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/