|
|
| Line 1: |
Line 1: |
| {{Infobox_Disease |
| |
| Name = {{PAGENAME}} |
| |
| Image = |
| |
| Caption = |
| |
| DiseasesDB = |
| |
| ICD10 = |
| |
| ICD9 = |
| |
| ICDO = |
| |
| OMIM = |
| |
| MedlinePlus = |
| |
| eMedicineSubj = |
| |
| eMedicineTopic = |
| |
| MeshID = |
| |
| }}
| |
| {{SI}}
| |
| {{CMG}}
| |
|
| |
|
| {{Editor Help}}
| |
|
| |
| ==Overview==
| |
|
| |
| '''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 medicine|general]] or [[internal medicine]]). [[Emergency medical technician]]s (EMTs) are often skilled in ALS, although they may employ slightly modified version of the algorithm.
| |
|
| |
| 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.
| |
|
| |
| 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.
| |
|
| |
| 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.
| |
|
| |
| Medication that may be administered may include [[adrenaline]] (epinephrine), [[amiodarone]], [[atropine]], [[bicarbonate]], [[calcium in biology|calcium]], [[potassium]] and [[magnesium]]. [[Saline (medicine)|Saline]] or colloids may be administered to increase the circulating volume.
| |
|
| |
| 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":
| |
| * [[Hypoxia (medical)|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 in biology|calcium]] or [[magnesium]] levels and [[hypoglycemia]] (low [[glucose]] levels).
| |
| * [[Hypothermia]] (body temperature not maintained)
| |
| * [[Tension pneumothorax]] (tear in the lung leading to collapsed lung and twisting of the large blood vessels)
| |
| * [[Cardiac tamponade|Tamponade]] (fluid or blood in the [[pericardium]], compressing the heart)
| |
| * [[Poisoning|Toxic]] and/or [[medication|therapeutic]] (chemicals, whether medication or poisoning)
| |
| * [[Pulmonary embolism|Thromboembolism]] and related mechanical obstruction (blockage of the blood vessels to the lungs or the heart by a [[thrombus|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.
| |
|
| |
| ==Other conditions==
| |
| ALS also covers various conditions related to cardiac arrest, such as [[cardiac arrhythmia]]s ([[atrial fibrillation]], [[ventricular tachycardia]]), [[poisoning]] and effectively all conditions that may lead to cardiac arrest if untreated, apart from the truly [[surgical emergency|surgical emergencies]] (which are covered by [[Advanced Trauma Life Support]]).
| |
|
| |
| ==External links==
| |
| * [http://www.resus.org.uk/pages/als.htm UK Resuscitation Council ALS page]
| |
| * [http://www.cprsearch.com/ CPRSearch.Com - The CPR & ALS Training Directory]
| |
| * [http://firstaid.about.com/od/glossary/g/07_als.htm About First Aid ALS Definition]
| |
|
| |
| {{Emergency medicine}}
| |
|
| |
| [[Category:Emergency medicine]]
| |
|
| |
| [[it:Supporto vitale avanzato]]
| |
| [[pl:Reanimacja]]
| |