Adult Advanced Life Support

ALS algorithm- reproduced with kind permission of Resuscitation Council (UK)

Unresponsive and not
breathing normally-Call resuscitation
team-CPR 30:2
Attach defibrillator/monitor
Minimise interruptions

Assess rhythm -Shockable
(VF/Pulseless VT)
1 Shock
Minimise interruptions
Immediately resume
CPR for 2 min
Minimise interruptions
Return of spontaneous
circulation
Immediate post cardiac
arrest treatment
 Use ABCDE approach
 Aim for SpO2 of 94-98%
 Aim for normal PaCO2
 12-lead ECG
 Treat precipitating cause
 Targeted temperature
management
Non-shockable
(PEA/Asystole)
Immediately resume
CPR for 2 min
Minimise interruptions

During CPR
 Ensure high quality chest compressions
 Minimise interruptions to compressions
 Give oxygen
 Use waveform capnography
 Continuous compressions when
advanced airway in place
 Vascular access (intravenous or
intraosseous)
 Give adrenaline every 3-5 min
 Give amiodarone after 3 shocks
Treat Reversible Causes
 Hypoxia
 Hypovolaemia
 Hypo-/hyperkalaemia/metabolic
 Hypothermia
 Thrombosis – coronary or
pulmonary
 Tension pneumothorax
 Tamponade – cardiac
 Toxins
Assess rhythm
Consider
 Ultrasound imaging
 Mechanical chest
compressions to facilitate
transfer/treatment
 Coronary angiography and
percutaneous coronary
intervention
 Extracorporeal CPR

From https://www.resus.org.uk/resuscitation-guidelines/adult-advanced-life-support/