Advanced Life Support (ALS) is a set of life-saving protocols and skills that extend Basic Life Support to support further circulation and provide an open air channel and adequate ventilation (breathing).
Video Advanced life support
Komponen ALS
These include:
- Trachea Intubation
- Fast order induction
- Cardiac monitoring
- Heart defibrillation
- Transcuntation runway
- intravenous (IV) cannulation
- Intraosseous access (IO) and intraosseous infusion
- Cricothyrotomy surgery
- Needle cricotyrotomy
- Decompress the needle for tension pneumothorax
- Advanced treatment administration via parenteral and enteral routes (IV, IO, PO, PR, ET, SL, topical, and transdermal)
- Advanced Cardiac Life Support (ACLS)
- Pediatric Advanced Life Support (PALS) or Pediatric Education for Pre-Hospital Providers (PEPP)
- Pre-Hospital Trauma Life Support (PHTLS), Basic Trauma Life Support (BTLS) or International Trauma Life Support (ITLS)
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2010 changed
ALS is a consensus treatment for cardiopulmonary resuscitation in cardiac arrest and related medical problems, as agreed in Europe by the European Resuscitation Council, most recently in 2010.
The 2010 revisions include:
- greater emphasis on continuous (undisturbed) chest compression
- less emphasis on breathing and breathing
- promotion of infusion of intraosseous fluids and drugs if access of IV is not available
- further decline of precordial bulge
- continuous simplification
- an expanded role for post-arrest hypothermia and an emphasis on post-captive normo-glycaemial maintenance.
ALS algorithm
ALS assumes that basic life support (administration of oxygen masks and chest compressions) is given.
The main ALS algorithm, which is called when the actual cardiac arrest has been established, depends on monitoring the heart's electrical activity on the heart monitor. Depending on the type of cardiac arrhythmias, defibrillation is applied, and medication is given. Oxygen is given and endotracheal intubation may be attempted to secure the airway. At regular intervals, the effects of treatment on heart rhythm, as well as the presence of cardiac output, are assessed.
Drugs that may be administered may include adrenaline (epinephrine), amiodarone, atropine, bicarbonate, calcium, potassium and magnesium. Saline or colloid may be given to increase circulating volume.
While CPR is given (either manually, or via automated equipment such as AutoPulse), team members consider eight potentially reversible causes for heart attacks, commonly abbreviated as "6Hs & 5Ts" according to AHA Advanced Cardiac Life Support (ACLS). Note these reversible causes are usually taught and remembered as 4Hs and 4Ts - including hypoglycemia and acidosis with hyper/hypokalemi and 'metabolic causes' and eliminating trauma from T because of this overuse with hypovolemia - this simplification helps remember during resuscitation.
Hs and Ts
- 'H's
- Hypoxia: low blood oxygen levels
- Hypovolaemia: low blood circulation, either due to blood loss or relative due to vasodilation
- Hyperkalemia or hypokalemia: impaired potassium levels in the blood, and associated disorders of calcium or magnesium levels.
- Hypothermia/Hyperthermia: body temperature is not maintained
- Hydrogen Ion (acidosis)
- Hypoglycemia: low blood glucose
- 'T's
- Tension pneumothorax: increased pressure in the thoracic cavity, causing decreased venous return to the heart
- Tamponade: fluid or blood in the pericardium, pressing the heart
- Toxic and/or therapeutic: chemicals, drugs or poisoning
- Thromboembolism and associated mechanical obstruction (blockage of blood vessels to the lungs or heart by blood clots or other substances)
As of December 2005, Advanced Cardiac Life Support guidelines have changed significantly. New global consensus has been sought based on the best available scientific evidence. The compression ratio for ventilation is now recommended as 30: 2 for adults, to produce higher coronary and cerebral perfusion pressures. Defibrillation is now given as a single shock, each immediately followed by two CPR minutes before the rhythm is revalued (five CPR cycles).
Other conditions
ALS also includes various conditions related to heart attacks, such as cardiac arrhythmias (atrial fibrillation, ventricular tachycardia), toxic and effectively all conditions that can cause cardiac arrest if left untreated, regardless of a truly emergency emergency (covered by Advanced Trauma Life). Support).
Who does ALS
Many health care providers are trained to manage some forms of ALS.
In out-of-hospital settings trained in emergency medical technicians, paramedics or medical personnel usually provide this level of care. Canadian Paramedics can be certified in ALS (Advance Care Paramedic-ACP) or in Basic Life Support (Primary Paramedic-PCP Care) (see paramedics in Canada). Emergency medical technicians (EMTs) are often experts in ALS, although they may use slightly modified versions of the medical algorithm. In the United States, Paramedic-level services are referred to as Advanced Life Support (ALS). Services managed by basic EMT are referred to as Basic Life Support (BLS), as those managed by EMT-Intermediate are called Life Support Medium (ILS). In the Republic of Ireland, Advanced Life Support (ALS) is provided by Advanced paramedics. Advanced Paramedic (AP) is the highest clinical level (level 6) in pre-hospital care in the Republic of Ireland based on standards established by PHECC, the Irish regulatory body for pre-hospital care and ambulance services. This terminology goes beyond emergency heart care to illustrate all the capabilities of the provider.
At the hospital, ALS is usually given by a team of doctors and nurses, with some clinical paramedics practicing on a particular system. The cardiac arrest team, or "Code Team" in the United States, generally includes senior doctors and nurses from different specialties such as emergency medicine, anesthesia, general or internal medicine.
References
External links
- Advanced adult life support on the UK Resuscitation Council website
Source of the article : Wikipedia
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