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Advanced cardiac life support

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peri-cardiac arrest care: Airway management, ventilation, CPR compressions (continued from BLS), defibrillation, and medications. Due to the seriousness of the diseases treated, the paucity of data known about most ACLS patients, and the need for multiple, rapid, simultaneous treatments, ACLS is executed as a standardized, algorithmic set of treatments. Successful ACLS treatment starts with diagnosis of the correct
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the course is usually the final requirement to receive certification. After receiving initial certification, providers must usually recertify every two years in a class with similar content that lasts about seven hours. Widely accepted providers of ACLS certification include, non-exclusively: American Heart Association, American Red cross, European Resuscitation Council or the Australian Resuscitation Council.
425: 104:(BLS) by adding recommendations on additional medication and advanced procedure use to the CPR guidelines that are fundamental and efficacious in BLS. ACLS is practiced by advanced medical providers including physicians, some nurses and paramedics; these providers are usually required to hold certifications in ACLS care. 482:
Some studies have raised concerns that ACLS education can be inconstantly or inadequately taught which can result in poor retention, leading to poor ACLS performance. One study from 1998 looked at the ACLS use of epinephrine, atropine, bicarbonate, calcium, lidocaine, and bretylium in cardiac arrests
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Like a medical intervention, researchers have had to ask whether ACLS is effective. Data generally demonstrates that patients have better survival outcomes (increased ROSC, increased survival to hospital discharge and/or superior neurological outcomes) when they receive ACLS; however a large study of
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BLS proficiency is usually a prerequisite to ACLS training; however the initial portions of an ACLS class may cover CPR. Initial training usually takes around 15 hours and includes both classroom instruction and hands-on simulation experience; passing a test, with a practical component, at the end of
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Research on ACLS can be challenging because ACLS is a bundle of care recommendations; with each individual treatment component being profoundly consequential. There is active debate within the resuscitation research community about the value of certain interventions. Active areas of research include
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Stemming from the need for standardized, evidence based ACLS guidelines, an international network of academic resuscitation organizations was created. The International Liaison Committee on Resuscitation (ILCOR) is the central, international institution that regional resuscitation committees strive
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Successful ACLS treatment generally requires a team of trained individuals. Common team roles include: Leader, back-up leader, 2 CPR performers, an airway/respiratory specialist, an IV access and medication administration specialist, a monitor/ defibrillator attendant, a pharmacist, a lab member to
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Austria, Belgium, Bosnia & Herzegovina, Croatia, Cyprus, Czechoslovakia, Denmark, Egypt, Finland, France, Germany, Hungary, Iceland, Italy, Luxembourg, Malta, Netherlands, Norway, Portugal, Poland, Romania, Russia, Serbia, Slovakia, Slovenia, Spain, Sudan, Sweden, Switzerland, Tunisia, Turkey,
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ACLS algorithms include multiple, simultaneous treatment recommendations. Some ACLS providers may be required to strictly adhere to these guidelines, however physicians may generally deviate to pursue different evidence-based treatment, especially if they are addressing an underlying cause of the
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and were updated in 1980, 1986, 1992, 2000, 2005, 2010, 2015. In the 2020 update the guidelines were restructured to align with ILCOR recommendations. These changes include the transition since 2015 away from the previous 5-year update cycle to an online format that can be updated as indicated by
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for specialized resuscitation techniques. Specialized resuscitation techniques are not covered by ACLS certifications and their use is restricted to further specialized providers. ACLS education is based on ILCOR recommendations which are then adapted to local practices by authoritative medical
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Advanced cardiac life support refers to a set of guidelines used by medical providers to treat life-threatening cardiovascular conditions. These life-threatening conditions range from dangerous arrhythmias to cardiac arrest. ACLS algorithms frequently address at least five different aspects of
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Due to the rapidity and complexity of ACLS care, as well as the recommendation that it be performed in a standardized fashion, providers must usually hold certifications in ACLS care. Certifications may be provided by a few different, generally national, organizations but their legitimacy is
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process. ILCOR traditionally published updates and recommendations every five years but now conducts continuous review work. ILCOR produces international recommendations which are then adopted by regional resuscitation committees which publish guidelines. Regional guidelines can have more
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send samples, and a recorder to document the treatment. For in-hospital events, these members are frequently physicians, mid-level providers, nurses and allied health providers; while for out-of-hospital events, these teams are usually composed of a small number of EMTs and paramedics.
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to contribute to and disseminate information from. The centralization of resuscitation research around ILCOR reduces redundant work internationally, allows for collaboration between experts from many regional organizations, and produces higher quality, higher powered research.
