What certifications must Tier II personnel maintain?

• A. ACLS and BLS only
• B. ACLS, PEPP or PALS
• C. PEPP or PALS and ITLS or PHTLS
• D. ACLS, PEPP or PALS, ITLS or PHTLS

Answer: (D)

Tier II personnel must be prepared to handle a broad range of emergencies across three main areas: adult cardiac/medical emergencies, pediatric care, and trauma situations. That means maintaining ACLS for adults, plus a pediatric certification (PEPP or PALS), and a trauma-focused certification (ITLS or PHTLS). This combination ensures you’re equipped for the key scenarios you’ll encounter in the field.

The reason this set is the best fit is that it covers all three essential domains. One option would only include ACLS and basic life support, missing pediatric and trauma aspects. Another option includes ACLS and a pediatric credential but omits trauma. A third includes pediatric and trauma credentials but lacks ACLS. Only the full trio—ACLS along with a pediatric certification and a trauma certification—provides comprehensive preparedness for Tier II roles.