The goal of Advanced Cardiovascular Life Support (ACLS) is to achieve the best possible outcome for patients who are experiencing a life-threatening cardiac event. ACLS is a series of responses to discrete clinical events. These responses are designed to be simple enough to be committed to memory and recalled under moments of stress. ACLS protocols have been developed thorough review of basic research, patient case studies, clinical studies, and opinions of experts in the field. The gold standard in the United States and other countries is the course curriculum published by the American Heart Association (AHA). Approximately every five years the AHA updates the guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). This handbook is based on the most recent AHA publication on ACLS and will periodically compare old versus new recommendations for a more comprehensive review.
IMPORTANT: Refer to the Basic Life Support (BLS) Provider Handbook, also presented by NHCPS, for a more comprehensive review of the BLS Survey if warranted. This handbook specifically covers ACLS algorithms and only briefly describes BLS. All ACLS providers are presumed capable of performing BLS correctly. While this guide covers BLS basics, it is essential that ACLS providers be proficient in BLS first.
While ACLS providers should always be mindful of timeliness, it is important to provide the intervention that most appropriately fits the needs of the patient. Proper utilization of ACLS requires rapid and accurate assessment of the patient’s condition. This not only applies to the provider’s initial assessment of a patient in distress, but also to reassessment throughout the course of treatment with ACLS.
ACLS protocols assume the provider may not have all of the information needed from the victim and all of the resources needed to properly use ACLS in all cases. For example, if a provider is utilizing ACLS on the side of the road, they will not have access to sophisticated devices to measure breathing or arterial blood pressure. Nevertheless, in such situations, ACLS providers have the framework to provide the best possible care in the given circumstances. ACLS algorithms are based on past performances and results in similar life-threatening cases and are intended to achieve the best possible outcome for the patient during emergencies. The foundation of all algorithms involves the systematic approach of the BLS Survey (using steps 1, 2, 3, 4) and the ACLS Survey (using steps A, B, C, D).