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ultimately determined by hospital hiring and privileging boards; that is, ACLS certification is frequently a requirement for employment as a health care provider at most hospitals. ACLS certifications usually provide education on the aforementioned aspects of ACLS care
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reviews on resuscitation known as "Continuous Evidence Evaluation (CEE) and Consensus on Science with Treatment Recommendations (CoSTRs)". ILCOR uses 6 international task forces to review over 180 topics through a structured
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Perkins, Gavin D.; Gräsner, Jan-Thorsen; Semeraro, Federico; Olasveengen, Theresa; Soar, Jasmeet; Lott, Carsten; Voorde, Patrick Van de; Madar, John; Zideman, David; Mentzelopoulos, Spyridon; Bossaert, Leo (2021-04-01).
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Nolan, Jerry P.; Maconochie, Ian; Soar, Jasmeet; Olasveengen, Theresa M.; Greif, Robert; Wyckoff, Myra H.; Singletary, Eunice M.; Aickin, Richard; Berg, Katherine M.; Mancini, Mary E.; Bhanji, Farhan (2020-10-20).
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Kurz, Michael Christopher; Schmicker, Robert H.; Leroux, Brian; Nichol, Graham; Aufderheide, Tom P.; Cheskes, Sheldon; Grunau, Brian; Jasti, Jamie; Kudenchuk, Peter; Vilke, Gary M.; Buick, Jason (July 2018).
638:(ERC) guidelines were developed in 1992. The 2000 ERC guidelines were developed in collaboration with ILCOR. 5-year updates were published from 2000 to 2015 and annual updates have been published since 2017. 96:) refers to a set of clinical guidelines established by the American Heart Association (AHA) for the urgent and emergent treatment of life-threatening cardiovascular conditions that will cause or have caused 478:
patients showed that this effect may only be if ACLS is delivered in the first six minutes of arrest. This study also found that ACLS increases survival but does not produce superior neurological outcomes.
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The International Liaison Committee on Resuscitation (ILCOR) was established 1992 to serve as a way for international resuscitation organizations to communicate and collaborate.
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Merchant, Raina M.; Topjian, Alexis A.; Panchal, Ashish R.; Cheng, Adam; Aziz, Khalid; Berg, Katherine M.; Lavonas, Eric J.; Magid, David J.; null, null (2020-10-20).
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is achieved. Note: chest compressions are not different in ACLS vs BLS, but continue to be a fundamental part of cardiac arrest care even when ACLS is being executed.
1246:"Interaction of defibrillation waveform with the time to defibrillation or the number of defibrillation attempts on survival from out-of-hospital cardiac arrest" 1355:"Executive Summary: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations" 111:" (ALS), when used distinctly, ACLS tends to refer to the immediate cardiac care, while ALS tends to refer to more specialized resuscitation care such as 504: 1955: 1959: 197:
arrest and/or unique aspects of a patient's care. ACLS algorithms are complex but the table, below, demonstrates common aspects of ACLS care.
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Holding ACLS certification simply attests a provider was tested on knowledge and application of ACLS guidelines. The certification does
834:"Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital" 1947: 989:"Advanced vs. Basic Life Support in the Treatment of Out-of-Hospital Cardiopulmonary Arrest in the Resuscitation Outcomes Consortium" 1965: 1687: 1985: 33:
Cardiopulmonary resuscitation of an avalanche victim who was medically evacuated to Craig Joint Theater Hospital in February 2010
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organizations such as the American Red Cross, the European Resuscitation Council, or the Resuscitation Council of Asia
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determining the value of vasopressors in arrests, ideal airway use and different waveforms for defibrillation.
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serves as a way for international resuscitation organizations to communicate and collaborate. ILCOR publishes
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Termination of shockable rhythms. Note: not all cardiac arrest rhythms can be treated with defibrillation.
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Identification of underlying cause of cardiac arrest, augmentation of perfusion and/or treatment of
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Hagihara, Akihito; Onozuka, Daisuke; Ono, Junko; Nagata, Takashi; Hasegawa, Manabu (January 2018).
668: 663: 149: 1402: 699:"Is advanced life support better than basic life support in prehospital care? A systematic review" 939:
Sanders, A. B.; Berg, R. A.; Burress, M.; Genova, R. T.; Kern, K. B.; Ewy, G. A. (January 1994).
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Prince, Cynthia R.; Hines, Elizabeth J.; Chyou, Po-Huang; Heegeman, David J. (September 2014).
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van Walraven, C.; Stiell, I. G.; Wells, G. A.; HĂ©bert, P. C.; Vandemheen, K. (November 1998).
