Knowledge

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.
436: 115:(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. 493:
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).
649:(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. 107:) 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 489:
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.
1257:"Interaction of defibrillation waveform with the time to defibrillation or the number of defibrillation attempts on survival from out-of-hospital cardiac arrest" 1366:"Executive Summary: 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations" 122:" (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 515: 1966: 1970: 208:
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
845:"Impact of advanced cardiac life support training program on the outcome of cardiopulmonary resuscitation in a tertiary care hospital" 1958: 1000:"Advanced vs. Basic Life Support in the Treatment of Out-of-Hospital Cardiopulmonary Arrest in the Resuscitation Outcomes Consortium" 1976: 1698: 1996: 44:
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).
679: 674: 160: 1413: 710:"Is advanced life support better than basic life support in prehospital care? A systematic review" 950:
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). 1306:"International Liaison Committee on Resuscitation" 2159: 589:Resuscitation Council of Southern Africa (RCSA) 511:International Liaison Committee on Resuscitation 1967:International Federation for Emergency Medicine 763:"Part 3: Adult Basic and Advanced Life Support" 1971:International Conference on Emergency Medicine 1724: 1202:"Optimal Airway Management in Cardiac Arrest" 1055:Kidd, Tracy; Kendall, Sharon (January 2007). 565:Heart and Stroke Foundation of Canada (HSFC) 1987:Canadian Association of Emergency Physicians 1148: 2093:Care of the Critically Ill Surgical Patient 1982:Australasian College for Emergency Medicine 1199: 1054: 501: 1731: 1717: 1544: 53:Advanced Cardiovascular Life Support, ACLS 38: 1647: 1597: 1381: 1176: 1166: 1015: 878: 860: 819: 735: 725: 1977:American College of Emergency Physicians 1436: 849:Indian Journal of Critical Care Medicine 434: 1997:European Society for Emergency Medicine 14: 2160: 2007:American Academy of Emergency Medicine 1738: 1300: 1298: 597:InterAmerican Heart Foundation (IAHF) 1712: 556:European Resuscitation Council (ERC) 443: 397:Specialized Resuscitation Techniques 191:with rapid ventricular response, and 2002:Asian Society for Emergency Medicine 1437:Recupero, Patricia R. (2008-09-01). 757: 755: 605:Resuscitation Council of Asia (RCA) 266:, double sequential defibrillation, 101:advanced cardiovascular life support 2087:Advanced Life Support in Obstetrics 1992:Royal College of Emergency Medicine 1649:10.1016/j.resuscitation.2021.02.003 1573: 1295: 1273:10.1016/j.resuscitation.2017.11.053 1017:10.1016/j.resuscitation.2018.04.031 479: 233:Diagnosis of malignant arrhythmia. 24: 581:New Zealand Resuscitation Council 25: 2204: 1683: 1477:"National Resuscitation Councils" 752: 640: 627: 573:Australian Resuscitation Council 548:American Heart Association (AHA) 2140: 2129: 2128: 1784:International emergency medicine 1559:10.1097/00000446-200701000-00024 1155:Annals of Translational Medicine 1073:10.1111/j.1365-2702.2006.01571.x 792:Clinical Medicine & Research 2141: 2081:Pediatric Advanced Life Support 1794:Pre-hospital emergency medicine 1622: 1538: 1514: 1494: 1469: 1430: 1406: 1356: 1345:from the original on 2018-06-26 1327: 1316:from the original on 2020-08-15 1248: 1193: 1142: 1095: 685:Pediatric Advanced Life Support 2069:Acute Care of at-Risk Newborns 2063:Neonatal Resuscitation Program 1694:European Resuscitation Council 1481:European Resuscitation Council 1048: 990: 943: 919: 895: 836: 779: 701: 647:European Resuscitation Council 13: 1: 2051:Advanced cardiac