1
AdvancedLifeSupportp p
Instructor Trainer’s Guide
p p
, p
ThispInstructorpTrainer’spGuidepisppartpofpthepAmericanpRedpCrosspAdvancedpLifepSupportpprogram.pThepemergencyp
carepprocedurespoutlinedpinpthepprogrampmaterialspreflectpthepstandardpofpknowledgepandpacceptedpemergencyppr
acticespinpthepUnitedpStatespatptheptimepthispmanualpwasppublished.pItpispthepreader’spresponsibilityptopstaypinformedp ofpc
hangespinpemergencypcarepprocedures.
PLEASEpREADpTHEpFOLLOWINGpTERMSpANDpCONDITIONSp(thep“TermspandpConditions”) pBEFOREpAGREEIN
Gp TOp ACCESS,p USEp ORp DOWNLOAD p THEp FOLLOWINGp AMERICANp NATIONAL p REDp CROSSpMATERIALS.p B
Yp PURCHASING, p DOWNLOADING, p ORp OTHERWISEp USINGp ORp ACCESSINGp THEpMATERIALS,p YOUp ACKNO
WLEDGEp ANDp HEREBYp AGREEp TOp BEp LEGALLYp BOUNDp BYp BOTHp THESEpTERMSp ANDp CONDITIONSp AND
p THE p AMERICAN p NATIONAL p RED p CROSS p TERMS p OF p USE p (AVAILABLE
ATphttp://www.redcross.org/terms-of-
use).pYOUpAGREEpTHATpTHEpINCLUDEDpCOURSEpMATERIALSpAREpPROVIDEDp “ASp IS”p ANDp WITHOUTp WARRAN
TIESp OFp ANYp KIND,p ANDp THATp ANYp ACCESSp TOp ORp USEp OFpTHESEp COURSEp MATERIALSp ISp ATp YOURp O
WNp RISK.
Thepfollowingpmaterialsp(includingpdownloadablepelectronicpmaterials,paspapplicable)pincludingpallpcontent,pgraphics,pim
agespandplogos,parepcopyrightedpby,pandpthepexclusiveppropertypof,pThepAmericanpNationalpRedpCrossp(“Red
Cross”).pUnlesspotherwisepindicatedpinpwritingpbypthepRedpCross,pthepRedpCrosspgrantspyoup(“Recipient”)ptheplimitedprig
htptopdownload,pprint,pphotocopypandpusepthepelectronicpmaterialsponlypforpusepinpconjunctionpwithpteachingporppreparingp
topteachpapRedpCrosspcoursepbypindividualsporpentitiespexpresslypauthorizedpbypthepRedpCross,psubjectptopthepfollowin
gprestrictions:
■ ThepRecipientpispprohibitedpfrompcreatingpnewp electronicpversionspofpthepmaterials.
■ ThepRecipientpispprohibitedpfromprevising,paltering,padaptingporpmodifyingpthepmaterials,pwhichpincludespremoving,pal
teringporpcoveringpanypcopyrightpnotices,pRedpCrosspmarks,plogos,porpotherpproprietarypnoticespplacedporpembe
ddedpinpthepmaterials.
■ ThepRecipientpispprohibitedpfrompcreatingpanypderivativepworkspincorporating,pinppartporpinpwhole,pthepcontentpofpthepm
aterials.
■ ThepRecipientpispprohibitedpfrompdownloadingpthepmaterials,porpanyppartpofpthepmaterials,pandpputtingpthemponpReci
pient’spownpwebsiteporpanypotherpthird-partypwebsitepwithoutpadvancepwrittenppermissionpofpthepRedpCross.
■ ThepRecipientpispprohibitedpfrompremovingpthesepTermspandpConditionspinpotherwise-
permittedpcopies,pandpisp likewisepprohibitedpfrompmakingpanypadditionalprepresentationsporpwarrantiesprelatingpt
opthepmaterials.
