What Is Advanced Life Support?


Advanced Life Support (ALS) is a set of life-saving protocols and skills that extend beyond Basic Life Support (BLS). It is used to provide urgent treatment to cardiac emergencies such as cardiac arrest, stroke, myocardial infarction, and other conditions.

ALS is one of the vital steps in the American Heart Association's Chain of Survival which is a sequence of actions that can increase survival rates of sudden cardiac arrest and other emergencies. The five critical actions include:

  • Immediate recognition of cardiac arrest and activation of the emergency response system
  • Early high-quality CPR with an emphasis on chest compressions
  • Rapid defibrillation
  • Effective advanced life support
  • Integrated post-cardiac arrest care

Professionals qualified to provide advanced cardiac life support are trained and authorized to administer medication, perform injections, and conduct airway procedures prior to the arrival of the patient at an advanced care facility and/or in a hospital environment.

High-quality cardiopulmonary resuscitation and early defibrillation should be performed within the first 3-4 minutes of a patient experiencing sudden cardiac arrest. The American Heart Association recommends ALS be performed within the first 8 minutes of sudden cardiac arrest or another cardiac emergency for the patient's best chance of survival.

What is the Difference between ALS and BLS?

BLS is a level of medical care used to treat victims experiencing life-threatening illnesses or injuries until they can be given full medical care at a hospital. BLS requires knowledge and skills related to CPR, use of AEDs, and relieving airway obstructions. Emergency medical technicians, paramedics, or even qualified bystanders can perform BLS.

ALS should be performed only by paramedics and healthcare providers who have undergone more extensive training than an EMT.

Some other key differences between BLS and ALS include:

  • A BLS provider is not authorized to use needles or other devices that cut into the skin, nor are they authorized to administer medicine. ALS providers are authorized to do both.
  • A BLS unit includes two emergency medical technicians, while an ALS unit also has at least one paramedic.
  • An ALS unit is equipped with airway equipment, cardiac life support, and more.

What Equipment Do You Need to Provide ALS?

Key pieces of equipment that trained ALS professionals should have on hand in the case of a cardiac emergency include:

  • Monitor/Defibrillator: A lightweight monitor/defibrillator like the ZOLL R Series or X Series for EMS offers optimal defibrillation and pacing for responding to cardiac emergencies. Key features support more advanced rescuers:
    • CPR Dashboard: Detailed real-time display of CPR quality helps guide rescuers
    • See-Thru CPR technology: Filters out CPR artifact to minimize pause time during CPR and increase chest compression fraction
    • SpO2, EtCO2, and NIBP monitoring
    • 12-lead capabilities with the X-Series to reduce time-to-balloon by interfacing with all leading ECG management and STEMI systems
  • Impedance Threshold Device: A simple, non-invasive device like the ResQCPR system or ResQGARD improves perfusion with intrathoracic pressure (IPR) therapy.
  • Ventilator: ZOLL ventilators feature on-screen prompts that enable medics to quickly and easily initiate efficient oxygenation and treatment to patients.

More Frequently Asked Questions

  • Who Can Perform ALS?

    Generally, ALS is performed by some highly-trained emergency medical technicians, paramedics, and other qualified healthcare professionals. It can be performed at the scene of an emergency or in a hospital environment. Healthcare providers who receive ALS training are expected to keep up with the latest procedures and research while periodically getting recertified in ALS.

  • How Long Does an Advanced Life Support Certification Last?

    An ALS certificate is valid for two years. While the initial certification consists of a two-day course that includes a written and practical exam, recertification can be completed in a condensed eight-hour course. As most hospitals do not recognize a grace period, it’s important for healthcare professionals to stay on top of their certification renewal date.

  • What is Pediatric ALS?

    Pediatric ALS is a training program offered by the American Heart Association and other organizations whose goal is to is provide pediatric healthcare providers with the knowledge and skills necessary to manage critically ill infants and children. The program teaches skills such as recognition and treatment of infants and children at risk for cardiopulmonary arrest.

    CPR techniques used for children is similar to that used for adults; but because children’s bones are more flexible, rescuers should take extra care when providing rescue breaths and compressions. Rescuers also need to analyze arrhythmias differently in pediatric patients and should reduce joule settings on monitor/defibrillators to prevent accidental overdose during defibrillation.

Learn More

Are you equipped to effectively treat a cardiac emergency? Learn more about capabilities of ZOLL monitor/defibrillators.