Advanced Life Support (ALS), also referred to as Advanced Cardiac Life Support (ACLS), is a set of life-saving protocols and skills that extend beyond Basic Life Support (BLS). It is used to provide urgent treatment to cardiac emergencies such as cardiac arrest, stroke, myocardial infarction, and other conditions.
ALS is one of the vital steps in the American Heart Association's Chain of Survival, which is a sequence of actions that can increase survival rates of sudden cardiac arrest (SCA) and other emergencies. The five critical actions include:
Professionals qualified to provide advanced cardiac life support are trained and authorized to administer medication, perform injections, and conduct airway procedures prior to the arrival of the patient at an advanced care facility and/or in a hospital environment.
High-quality cardiopulmonary resuscitation (CPR) and early defibrillation should be performed within the first 3-4 minutes of a sudden cardiac arrest. The American Heart Association recommends advanced cardiovascular life support be performed within the first 8 minutes of sudden cardiac arrest or another cardiac emergency for the patient's best chance of survival.
Basic Life Support is a level of medical skill used to treat victims experiencing life-threatening illnesses or injuries until they can be given full medical care at a hospital. BLS requires knowledge and skills related to CPR, use of AEDs, and relieving airway obstructions. Emergency medical technicians, paramedics, or even qualified bystanders can perform BLS.
ALS should be performed only by paramedics and healthcare providers who have undergone more extensive training than an EMT.
Some other key differences between BLS and ALS include:
Key equipment that trained advanced cardic life support professionals should have on hand in the case of a cardiac emergency include:
Generally, advanced cardiac life support is performed by highly trained paramedics and other qualified healthcare professionals. It can be performed at the scene of an emergency or in a hospital environment. Healthcare providers who receive ACLS training are expected to keep up with the latest procedures and research while periodically getting recertified in ACLS.
An ACLS certification is valid for two years. While the initial certification consists of a two-day course that includes a written and practical exam, recertification can be completed in a condensed eight-hour course. As most hospitals do not recognize a grace period, it's important for healthcare professionals to stay on top of their certification renewal date.
Pediatric Advanced Life Support (PALS) is a training program offered by the American Heart Association and other organizations whose goal is to equip pediatric healthcare providers with the knowledge and skills necessary to manage critically ill infants and children. The program teaches skills such as recognition and treatment of infants and children at risk of cardiopulmonary arrest.
Pediatric defibrillation and CPR techniques are similar to those used for adults, but because children vary in size and weight from adults, special attention must be paid to providing proper chest compression depth and appropriate ventilations. Rescuers also need to consider differences with arrhythmia interpretation and use of weight-based energy settings for defibrillation.
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