Which certifications must Tier III RN personnel maintain?

• A. BLS only
• B. ACLS
• C. EMT-B certification
• D. ACLS, PEPP, PALS, NRP or equivalent, ITLS, PHTLS, TNCC or TNC

Answer: (D)

Tier III RN personnel must maintain a comprehensive set of certifications in adult, pediatric, neonatal, and trauma care to be prepared for a wide range of emergencies and to ensure safe, effective handoffs in the EMS system. This collection—ACLS for adult life support, PEPP and PALS for pediatric life support, NRP or an equivalent neonatal program, ITLS and PHTLS for prehospital trauma care, and TNCC or its equivalent for trauma nursing—ensures competency across the lifespan and in traumatic events. Relying on BLS alone or on a single certification like ACLS would leave gaps in pediatric, neonatal, and trauma management, and EMT-B certification is not sufficient for Tier III RN responsibilities.