AS2.1-2 | Basic and Advanced Life Support Across Age Groups — Summary & Reflection

KEY TAKEAWAYS

Basic and Advanced Life Support is a procedural competency built on precise technical knowledge applied under extreme time pressure. BLS provides circulatory support until definitive therapy: compressions at 100–120/min and 5–6 cm depth in adults (one-third AP diameter in children and neonates), ratio 30:2 in adults, 15:2 with two providers in children, 3:1 in neonates, preceded by five initial breaths in paediatric/neonatal arrest. ALS adds rhythm-directed therapy: shockable rhythms (VF/pVT) receive early defibrillation (adults: 150–200 J biphasic; children: 4 J/kg) with adrenaline 1 mg IV (adults) or 10 mcg/kg (children) after the third shock, and amiodarone 300 mg IV (adults) or 5 mg/kg (children) after the third shock. Asystole and PEA are non-shockable — defibrillation is contraindicated; adrenaline is given immediately and the 4Hs/4Ts systematically sought. Post-ROSC care targets normoxia, normocapnia, euglycaemia, blood pressure support, targeted temperature management at 36°C, and urgent coronary reperfusion if STEMI is identified. Quality CPR — monitored by EtCO₂ and feedback devices — remains the single most powerful intervention at every stage.

REFLECT

Consider the last time you witnessed or participated in a resuscitation attempt. Were the compressions being delivered at the correct rate and depth? Was there full chest recoil? Did the team pause compressions excessively? How quickly was the defibrillator attached and used? If you identified gaps in that resuscitation compared to the standards described in this SDL, what system or training change would have the highest impact on closing that gap? If you have not yet participated in a real resuscitation, identify the location and contents of the nearest crash trolley in your clinical placement and discuss the ALS algorithm with your supervising consultant before your next operating list.