Advanced Cardiac Life Support (ACLS) is a protocol for handling patients who are experiencing serious medical emergencies such as cardiac arrest. The term also refers to the skills and training necessary to use the protocol safely and properly. Because ACLS involves advanced medical skills, certification and training is only offered to medical professionals such as doctors and nurses, since lay people do not have the necessary knowledge and skills. Several organizations offer training and certification, which is required in many hospitals and health care environments.
The principles of ACLS are an expansion on Basic Life Support (BLS), which includes Cardiopulmonary Resuscitation (CPR) and other simple measures to stabilize a patient until he or she can receive more experienced medical care. Much like CPR, ACLS relies on the ABC's of first aid, in which the Airway of the patient is secured, Breathing is assessed and stabilized, and Circulation is closely monitored. Unlike more basic care providers, people who are certified in advanced techniques can provide many more interventions.
Medical interventions such as intubation to open the airway and shocking with a defibrillator to regulate heart rhythm are one part of ACLS, as is the administration of pharmaceuticals which are intended to assist with resuscitation. A provider must be able to rapidly and accurately read data like electrocardiograms, and make decisions for the patient based on this data. ACLS certification also includes training in how to start intravenous (IV) lines, giving medical personnel quick access to the patient's veins. Surgical intervention such as the placement of central lines and chest tubes is also included in training.
Anyone who works in an emergency room will be trained in ACLS, and most medical students around the world take certification programs so that they are prepared on their rotations. In addition to resuscitation, the goal of ACLS is to begin to identify what is wrong with the patient, so that a long term treatment plan can be created. The guidelines are constantly changing, due to new information in the medical field, and frequent recertification is required for people after they are certified. Recertification also ensures that the material is always fresh, so that a healthcare provider can confidently make the right decision in a critical moment.
Guidelines for ACLS are published in major medical journals around the world, and they are also usually available through organizations like the American Heart Association. These guidelines may vary from nation to nation, because different countries have different approaches to resuscitation, and some may have a wider array of legal and available drugs and tools. In all cases, the fundamental practice of keeping up chest compressions and using timely defibrillation are a core tenet of ACLS.
