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ALS (Advanced Life Support)


Advanced Life Support (ALS) is a set of life-saving protocols and skills that extend beyond Basic Life Support (BLS) to further support the Circulation and provide an open airway and adequate ventilation (breathing).

Components of ALS

These include:

  • Cardiac monitoring
  • Cardiac defibrillation
  • Trans-Cutaneous pacing
  • IntraVenous cannulation (IV)
  • IntraOsseous (IO) access and IntraOsseous infusion
  • Surgical cricothyrotomy (Last resort!)
  • Needle cricothyrotomy (Last resort!)
  • needle decompression of tension pneumothorax
  • Advanced medication administration through parenteral and enteral routes (IV, IO, PO, PR, ET, SL, topical, and trans-dermal)
  • Advanced Cardiac Life Support (ACLS)
  • Pediatric Advanced Life Support (PALS) or Pediatric Emergencies for Pre-Hospital Providers (PEPP)
  • Pre-Hospital Trauma Life Support (PHTLS), Basic Trauma Life Support (BTLS) or International Trauma Life Support (ITLS)

Who is allowed to perform ALS

Many healthcare providers are trained to administer some form of ALS.

In out-of-hospital settings trained Emergency Medical Technicians (EMT's), Paramedics (Medics) typically provide ALS care. Canadian Paramedics may be certified in either ALS (Advance Care Paramedic-ACP) or in Basic Life Support (Primary Care Paramedic-PCP). Emergency Medical Technicians (EMT's) are often skilled in ALS, although they may employ a slightly modified version of the medical algorithm. In the United States Paramedic level services are referred to as Advanced Life Support (ALS). Services staffed by basic EMT's (EMT-B's) are referred to as Basic Life Support (BLS), and those staffed by EMT-Intermediates (EMT-I's) are called Intermediate Life Support (ILS). This terminology extends beyond emergency cardiac care to describe all capabilities of the providers.

In hospitals, ALS is usually given by a team of Physicians and Nurses. These cardiac arrest teams generally include junior doctors from various specialties such as Anesthetics, General Medicine, or Internal Medicine.


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