AnyprightspnotpexpresslypgrantedphereinparepreservedpbypthepRedpCross.pThepRedpCrosspdoespnotppermitpitspmaterialspt
opbepreproducedporppublishedpwithoutpadvancepwrittenppermissionpfrompthepRedpCross.pToprequestppermissionptopre
produceporppublishpRedpCrosspmaterials,ppleasepsubmitpyourpwrittenprequestptopThepAmericanpNationalpRedpCrosspbyp
goingptopthepContactpUsppageponpredcross.orgpandpfillingpoutpthepGeneralpInquirypForm.
Copyrightp©p 2016,p2019p bypThep Americanp Nationalp Redp Cross.pALLp RIGHTSp RESERVED
ThepRedpCrosspemblempandpthepAmericanpRedpCrosspnamepandplogospareptrademarkspofpThepAmericanpNationalpRedp
Crosspandpprotectedpbypvariouspnationalpstatutes.
PublishedpbypThepAmericanpRedpCross
, 3
Science and Technical Content
p p p
TheptechnicalpcontentpwithinpthepAmericanpRedpCrosspAdvancedpLifepSupportpprogrampispconsistentpwithpthepmostp
currentpsciencepandptreatmentprecommendationspfrom:
■ ThepInternationalpLiaisonpCommitteeponpResuscitationp(ILCOR)p2015–
2018pInternationalpConsensusponpCardiopulmonarypResuscitationpandpEmergencypCardiovascularpCarepSciencepwi
thpTreatmentpRecommendations
■ Thep2015–
2018pAmericanpHeartpAssociationpGuidelinespUpdatepforpCardiopulmonarypResuscitationpandpEmergen
cypCardiovascularpCare
GuidancepforpthispcoursepwaspprovidedpbypthepRedpCrosspScientificpAdvisorypCouncil,pappanelpofpnationallyprecogni
zedpexpertspinpvariouspfields,pincludingpemergencypmedicine,pemergencypmedicalpservices,pnursing,poccupationalp
health,psportspmedicine,pschoolpandppublicphealth,paquatics,pemergencyppreparednesspandpdisasterpmobilization.pMo
repinformationponpthepsciencepofpthepcoursepcontentpcanpbepfoundpatpthepfollowingpwebsites:
■ ilcor.org
■ redcross.org/science
Dedication
ThispprogrampispdedicatedptopthepthousandspofpemployeespandpvolunteerspofpthepAmericanpRedpCrosspwhopcontributept
heirptimepandptalentptopsupportingpandpteachingplifesavingpskillspworldwidepandptopthepthousandspofpcoursepparticip
antspwhophavepdecidedptopbeppreparedptoptakepactionpwhenpanpemergencypstrikes.
Acknowledgments
ManypindividualspsharedpinpthepdevelopmentpofpthepAmericanpRedpCrosspAdvancedpLifepSupportpprogrampinpvariouspt
echnical,peditorial,pcreativepandpsupportivepways.pTheirpcommitmentptopexcellencepmadepthispmanualppossible.
