1. science
2. medicine
3. pediatrics

Tuition:
Learning Objectives:
Two Day Provider Course:
$265 General (includes PALS manual)
Upon completion of this course, participants will
be able to:
1. Identify and treat medical conditions that
place a child at risk for cardiac arrest.
2. Use a systematic approach to pediatric
assessment.
3. Use the Evaluate-Identify-Intervene
approach to assessment and management of
a seriously ill infant or child.
4. Use effective resuscitation team
communication.
One Day Update Course:
$165 General (includes PALS manual)
 The discount applies to QMC part time, part time
quarterly or full time employees only.
 Tuition fees are waived for permanent part
time, or full time QMC employees required to
maintain PALS certification.
Continuing Education Credit:
Return the completed registration form with
payment to:
The Queen's Medical Center designates this live
activity for a maximum of (see below) AMA PRA
Category 1 CreditsTM:
Clinical Education
The Queen’s Medical Center
1301 Punchbowl Street
Honolulu, HI 96813
14.5 - Pediatric Advanced Life Support - Provider
Course
Refund Policy:
7.25 - Pediatric Advanced Life Support - Renewal
Course

$30 processing fee for cancellations

No refunds for cancellations received less
than 72 hours prior to class

$30 processing fee for rescheduling

No refunds for no shows
Physicians should claim only the credit
commensurate with the extent of their
participation in the activity.
Program Planning Committee:
Alson Inaba, MD, PALS/I, PALS/RF, PALS/NF
Sharon Keith, RN, PALS/P, QMC TC Coordinator
Registration:
Location:
All classes are held on The Queen’s Medical Center
campus. Location and maps will be provided with
your course materials.
2015
Sponsored by:
Open enrollment is on a first come, first served
basis, upon receipt of payment. Class size is limited.
Confirmation will be e-mailed before class.
For further information, please e-mail
[email protected] or contact The Queen’s Medical
Center, Clinical Education Department at 691-4731.
Pediatric Advanced Life Support
The American Heart Association strongly promotes
knowledge and proficiency in BLS, ACLS, and PALS and has
developed instructional materials for this purpose. Use of
these materials in an educational course does not represent
course sponsorship by the American Heart Association, and
any fees charged for such a course do not represent income
to the Association.
Clinical Education
PALS Course Registration
Name
RN
MD
PALS 2015
Provider Course (2 Days)
0700-0730 Registration
0730-1630 Course
Thursday/Friday Feb. 26/27, 2015
Thursday/Friday Apr. 30 & May 1, 2015
Thursday/Friday Oct. 29/30, 2015
Specialty:
Other (Specify):
Mailing Address
City
State
Home Phone
Zip
Work Phone
Institution/Agency
Department/Specialty
E-mail
Select a Date/Time:
2-Day Provider
Thur/Fri 2/26 & 2/27
Thur/Fri 4/30 & 5/1
Thur/Fri 10/29 & 10/30
Update Course (1 Day)
0700-0730 Registration
0730-1630 Course
Wednesday
Feb. 25, 2015
Wednesday
Apr. 29, 2015
Thursday
Aug. 27, 2015
Wednesday
Oct. 28, 2015
Course Description:
1-Day Update
Wed 02/25/2015
Wed 04/29/2015
Thur 08/27/2015
Wed 10/28/2015
Registration Fees:
with PALS Manual
with PALS Manual
$275 Community
$175 Community
$240 QMC Employee
$150 QMC Employee
without PALS Manual
without PALS Manual
$235 Community
$135 Community
$200 QMC Employee
$115 QMC Employee
$40 PALS Manual
Method of Payment:
Check payable to: The Queen’s Medical Center
Ck #____
VISA MC AMEX DISC (circle one)
Cardholder’s Name (as it appears on card)
Card Number
Course Prerequisites:
Current certification in Basic Life Support for
Healthcare Providers (BLS-HCP card).
All PALS participants are required to be
proficient in Basic Life Support for Healthcare
Providers skills (BLS-HCP). You will be asked
to demonstrate those skills to successfully
complete the PALS course.
Knowledge of cardiac arrhythmias and ability
to recognize arrhythmias.
Exp. Date
Card Billing Address (required)
3-Digit Security Code
The Pediatric Advanced Cardiac Life Support
course is designed for healthcare providers who
initiate and direct advanced life support beyond
basic life support through the stabilization or
transport phases of a pediatric emergency.
Cardiovascular pharmacology for children;
mechanism of action, indications, dosage and
precautions for emergency medications.
Total Amount
Send completed registration form with payment to:
Seating is limited. Payment must be received
with registration; no show=no refund; No POs.
The Queen’s Medical Center-Clinical Education
1301 Punchbowl Street
Honolulu, HI 96813
Ph (808) 691-4731; Fax (808) 691-7763
E-mail: [email protected]
*PLEASE CONTACT THE CLINICAL EDUCATION
OFFICE FOR CLASS AVAILIBILITY PRIOR TO
SUBMITTING FORM / PAYMENT.
Signature
Course Director:
Alson Inaba, MD, PALS/I, PALS/RF, PALS/NF
Physician, Emergency Services
Kapiolani Medical Center for Women &
Children
Classes:
Provider Class:
This is a full, 2-day session with skill stations
covering respiratory emergencies, electrical
therapies, and vascular access; competency
testing in CPR/AED; learning station for core
case discussions, core case simulations, and
effective team behaviors; and core case
testing.
This class is for first time students, students
who want an in-depth review or students who
have expired PALS completion cards.
Update Class:
This is a one-day renewal designed to
accommodate experienced professionals who
are self-directed to review the PALS protocols
on their own and need less practice time in
the classroom before performing in the
testing station.
Renewal students should have a current PALS
card. If you took your last PALS course more
than 24 months ago, you are advised to take
the Provider course.
Course Materials:
AHA requires that all students have the new
2011 PALS Provider Manual.
You MUST BRING YOUR PALS Manual to class.