What is advanced cardiac life support (ACLS)?

Advanced cardiac life support (ACLS) is a group of procedures and techniques that treat immediately life-threatening conditions, including cardiac arrest, shock, stroke, and trauma. ACLS procedures and techniques are arranged into algorithms. Algorithms are a set of standard guidelines that improve the speed, effectiveness and outcomes of ACLS. The goal of ACLS is to stabilize your condition. This includes restoring normal vital signs and alertness. 

ACLS and other types of intensive medical care save lives. ACLS generally does not reverse or cure an underlying end-stage or life-threatening condition. It is not successful in all cases. 

Do-not-resuscitate (DNR) options that do not use ACLS may be appropriate in some cases, such as in end-stage cancer. Discuss all end-stage disease treatment options with your doctor to understand which choices are best for you or your family member. You can specify your choices ahead of time.

Types of ACLS treatments

Some conditions and diseases require many ACLS procedures and techniques, while others may only use a few. ACLS includes:

  • Airway stabilization and treatment including placing a breathing tube in the windpipe (intubation). Mechanical ventilation using a ventilator assists or performs breathing.
  • Arterial line insertion to take continuous blood pressure readings. It also provides a catheter in an artery to draw blood for necessary lab tests. 
  • Breathing treatments to open constricted airways  due to asthma, allergic reactions, or COPD (chronic obstructive pulmonary disease)
  • Cardiopulmonary resuscitation (CPR) to keep oxygenated blood pumping through the body until the heart and lungs can perform this on their own. This requires pushing down fast and firmly on the chest.
  • Cardioversion to treat certain cardiac arrhythmias (abnormal heartbeats). A common example is atrial fibrillation. Cardioversion uses medications or low-energy electrical shocks to restore a normal heartbeat.
  • Chest tubes or needle decompression to re-inflate a collapsed lung
  • Defibrillation to restore a normal heartbeat using a high-energy electrical shock 
  • Intravenous (IV) or central venous catheter placement to deliver fluids, medications, and blood transfusions 
  • IV medications to treat many conditions. IV medications can reverse life-threatening allergic reactions, correct acidosis, and suppress abnormal heartbeats. They can reduce the workload on the heart, reduce fluid buildup, and dissolve a clot that is causing a heart attack. They can also improve blood pressure and vital signs. 
  • Oxygen therapy to increase the amount of oxygen in the blood
  • Pacing to correct certain abnormal heartbeats

Why is advanced cardiac life support (ACLS) performed? 

Advanced cardiac life support (ACLS) treats severe or life-threatening conditions including: 

  • Coma including coma due to stroke, head injury, seizures, meningitis, or diabetes 
  • Drug toxicity and chemical exposure including overdose, poisoning, or serious adverse effects of medications and street drugs
  • Electrolyte imbalance including abnormal amounts of potassium, calcium or magnesium in the bloodstream 
  • Heart conditions including cardiac arrest, heart attack, certain congenital heart defects (birth defects), congestive heart failure, and cardiac arrhythmias (abnormal heartbeats). 
  • Arrhythmias include ventricular fibrillation, ventricular tachycardia, supraventricular tachycardia, and rapid atrial fibrillation
  • Respiratory failure including problems due to asthma, pulmonary edema (fluid in the lungs), and pulmonary embolism (blood clot in the lung)
  • Severe allergic reactions including anaphylaxis, a life-threatening allergic reaction
  • Shock including shock due to severe bleeding, spinal cord injury, heart conditions, and sepsis (a body-wide reaction to infection)
  • Terminal illnesses including end-stage liver failure and advanced cancer
  • Trauma and injuries including severe burns, major cuts, head and spinal cord injuries, multiple trauma, and smoke inhalation