American Red Cross Scientific Advisory Council
p p p p p
WepwouldplikeptopextendpourpgratitudeptopthepfollowingpmemberspofpthepAmericanpRedpCrosspScientificpAdvisorypCou
ncilpforptheirpguidancepandpreviewpofpthispprogram:
Davidp Markenson,p MD,p MBA,p FCCM,p FAAP,p FACEP,p EMT-P
ChiefpMedicalpOfficer,pAmericanpRedpCrosspSc
ientificpAdvisorypCouncilpChair
Richardp N.p Bradley,p MD,p FACEP
ResuscitationpSubcouncilpChair
ProfessorpofpEmergencypMedicinepandpChiefpofpthepDivisionpofpEmergencypMedicalpServicespandpDisasterpMedicinep
atpMcGovernpMedicalpSchool,pUniversitypofpTexaspHealthpSciencepCenter
Michaelp G.p Millin,p MD,p MPH,p FACEP,p FAEMS
ResuscitationpSubcouncilpVicepChair
AssociatepProfessorpofpEmergencypMedicinepatpJohnspHopkinspUniversitypSchoolpofpMedicine;pMedicalpDirector,pPrin
cepGeorge’spCountypFire/EMSpDepartment
Ritap V.p Burke,p PhD,p MPH
AssistantpProfessorpofpResearchpSurgerypandpPreventivepMedicinepatpKeckpSchoolpofpMedicinepofpthepUniversitypofpSouther
npCaliforniapandpthepTraumapProgrampatpChildren’spHospitalpLospAngeles;pCo-
chairpofpthepChildrenpinpDisasterspWorkingpGrouppandpthepPediatricpTraumapSociety
Acknowledgments
|p iii
, Pascalp Cassan,p MD
Head,pGlobalpReferencepCentrepforpFirstpAid,pInternationalpFederationpofpRedpCrosspandpRedpCrescentpSocietiesp(Pa
ris)
Wendellp E.p Jones,p MD,p MBA,p CPE,p FACP
ChiefpMedicalpOfficer,pVeteranspIntegratedpServicepNetworkp17;pAssistantpProfessorpofpInternalpMedicinepatpthepUniv
ersitypofpTexaspSouthwestern
Stamatiosp Lerakis,p MD,p PhD,p FACC,p FAHA,p FASE,p FASNC,p FCCP
ProfessorpofpMedicinep(Cardiology),pRadiologypandpImagingpSciencespatpEmorypUniversitypSchoolpofpMedicine;pDire
ctorpofpCardiacpMRIpandpInterventionalpEchocardiographypatpEmorypUniversitypHospital;pAdjunctpProfessorpofpBiomed
icalpEngineeringpatpEmorypUniversitypandpGeorgiapInstitutepofpTechnology
Andrewp MacPherson,p BSc,p MD,p CCFP-EM,p FCFP
Emergency,pTraumapandpEMpPhysician,pAssociatepProfessor,pDepartmentpofpEmergencypMedicine,pUniversitypofpBritis
hpColumbia;pCanadianpRedpCross
Irap Nemeth,p MD
AssistantpProfessorpofpEmergencypMedicine,pAssociatepMedicalpDirector,pEMSpandpLifeFlight,pDepartmentpofpEmerg
encypMedicine,pUMasspMemorialpMedicalpCenter
Josephp W.p Rossano,p MD
Chief,pDivisionpofpCardiology,pCo-
ExecutivepDirectorpofpthepCardiacpCenter,pJenniferpTerkerpEndowedpChairpinpPediatricpCardiologypandpAssociat
epProfessorpofpPediatricspatpthepChildren’spHospitalpofpPhiladelphiapandpthepPerelmanpSchoolpofpMedicinepatp
thepUniversitypofpPennsylvania
Content Direction
p
Thepdevelopmentpofpthispprogrampwouldpnotphavepbeenppossiblepwithoutpthepleadership,pvaluablepinsightspandpde
dicationpofpthepsubjectpmatterpexperts,pwhopgenerouslypsharedptheirptimeptopensurepthephighestpqualitypprogram:
Bobp Page,p M.Ed.,p NRP,p CCP,p NCEE
President,pEdutainmentp Consultingpandp Seminars,pLLC
Jannahp N.p Amiel,p MS,p BSN,p RN
NursepEducatorpandpConsultant|ptootRN™,pLLC
Jonathanp L.p Epstein,p MEMS,p NRP
SeniorpDirector
Science,pIndustrypandpGovernmentpRelationsp
AmericanpRedpCross
Stephaniep Olcese,p B.S.N.,p M.S.
Medicalp Writer
Program Development
p
Specialpthanksptopthepprogrampdevelopmentpteampforptheirpexpertisepandpmixpofppatiencepandppersistenceptopbringpthisp pro
grampthroughptopcompletion:pMelaniepCann,pDaniellepDiPalma,pSarahpKyle,pMaureenpPancza,pMaureenpSchultz,pLaur
apScott,pNicholepSteffenspandpJenniferpSurich.
ivp | AmericanpRedpCrossp|pAdvancedpLifepSupportpInstructorpTrainer’spGuid
e
AdvancedLifeSupportp p
Instructor Trainer’s Guide
p p
, p
ThispInstructorpTrainer’spGuidepisppartpofpthepAmericanpRedpCrosspAdvancedpLifepSupportpprogram.pThepemergencyp
carepprocedurespoutlinedpinpthepprogrampmaterialspreflectpthepstandardpofpknowledgepandpacceptedpemergencyppr
acticespinpthepUnitedpStatespatptheptimepthispmanualpwasppublished.pItpispthepreader’spresponsibilityptopstaypinformedp ofpc
hangespinpemergencypcarepprocedures.
