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Pediatric International Trauma Life Support Registration Form

 This one-day course is designed to teach all levels of EMS personnel including first responders, EMTs, paramedics, trauma nurses, emergency nurses, and emergency physicians the skills necessary to recognize mechanisms of injury, assess and perform critical interventions, then package and transport the injured infant or child. Pediatric ITLS uses principles of prehospital trauma care and refines them for specific use on infants and children. These same principles apply for children being transferred from a primary hospital to a tertiary care facility. 

Please contact Life Support Education (336-716-2800) about picking up your ITLS Pediatric manual once you have registered for the course and received your confirmation.

Fee:  No Fee (NCBH Employee) must purchase book ($40)

          $85 (Non NCBH Employee)

*Refunds will not be given if you are unable to attend this course.  Please do not pay for a course unless you are prepared to attend on the date that you have scheduled.



Reading the ITLS Pediatric text and completing the pretest for the course is required. It is highly recommended that students have previously completed an ITLS, PHTLS, or PALS course. Upon completing course registration requirements, Life Support Education staff will provide you with appropriate study materials.


Successful completion requires a score of at least 74% on the written evaluation as well as successful completion of the patient assessment testing stations. Basic personnel (MR & EMT) will take a basic written exam and will only perform the basic level skills in their testing stations. Advanced personnel will take an advanced level written exam and will perform at the advanced level in the testing stations. 

Class Date 
First Name  
Middle Initial  
Last Name  
Credentials (RN, EMT-P, MD, etc)  
Zip Code  
Phone Number  
Are you an WFBH Employee?
WFBH Employees: No Fee but must purchase book
Non-Employees: $100
NOTE: A book is included in the fee for outside students.
If you are an NCBH Employee: 
Employee ID 
Managers Name    

Books and study materials can be picked up from Life Support Education once payment is received.




Quick Reference

Life Support Education
Kathy Nelson

Phone 336-716-2005
Fax 336-716-5927

Contact Kathy

Mikell White

Phone 336-716-2800
Fax 336-716-5927

Contact Mikell


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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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