Advanced cardiac life support
Guidelines for treating life-threatening cardiovascular conditions.
Advanced cardiac life support (ACLS) is a set of clinical guidelines established by the American Heart Association for the urgent treatment of life-threatening cardiovascular conditions that cause or have caused cardiac arrest. It expands on basic life support by adding recommendations on medications and advanced procedures to cardiopulmonary resuscitation. ACLS is practiced by advanced medical providers such as physicians, some nurses, and paramedics, who are usually required to hold certifications in ACLS care.
- field
- Emergency medicine, cardiology
- established_by
- American Heart Association
- first_published
- 1974
- governing_body
- International Liaison Committee on Resuscitation (ILCOR)
- prerequisite
- Basic life support (BLS) proficiency
- certification_renewal
- Every two years
Lore & Background
ACLS guidelines were first published in 1974 by the American Heart Association and updated in 1980, 1986, 1992, 2000, 2005, 2010, and 2015. In the 2020 update, the guidelines were restructured to align with ILCOR recommendations, transitioning from a five-year update cycle to an online format that can be updated as indicated by continuous evidence review. The International Liaison Committee on Resuscitation was established in 1992 to serve as a way for international resuscitation organizations to communicate and collaborate.
Reader's Guide
ACLS is significant because it provides standardized, algorithmic treatment for cardiac arrest and dangerous arrhythmias, improving survival outcomes when delivered promptly. Its guidelines cover airway management, ventilation, CPR compressions, defibrillation, and medications. Research shows patients have better survival outcomes when they receive ACLS, though one large study found this effect may only apply if ACLS is delivered in the first six minutes of arrest and that it does not produce superior neurological outcomes. The certification process ensures providers are tested on knowledge and application, but does not supersede a provider's scope of practice as determined by state law or employer protocols. Active debate continues within the resuscitation research community about the value of certain interventions, such as vasopressors and ideal airway use.
Did You Know?
- ACLS expands on basic life support by adding recommendations on additional medication and advanced procedure use to CPR guidelines.
- Common cardiac arrest rhythms covered by ACLS guidelines include ventricular tachycardia, ventricular fibrillation, pulseless electrical activity, and asystole.
- ACLS certification is frequently a requirement for employment as a health care provider at most hospitals.
- A 1998 study found that epinephrine, atropine, bicarbonate, calcium, lidocaine, and bretylium were not associated with higher resuscitation rates in cardiac arrests.
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