PLEASEpREADpTHEpFOLLOWINGpTERMSpANDpCONDITIONSp(thep“TermspandpConditions”) pBEFOREpAGREEIN
Gp TOp ACCESS,p USEp ORp DOWNLOAD p THEp FOLLOWINGp AMERICANp NATIONAL p REDp CROSSpMATERIALS.p B
Yp PURCHASING, p DOWNLOADING, p ORp OTHERWISEp USINGp ORp ACCESSINGp THEpMATERIALS,p YOUp ACKNO
WLEDGEp ANDp HEREBYp AGREEp TOp BEp LEGALLYp BOUNDp BYp BOTHp THESEpTERMSp ANDp CONDITIONSp AND
p THE p AMERICAN p NATIONAL p RED p CROSS p TERMS p OF p USE p (AVAILABLE
ATphttp://www.redcross.org/terms-of-
use).pYOUpAGREEpTHATpTHEpINCLUDEDpCOURSEpMATERIALSpAREpPROVIDEDp “ASp IS”p ANDp WITHOUTp WARRAN
TIESp OFp ANYp KIND,p ANDp THATp ANYp ACCESSp TOp ORp USEp OFpTHESEp COURSEp MATERIALSp ISp ATp YOURp O
WNp RISK.
Thepfollowingpmaterialsp(includingpdownloadablepelectronicpmaterials,paspapplicable)pincludingpallpcontent,pgraphics,pim
agespandplogos,parepcopyrightedpby,pandpthepexclusiveppropertypof,pThepAmericanpNationalpRedpCrossp(“Red
Cross”).pUnlesspotherwisepindicatedpinpwritingpbypthepRedpCross,pthepRedpCrosspgrantspyoup(“Recipient”)ptheplimitedprig
htptopdownload,pprint,pphotocopypandpusepthepelectronicpmaterialsponlypforpusepinpconjunctionpwithpteachingporppreparingp
topteachpapRedpCrosspcoursepbypindividualsporpentitiespexpresslypauthorizedpbypthepRedpCross,psubjectptopthepfollowin
gprestrictions:
■ ThepRecipientpispprohibitedpfrompcreatingpnewp electronicpversionspofpthepmaterials.
■ ThepRecipientpispprohibitedpfromprevising,paltering,padaptingporpmodifyingpthepmaterials,pwhichpincludespremoving,pal
teringporpcoveringpanypcopyrightpnotices,pRedpCrosspmarks,plogos,porpotherpproprietarypnoticespplacedporpembe
ddedpinpthepmaterials.
■ ThepRecipientpispprohibitedpfrompcreatingpanypderivativepworkspincorporating,pinppartporpinpwhole,pthepcontentpofpthepm
aterials.
■ ThepRecipientpispprohibitedpfrompdownloadingpthepmaterials,porpanyppartpofpthepmaterials,pandpputtingpthemponpReci
pient’spownpwebsiteporpanypotherpthird-partypwebsitepwithoutpadvancepwrittenppermissionpofpthepRedpCross.
■ ThepRecipientpispprohibitedpfrompremovingpthesepTermspandpConditionspinpotherwise-
permittedpcopies,pandpisp likewisepprohibitedpfrompmakingpanypadditionalprepresentationsporpwarrantiesprelatingpt
opthepmaterials.
