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Adult Advanced Life Support

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

ï‚· Use ABCDE approach

ï‚· Aim for SpO2 of 94-98%

ï‚· Aim for normal PaCO2

ï‚· 12-lead ECG

ï‚· Treat precipitating cause

ï‚· Targeted temperature

management

Non-shockable

(PEA/Asystole)

Immediately resume

CPR for 2 min

Minimise interruptions

During CPR

ï‚· Ensure high quality chest compressions

ï‚· Minimise interruptions to compressions

ï‚· Give oxygen

ï‚· Use waveform capnography

ï‚· Continuous compressions when

advanced airway in place

ï‚· Vascular access (intravenous or

intraosseous)

ï‚· Give adrenaline every 3-5 min

ï‚· Give amiodarone after 3 shocks

Treat Reversible Causes

ï‚· Hypoxia

ï‚· Hypovolaemia

ï‚· Hypo-/hyperkalaemia/metabolic

ï‚· Hypothermia

ï‚· Thrombosis - coronary or

pulmonary

ï‚· Tension pneumothorax

 Tamponade – cardiac

ï‚· Toxins

Assess rhythm

Consider

ï‚· Ultrasound imaging

ï‚· Mechanical chest

compressions to facilitate

transfer/treatment

ï‚· Coronary angiography and

percutaneous coronary

intervention

ï‚· Extracorporeal CPR

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

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