Advanced Life Support (ALS) is a treatment consensus for cardiopulmonary resuscitation in cardiac arrest and related medical problems, as agreed in Europe by the European Resuscitation Council, most recently in 2005. It is practiced by in-hospital cardiac arrest teams, which generally consist of junior doctors from various specialties (anesthetics, general or internal medicine). Emergency medical technicians (EMTs) are often skilled in ALS, although they may employ slightly modified version of the algorithm. Wikibooks has more about this subject: First Aid/CPR Cardiopulmonary resuscitation (CPR) is an emergency first aid procedure for a victim of cardiac arrest. ... The European Resuscitation Council (ERC) is the European Interdisciplinary Council for Resuscitation Medicine and Emergency Medical Care. ... 2005 (MMV) was a common year starting on Saturday of the Gregorian calendar. ... A physician visiting the sick in a hospital. ... Anesthesia (AE), also anaesthesia (BE), is the process of blocking the perception of pain and other sensations. ... Internal medicine is concerned with the diagnosis and treatment of internal diseases, that is, those that affect internal organs or the body as a whole. ... Doctors of internal medicine (internists) are medical specialists who focus on adult medicine and have had special study and training focusing on the prevention and treatment of adult diseases. ... The examples and perspective in this article or section may not represent a worldwide view. ...

In the US, an EMT capable of performing advanced life support is either an EMT-Intermediate or an EMT-Paramedic, commonly referred to simply as a paramedic. Canadian paramedics may be certified in either ALS or in only basic life support. A Paramedic is a specialized health care professional who responds to medical and trauma emergencies in the pre-hospital (out-of-hospital) environment for the purpose of stabilizing and transporting the patient to an appropriate medical facility, usually by ambulance. ...

The treatment algorithms that comprise ALS were agreed by the European Resuscitation Council to improve the outcomes of cardiac arrest.

Main algorithm

ALS presumes that basic life support (bag-mask administration of oxygen and chest compressions) are administered. Basic life support (BLS) is a specific level of prehospital medical care provided by trained responders, including emergency medical technicians, in the absence of advanced medical care. ... General Name, Symbol, Number oxygen, O, 8 Chemical series Nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Atomic mass 15. ...

The main algorithm of ALS, which is invoked when actual cardiac arrest has been established, relies on the monitoring of the electrical activity of the heart on a cardiac monitor. Depending on the type of cardiac arrhythmia, defibrillation is applied, and medication is administered. Oxygen is administered and endotracheal intubation may be attempted to secure the airway. At regular intervals, the effect of the treatment on the heart rhythm, as well as the presence of cardiac output, is assessed. The heart and lungs, from an older edition of Grays Anatomy. ... Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... Typical view of the defibrillator operator. ... Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... General Name, Symbol, Number oxygen, O, 8 Chemical series Nonmetals, chalcogens Group, Period, Block 16, 2, p Appearance colorless (gas) very pale blue (liquid) Atomic mass 15. ... Intubation being practiced on a dummy (conventional technique using a laryngoscope) In medicine, intubation is the placement of a tube into an external or internal orifice of the body. ... Cardiac output is the volume of blood being pumped by the heart, in particular a ventricle in a minute. ...

Medication that may be administered may include adrenaline (epinephrine), amiodarone, atropine, bicarbonate, calcium, potassium and magnesium. Saline or colloids may be administered to increase the circulating volume. Image File history File links No higher resolution available. ... Epinephrine (INN) or adrenaline (BAN) is a hormone and a neurotransmitter. ... Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. ... Atropine is a tropane alkaloid extracted from the deadly nightshade (Atropa belladonna) and other plants of the family Solanaceae. ... In inorganic chemistry, a bicarbonate (IUPAC-recommended nomenclature: hydrogencarbonate) is an intermediate form in the deprotonation of carbonic acid. ... Calcium plays a vital role in the anatomy, physiology and biochemistry of organisms and of the cell, particularly in signal transduction pathways. ... General Name, Symbol, Number potassium, K, 19 Chemical series alkali metals Group, Period, Block 1, 4, s Appearance silvery white Atomic mass 39. ... General Name, Symbol, Number magnesium, Mg, 12 Chemical series alkaline earth metals Group, Period, Block 2, 3, s Appearance silvery white Atomic mass 24. ... In medicine, saline is a solution of sodium chloride in sterile water, used commonly for intravenous infusion, rinsing contact lenses, and nasal irrigation or jala neti. ...