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Ryynänen, Olli-Pekka; Iirola, Timo; Reitala, Janne; Pälve, Heikki; Malmivaara, Antti (2010).
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rhythm causing the arrest. Common cardiac arrest rhythms covered by ACLS guidelines include:
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than ILCOR recommendations. ILCOR is composed of the following regional organizations:
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and found that these medications were not associated with higher resuscitation rates.
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as determined by state law or employer protocols; and does not, itself, provide any
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Sodhi, Kanwalpreet; Singla, Manender Kumar; Shrivastava, Anupam (October 2011).
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Argentina, Barbados, Bolivia, Jamaica, Trinidad and Tobago, United States
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While "ACLS" is almost always semantically interchangeable with the term "
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Ventilate the lungs to allow for subsequent oxygenation of the blood.
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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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Hong Kong, Japan, Korea, Philippines, Singapore, Thailand, Taiwan
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Journal of the American Academy of Psychiatry and the Law Online
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Cleat and protect the airway to allow for adequate ventilation.
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Stabilizes arrhythmia, promote ROSC and increase perfusion.
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Cardiac arrest treatment, Cardiovascular emergency treatment
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Jung, Julianna; Rice, Julie; Bord, Sharon (December 2018).
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while "BLS" may refer to the fundamental care provided by
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Emergency Medicine, Cardiology, Critical Care, Anesthesia
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The ACLS guidelines were first published in 1974 by the
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Mutchner L (January 2007). "The ABCs of CPR – again".
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(October 2020). 1295:"International Liaison Committee on Resuscitation" 2148: 578:Resuscitation Council of Southern Africa (RCSA) 500:International Liaison Committee on Resuscitation 1956:International Federation for Emergency Medicine 752:"Part 3: Adult Basic and Advanced Life Support" 1960:International Conference on Emergency Medicine 1713: 1191:"Optimal Airway Management in Cardiac Arrest" 1044:Kidd, Tracy; Kendall, Sharon (January 2007). 554:Heart and Stroke Foundation of Canada (HSFC) 1976:Canadian Association of Emergency Physicians 1137: 2082:Care of the Critically Ill Surgical Patient 1971:Australasian College for Emergency Medicine 1188: 1043: 490: 1720: 1706: 1533: 42:Advanced Cardiovascular Life Support, ACLS 27: 1636: 1586: 1370: 1165: 1155: 1004: 867: 849: 808: 724: 714: 1966:American College of Emergency Physicians 1425: 838:Indian Journal of Critical Care Medicine 423: 1986:European Society for Emergency Medicine 2149: 1996:American Academy of Emergency Medicine 1727: 1289: 1287: 586:InterAmerican Heart Foundation (IAHF) 1701: 545:European Resuscitation Council (ERC) 432: 386:Specialized Resuscitation Techniques 180:with rapid ventricular response, and 1991:Asian Society for Emergency Medicine 1426:Recupero, Patricia R. (2008-09-01). 746: 744: 594:Resuscitation Council of Asia (RCA) 255:, double sequential defibrillation, 90:advanced cardiovascular life support 2076:Advanced Life Support in Obstetrics 1981:Royal College of Emergency Medicine 1638:10.1016/j.resuscitation.2021.02.003 1562: 1284: 1262:10.1016/j.resuscitation.2017.11.053 1006:10.1016/j.resuscitation.2018.04.031 468: 222:Diagnosis of malignant arrhythmia. 13: 570:New Zealand Resuscitation Council 14: 2193: 1672: 1466:"National Resuscitation Councils" 741: 629: 616: 562:Australian Resuscitation Council 537:American Heart Association (AHA) 2129: 2118: 2117: 1773:International emergency medicine 1548:10.1097/00000446-200701000-00024 1144:Annals of Translational Medicine 1062:10.1111/j.1365-2702.2006.01571.x 781:Clinical Medicine & Research 2130: 2070:Pediatric Advanced Life Support 1783:Pre-hospital emergency medicine 1611: 1527: 1503: 1483: 1458: 1419: 1395: 1345: 1334:from the original on 2018-06-26 1316: 1305:from the original on 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Index


Specialty
edit on Wikidata
cardiac arrest
Basic Life Support
Advanced Life Support
ECMO
PCI
paramedics
EMTs
EMRs
EKG
ventricular tachycardia
ventricular fibrillation
Pulseless Electrical Activity
asystole
narrow
tachycardias
torsades de pointe
atrial fibrillation
flutter
bradycardia
Chest Compressions
mechanical CPR
ROSC
defibrillation
transvenous pacing
transcutaneous pacing
Endotracheal intubation
supraglottic airway

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