life support 2034:Cardiopulmonary resuscitation 1526:Resuscitation Council of Asia 1120:10.1016/s0196-0644(98)70031-9 968:10.1016/s0196-0644(94)70009-5 695: 659:Cardiopulmonary resuscitation 165:Pulseless Electrical Activity 97:Advanced cardiac life support 33:Advanced cardiac life support 18:Advanced Cardiac Life Support 2075:Pediatric basic life support 2057:Advanced trauma life support 2040:Mouth-to-mouth resuscitation 1789:Pediatric emergency medicine 1704:2020 Guidelines from the AHA 1699:2015 Guidelines from the AHA 1599:10.1161/CIR.0000000000000918 1383:10.1161/CIR.0000000000000890 1108:Annals of Emergency Medicine 956:Annals of Emergency Medicine 637:continuous evidence review. 7: 1061:Journal of Clinical Nursing 652: 145: 10: 2209: 2188:Emergency medicine courses 2183:Emergency medical services 2168:American Heart Association 1759:Emergency medical services 690:Resuscitation Council (UK) 634:American Heart Association 614: 250:Perfusion of blood before 2123: 2102: 2015: 1957: 1906: 1817: 1746: 1592:(16_suppl_2): S337–S357. 1218:10.1016/j.ccc.2020.07.008 903:"FAQs about AHA Training" 645:The first version of the 83: 75: 67: 57: 49: 37: 32: 1934:Epinephrine / Adrenaline 1553:(1): 60–69, quiz 69–70. 680:Indian Heart Association 675:British Heart Foundation 619: 560:Ukraine, United Kingdom 502:International guidelines 202: 161:ventricular fibrillation 1168:10.21037/atm.2018.12.31 862:10.4103/0972-5229.92070 727:10.1186/1757-7241-18-62 468:supersede a provider's 299:, tracheal suctioning, 285:Endotracheal intubation 219:Possible Interventions 157:ventricular tachycardia 2193:Emergency life support 1376:(16_suppl_1): S2–S27. 540:Regional Organization 440: 439:Example ACLS algorithm 27:Emergency medical care 2115:Injury Severity Score 1886:Nasopharyngeal airway 1859:Intraosseous infusion 1206:Critical Care Clinics 804:10.3121/cmr.2014.1201 438: 421:central venous access 272:transcutaneous pacing 120:Advanced Life Support 1892:Oropharyngeal airway 1769:Emergency psychiatry 1754:Emergency department 297:waveform capnography 2178:Medical emergencies 1871:Tracheal intubation 1865:Intravenous therapy 1339:www.costr.ilcor.org 1310:www.ilcor.org/about 543:Affiliated Nations 536: 530:medicolegal bearing 520:scientific evidence 388:intraosseous access 305:oropharygeal airway 289:supraglottic airway 230:EKG, clinical exam 212: 185:atrial fibrillation 175:- and wide-complex 2045:Basic life support 1949:Sodium bicarbonate 1747:Emergency medicine 1740:Emergency medicine 535: 444:ACLS Certification 441: 384:crystalloid fluids 281:Airway Management 268:transvenous pacing 262:Mono- or biphasic 242:Chest Compressions 211: 181:torsades de pointe 113:Basic Life Support 2155: 2154: 1944:Magnesium sulfate 1853:Electrocardiogram 1779:Medical emergency 1764:Emergency nursing 1161:(Suppl 2): S129. 612: 611: 525:systematic-review 470:scope of practice 433: 432: 227:Rhythm diagnosis 94: 93: 16:(Redirected from 2200: 2144: 2143: 2132: 2131: 1733: 1726: 1719: 1710: 1709: 1678: 1677: 1651: 1626: 1620: 1619: 1601: 1577: 1571: 1570: 1542: 1536: 1535: 1533: 1532: 1518: 1512: 1511: 1509: 1508: 1498: 1492: 1491: 1489: 1487: 1473: 1467: 1466: 1434: 1428: 1427: 1425: 1424: 1410: 1404: 1403: 1385: 1360: 1354: 1353: 1351: 1350: 1331: 1325: 1324: 1322: 1321: 1302: 1293: 1292: 1252: 1246: 1245: 1197: 1191: 1190: 1180: 1170: 1146: 1140: 1139: 1099: 1093: 1092: 1052: 1046: 1045: 1019: 994: 988: 987: 947: 941: 940: 938: 937: 923: 917: 916: 914: 913: 899: 893: 892: 882: 864: 840: 834: 833: 823: 783: 777: 776: 774: 773: 759: 750: 749: 739: 729: 705: 537: 534: 480:Efficacy of ACLS 401:Echocardiography 376:calcium chloride 213: 210: 87:edit on 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Index

Advanced Cardiac Life Support

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

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