While CPR is given (either manually, or through automated equipment such as AutoPulse), members of the team consider eight forms of potentially reversible causes for cardiac arrest, commonly abbreviated as "4H4T": AutoPulse The AutoPulse is an automated cardiopulmonary resuscitation machine created by Revivant. ...

• Hypoxia (low oxygen levels in the blood)
• Hypovolemia (low amount of circulating blood, either absolutely due to blood loss or relatively due to vasodilation)
• Hyperkalemia or hypokalemia (disturbances in the level of potassium in the blood) and related disturbances of calcium or magnesium levels and hypoglycemia (low glucose levels).
• Hypothermia (undercooling)
• Tension pneumothorax (tear in the lung leading to collapsed lung and twisting of the large blood vessels)
• Tamponade (fluid or blood in the pericardium, compressing the heart)
• Toxic and/or therapeutic (chemicals, whether medication or poisoning)
• Thromboembolism and related mechanical obstruction (blockage of the blood vessels to the lungs or the heart by a blood clot or other material)

As of December 2005, Advanced Life Support guidelines have changed significantly. A major new worldwide consensus has been sought based upon the best available scientific evidence. The ratio of compressions to ventilations is now recommended as 30:2 for adults, to produce higher coronary and cerebral perfusion pressures. Defibrillation is now administered as a single shock, each followed immediately by 2 minutes of CPR before rhythm is re-assessed. Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia) or region of the body (tissue hypoxia) is deprived of adequate oxygen supply. ... In physiology and medicine, hypovolemia is a state of decreased blood volume; more specifically, decrease in volume of blood plasma. ... The blood vessels are part of the circulatory system and function to transport blood throughout the body. ... Hyperkalemia is an elevated blood level (above 5. ... Hypokalemia is a potentially fatal condition in which the body fails to retain sufficient potassium to maintain health. ... General Name, Symbol, Number potassium, K, 19 Chemical series alkali metals Group, Period, Block 1, 4, s Appearance silvery white Atomic mass 39. ... Calcium plays a vital role in the anatomy, physiology and biochemistry of organisms and of the cell, particularly in signal transduction pathways. ... General Name, Symbol, Number magnesium, Mg, 12 Chemical series alkaline earth metals Group, Period, Block 2, 3, s Appearance silvery white Atomic mass 24. ... Hypoglycemia (hypoglycæmia in the UK) is a medical term referring to a pathologic state produced by a lower than normal amount of sugar (glucose) in the blood. ... Glucose (Glc), a monosaccharide (or simple sugar), is the most important carbohydrate in biology. ... Hypothermia refers to any condition in which the temperature of a body drops below the level required for normal metabolism and/or bodily function to take place. ... A tension pneumothorax is a life threatening condition that results from a progressive deterioration and worsening of a simple pneumothorax, associated with the formation of a one-way valve at the point of rupture. ... Cardiac tamponade, also known as pericardial tamponade, is a medical emergency condition where liquid accumulates in the pericardium in a relatively short time. ... The pericardium is a double-walled sac that contains the heart and the roots of the great vessels. ... For biological toxicity, see toxin and poison. ... Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... A pulmonary embolism (thromboembolism) occurs when a blood clot, generally a venous thrombus, becomes dislodged from its site of formation and embolizes to the arterial blood supply of one of the lungs. ... Blood clot diagram. ... Typical view of the defibrillator operator. ... For other meanings of CPR, see CPR (disambiguation). ...

Other conditions

ALS also covers various conditions related to cardiac arrest, such as cardiac arrhythmias (atrial fibrillation, ventricular tachycardia), poisoning and effectively all conditions that may lead to cardiac arrest if untreated, apart from the truly surgical emergencies (which are covered by Advanced Trauma Life Support). Cardiac arrhythmia is a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... Tachycardia is an abnormally rapid beating of the heart, defined as a resting heart rate of over 100 beats per minute. ... For biological toxicity, see toxin and poison. ... Surgical emergency is a medical emergency which requires immediate surgical intervention (the only way to solve the problem successfully). ... Advanced Trauma Life Support is a training program in acute management of trauma cases, developed in 1976 by the American College of Surgeons. ...

External links

• UK Resuscitation Council ALS page
• CPRSearch.Com - The CPR & ALS Training Directory
• About First Aid ALS Definition

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