the person and/or organization about which the complaint is made
(“Respondent”)
• A detailed written description of the dispute, complaint, or problem
• Reference to the appropriate rule, standard, and/or guidelines related to the matter
• Copies of all related correspondence, records, and other documentation
The volunteer/instructor has 30 days to respond to the written complaint. A final decision will be made by the
Director of Field Operations within 30 calendar days after the volunteer/instructor’s response.

9—Reference and Resources
Table 7. Acronyms and Abbreviations
Abbreviation Definition
ACLS Advanced Cardiovascular Life Support
ACLS EP ACLS for Experienced Providers
AED automated external defibrillator
AHA American Heart Association
BLS Basic Life Support
CE continuing education
CEU continuing education unit
CME continuing medical education
CPR cardiopulmonary resuscitation
ECC Emergency Cardiovascular Care
EMS emergency medical services
HSFC Heart and Stroke Foundation of Canada
ITC International Training Center (see Instructor Alignment for details on primary and secondary ITCs
PALS Pediatric Advanced Life Support
PAM Program Administration Manual
PEARS Pediatric Emergency Assessment, Recognition, and Stabilization
RF Regional Faculty
RQI Resuscitation Quality Improvement® (RQI®) program
TCA Training Center Administrator
TCC Training Center Coordinator
TCF Training Center Faculty
TS Training Site
TSA Training Site Administrator
Table 8. Resources on the ECC Training Network

Resource Description
Atlas (atlas.heart.org): All • Is available to all TCCs, TCAs, TSCs, TSAs, and instructors
instructors are required to be • Provides up-to-date resources and reference information about ECC
aligned in Atlas. The TCC reserves Programs and science
the right to accept or decline • Requires user registration to access
alignments in Atlas. • Periodically offers surveys and electronic submission of reports
AHA Platforms: All instructors are • Provides a section for TCCs, TCAs, TSCs, and TSAs to manage instructors and
required to be aligned on the AHA resources
• Provides the instructor ID number required on course completion cards
• Allows instructors to list courses and skills sessions for practice and testing
Resource Description
Platforms according to their • Can be used to issue eCards
territory. • Provides TCCs, TCAs, TSCs, and TSAs with the ability to manage eCards and
the issuance of eCards to TSs, instructors, and students
• Allows instructors to manage issuance of eCards to students
• Provides access to all current and previously issued eCards in their student
profile
• Allows students to print copies of eCards in either full-size or wallet-size
options
TCC Support: • Provides assistance and answers to questions
[email protected]
Information for students: • Offers students the ability to search for ECC courses in a specific country
atlas.heart.org and • Provides information about eLearning, course cards, and eBooks
international.heart.org • Provides information about ECC regional conferences
AHA eLearning website: • Provides access to ECC online courses
www.eLearning.heart.org
International Training: • Is the primary public email for the Training Network outside the United
[email protected] States
AHA website: • Provides AHA-related issues from Advocacy to Science and Research
international.heart.org • Lists AHA events happening in your area, including fundraising events
• Provides information about prevention education, diet, blood pressure,
physical activity, and nutrition
• Provides general information about AHA programs and services


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Emergency Cardiovascular Care

Program Administration Manual

Effective April 1, 2022

© 2022 American Heart Association

AHA Program Administration Manual: International Version, 2022

AHA Program Administration Manual: International Version, 2022 1

Figure 1. International AHA Training Network structure.

The Role of the ITC

Laws, Rules, and Regulations

AHA Program Administration Manual: International Version, 2022 2

New ITC Application Criteria

• The establishment of an ITC supports the AHA mission.

• Represents the ITC and is selected by the ITC

AHA Program Administration Manual: International Version, 2022 3

• Be at least 21 years old

AHA Program Administration Manual: International Version, 2022 4

• Conducts course monitoring on a routine basis and as requested by the AHA

AHA Program Administration Manual: International Version, 2022 5

Transfer of ITC Agreement

Terminating an ITC Agreement

AHA Program Administration Manual: International Version, 2022 6

Table 1. Steps for Terminating an ITC Agreement

Table 2. Steps for Transitioning an ITC to a TS

AHA Program Administration Manual: International Version, 2022 7

Following AHA Policies and Procedures

Liability Insurance for ITCs

AHA Program Administration Manual: International Version, 2022 8

Managing Records: Document Retention

• An original or a copy of the current, signed ITC Agreement

AHA Program Administration Manual: International Version, 2022 9

Instructor and TCF Records (All Disciplines)

AHA Program Administration Manual: International Version, 2022 10

Instructor Records Transfer

Table 3. Steps to Transfer Instructor Records

AHA Program Administration Manual: International Version, 2022 11

Interfacing With Instructors

AHA Program Administration Manual: International Version, 2022 12

Course Completion Card Management

Issuing Course Completion Cards and Security

AHA Program Administration Manual: International Version, 2022 13

Filling Out Course Completion Cards

AHA Program Administration Manual: International Version, 2022 14

Course Completion Card Validity Period

Written Exams and Skills Tests

• Ensuring that instructors use current versions of each exam as appropriate

AHA Program Administration Manual: International Version, 2022 15

Skills Tests for AHA eLearning or Classroom Course Completion

Course Fees, Materials, and Equipment

Use of AHA Materials

AHA Program Administration Manual: International Version, 2022 16

• Increasing the number of distributors that we have worldwide

Instructor Material Requirements

• Instructors follow the appropriate decontamination of equipment according to the manufacturer’s

Copyright of AHA Materials

AHA Program Administration Manual: International Version, 2022 17

Quality Assurance Plan

• Increased training numbers

AHA Program Administration Manual: International Version, 2022 18

Responsibilities of ITCs to Instructors

• A smoke-free facility, including surrounding grounds, parking lots, and entrances