When it comes to caring for your loved one during a medical emergency, you expect the best care and response from those coming to help. But what can you learn to do to help in those situations, and when should you wait for assistance from a medical professional? There are ways that you can help—by providing basic life support. But what is the difference between that and advanced life support? Is one better than the other?
Is ALS better than BLS?
Advanced life support and basic life support can be beneficial, but it depends on the situation. ALS helps improve those who suffer from a heart attack, epileptic seizures, respiratory distress, or multiple injuries, while BLS is best for those with penetrating injuries. Since ALS is performed by a trained medical professional and BLS can be performed by any trained civilian, most doctors and hospital staff prefer ALS to be performed on incoming patients.
But what is BLS, and what is ALS? What are the differences between the two? Read on to find out more.
Basic Life Support
Basic life support, or BLS, describes certain medical care processes that trained medical personnel such as emergency medical technicians or paramedics can do before a victim makes it to a hospital.
Some of the actions that comprise basic life support include defibrillation or chest compressions and rescue breaths in the case of cardiac arrest, rescue breaths in the case of respiratory arrest, cardiopulmonary resuscitation in drowning victims, and the Heimlich maneuver if the patient is choking.
Basic life support is the very first step in making sure a patient is stabilized. Anyone can take a BLS course, which includes how to use an automated external defibrillator, how to perform CPR, and how to perform the Heimlich Maneuver.
Advanced Life Support
Advanced life support, or ALS, builds upon the life saving processes taught and performed in basic life support. Their focus is increasing circulation and increasing ventilation to the patient to give them more time to get to a medical facility. Most of the advanced life support processes considers how to save someone who has gone into cardiac arrest.
ALS professionals are taught how to recognize the “Hs and Ts”, which is a mnemonic that outlines the reversible causes of cardiac arrest. Although there are many different reasons someone may go into cardiac arrest, knowing those options puts them a step above those with BLS training.
Professionals taught advanced life support can perform a number of other life saving processes, including cardiac defibrillation without using an automated external defibrillator, placing an IV, performing a cricothyrotomy—also known as a crike, where a trained professional cuts open a patient’s throat to provide an airway—decompressing a tension pneumothorax, and providing medication through different routes, including an IV.
Those trained in advanced life support also know how to read electrocardiograms, which is something BLS classes do not teach.
Advanced life support builds upon basic life support, as it assumes that some sort of basic life support has already been administered, like CPR or chest compressions. Following that basic action, professionals move forward and consider certain algorithms, or sets of steps, to sort out the best treatment for the patient before they make it to the hospital.
ALS and BLS Compared
Both advanced life support and basic life support are focused on making sure the patient can make it to the hospital for specialized, life-saving care. Emergency medical technicians are either trained in basic life support or both basic and advanced life support.
ALS is much more invasive than BLS.
Because of the nature of advanced life support, basic life support is much less invasive. Those trained in advanced life support can use needles and set up IVs and perform certain life saving procedures such as the cricothyrotomy mentioned before. They can also decompress a tension pneumothorax, which requires the ALS trained professional to insert a needle into the chest cavity to relieve pressure. This is extremely invasive and leads to the insertion of a chest tube upon arrival at the hospital.
ALS allows medical professionals to administer medication and treat cuts and other injuries.
Going off the first point about needles, advanced life support professionals can provide medication through IVs or in other ways while those performing basic life support cannot give a patient medication.
Those trained in ALS can give basic treatment when it comes to any cuts, burns, or injuries. Those trained in BLS do not have the training to do it.
ALS Units have more advanced equipment.
Like the name states, advanced life support professionals have access to better equipment, mainly to support life—airway equipment, cardiac life support, monitors, testing devices for glucose levels.
ALS ambulances have the equipment to provide medication as well—they carry life saving medications in board, while those who only provide basic life support do not.
ALS professionals have more training than BLS professionals.
The training for ALS is much longer than the training for BLS. When an ambulance unit has at least one paramedic on hand, that unit is typically considered an ALS unit. Medical professionals follow certain “algorithms” or a set of instructions or steps to make sure that treatment is standardized and effective, which is taught in their training. Some of these algorithms include knowing how to recognize and assist in cases of cardiac arrest, ventricular fibrillation, tachycardia, bradycardia, opioid emergencies, or suspected strokes.
ALS professionals can administer many different medications, like adrenaline or epinephrine, atropine, calcium, saline, colloids, or potassium to assist in better blood flow and mitigate the negative results of a heart condition.
When working in the medical field as a first responder, BLS ambulances function with two emergency medical technicians, while ALS ambulances have at least one paramedic.
Basic life support training is much shorter than advanced life support training.
Anyone can sign up for a BLS class, but most ALS classes are related to the medical field and can take years to complete. ALS should also only be performed by a paramedic or other health care provider, who have gone through the training.
In addition, it’s important to note that emergency medical technicians typically have basic life support training, while paramedics have advanced life support training.
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Which is better: ALS or BLS?
While basic life support is better than none, many medical professionals prefer advanced life support intervention. Not only are those trained in ALS better equipped and have additional knowledge, but anyone can take a BLS course, regardless of skill.
According to a study performed by the Scandinavian Journal of Trauma, Resuscitation, and Emergency Medicine, neither ALS or BLS improves a patient’s chance of survival. While resuscitation and defibrillation are both important and essential, basic life support typically is enough in most cases. ALS can sometimes be harmful if a patient is intubated without any anesthesia but can be helpful for those with multiple injuries or severe brain injuries.
They also concluded that ALS helps improve those who suffer from a heart attack, epileptic seizures, respiratory distress, or multiple injuries, while BLS is best for those with penetrating injuries.
In another study published on Frontiers in Medicine, researchers concluded after looking at over 2,500 studies that there was no significant difference between the medical results of patients who received ALS or BLS, showing no advantage or disadvantage to one or the other.
When it comes down to care, basic life support and advanced life support are both valid and useful. If someone needs help and there is a person nearby that can provide basic life support, that is a good way to make sure the patient is stabilized until more advanced help can make it to their aid. Remember that training is key—take a CPR class or a basic life support class if you find yourself wanting to be able to provide that in case of emergency, or if you think you could make it your career, consider becoming an EMT or a paramedic. Your knowledge could save lives.
Does BLS training cover first aid?
Basic life support training does not usually cover first aid, but it varies from class to class. BLS training is usually geared towards conducting CPR on a patient in teams, working with breathing emergencies, and working with obstructed airways. Depending on the training and how it is taught, some BLS programs teach on how to administer Nalaxone, or Narcan, to counteract an opioid overdose.
How long does an Advanced Life Support Certification last?
An Advanced Life Support Certification is valid for two years. Before certification, a candidate must attend a two-day course and take a written and practical exam. The American Heart Association provides courses and training on ALS, mainly focusing on cardiovascular life support.
What is Pediatric Advanced Life Support?
When performing advanced life support, it’s important to realize that working on children is much different than working on adults. The Pediatric Advanced Life Support program provided by the American Heart Association helps train medical professionals in the best practices of recognizing and mitigating cardiopulmonary arrest in children and infants.
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