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In the US, an EMT capable of performing advanced life support is either an EMT-Intermediate or an EMT-Paramedic, commonly referred to simply as a Paramedic . Canadian paramedics may be certified in either ALS or in only basic life support. The treatment algorithms that comprise ALS were agreed by the European Resuscitation Council to improve the outcomes of cardiac arrest. MAIN ALGORITHM ALS presumes that Basic Life Support (bag-mask administration of Oxygen and chest compressions) are administered. The main algorithm of ALS, which is invoked when actual cardiac arrest has been established, relies on the monitoring of the electrical activity of the Heart on a cardiac monitor. Depending on the type of Cardiac Arrhythmia , Defibrillation is applied, and Medication is administered. Oxygen is administered and Endotracheal Intubation may be attempted to secure the airway. At regular intervals, the effect of the treatment on the heart rhythm, as well as the presence of Cardiac Output , is assessed. Medication that may be administered may include Adrenaline (epinephrine), Amiodarone , Atropine , Bicarbonate , Calcium , Potassium and Magnesium . Saline or colloids may be administered to increase the circulating volume. While CPR is given (either manually, or through automated equipment such as AutoPulse ), members of the team consider eight forms of potentially reversible causes for cardiac arrest, commonly abbreviated as "4H4T":
As of December 2005, Advanced Life Support guidelines have changed significantly. A major new worldwide consensus has been sought based upon the best available scientific evidence. The ratio of compressions to ventilations is now recommended as 30:2 for adults, to produce higher coronary and cerebral perfusion pressures. Defibrillation is now administered as a single shock, each followed immediately by 2 minutes of CPR before rhythm is re-assessed. OTHER CONDITIONS ALS also covers various conditions related to cardiac arrest, such as Cardiac Arrhythmia s ( Atrial Fibrillation , Ventricular Tachycardia ), Poisoning and effectively all conditions that may lead to cardiac arrest if untreated, apart from the truly Surgical Emergencies (which are covered by Advanced Trauma Life Support ). EXTERNAL LINKS
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