AnyprightspnotpexpresslypgrantedphereinparepreservedpbypthepRedpCross.pThepRedpCrosspdoespnotppermitpitspmaterialspt
opbepreproducedporppublishedpwithoutpadvancepwrittenppermissionpfrompthepRedpCross.pToprequestppermissionptopre
produceporppublishpRedpCrosspmaterials,ppleasepsubmitpyourpwrittenprequestptopThepAmericanpNationalpRedpCrosspbyp
goingptopthepContactpUsppageponpredcross.orgpandpfillingpoutpthepGeneralpInquirypForm.
Copyrightp©p 2016,p2019p bypThep Americanp Nationalp Redp Cross.pALLp RIGHTSp RESERVED
ThepRedpCrosspemblempandpthepAmericanpRedpCrosspnamepandplogospareptrademarkspofpThepAmericanpNationalpRedp
Crosspandpprotectedpbypvariouspnationalpstatutes.
PublishedpbypThepAmericanpRedpCross
, 3
Science and Technical Content
p p p
TheptechnicalpcontentpwithinpthepAmericanpRedpCrosspAdvancedpLifepSupportpprogrampispconsistentpwithpthepmostp
currentpsciencepandptreatmentprecommendationspfrom:
■ ThepInternationalpLiaisonpCommitteeponpResuscitationp(ILCOR)p2015–
2018pInternationalpConsensusponpCardiopulmonarypResuscitationpandpEmergencypCardiovascularpCarepSciencepwi
thpTreatmentpRecommendations
■ Thep2015–
2018pAmericanpHeartpAssociationpGuidelinespUpdatepforpCardiopulmonarypResuscitationpandpEmergen
cypCardiovascularpCare
GuidancepforpthispcoursepwaspprovidedpbypthepRedpCrosspScientificpAdvisorypCouncil,pappanelpofpnationallyprecogni
zedpexpertspinpvariouspfields,pincludingpemergencypmedicine,pemergencypmedicalpservices,pnursing,poccupationalp
health,psportspmedicine,pschoolpandppublicphealth,paquatics,pemergencyppreparednesspandpdisasterpmobilization.pMo
repinformationponpthepsciencepofpthepcoursepcontentpcanpbepfoundpatpthepfollowingpwebsites:
■ ilcor.org
■ redcross.org/science
Dedication
ThispprogrampispdedicatedptopthepthousandspofpemployeespandpvolunteerspofpthepAmericanpRedpCrosspwhopcontributept
heirptimepandptalentptopsupportingpandpteachingplifesavingpskillspworldwidepandptopthepthousandspofpcoursepparticip
antspwhophavepdecidedptopbeppreparedptoptakepactionpwhenpanpemergencypstrikes.
Acknowledgments
ManypindividualspsharedpinpthepdevelopmentpofpthepAmericanpRedpCrosspAdvancedpLifepSupportpprogrampinpvariouspt
echnical,peditorial,pcreativepandpsupportivepways.pTheirpcommitmentptopexcellencepmadepthispmanualppossible.
American Red Cross Scientific Advisory Council
p p p p p
WepwouldplikeptopextendpourpgratitudeptopthepfollowingpmemberspofpthepAmericanpRedpCrosspScientificpAdvisorypCou
ncilpforptheirpguidancepandpreviewpofpthispprogram:
Davidp Markenson,p MD,p MBA,p FCCM,p FAAP,p FACEP,p EMT-P
ChiefpMedicalpOfficer,pAmericanpRedpCrosspSc
ientificpAdvisorypCouncilpChair
Richardp N.p Bradley,p MD,p FACEP
ResuscitationpSubcouncilpChair
ProfessorpofpEmergencypMedicinepandpChiefpofpthepDivisionpofpEmergencypMedicalpServicespandpDisasterpMedicinep
atpMcGovernpMedicalpSchool,pUniversitypofpTexaspHealthpSciencepCenter
Michaelp G.p Millin,p MD,p MPH,p FACEP,p FAEMS
ResuscitationpSubcouncilpVicepChair
AssociatepProfessorpofpEmergencypMedicinepatpJohnspHopkinspUniversitypSchoolpofpMedicine;pMedicalpDirector,pPrin
cepGeorge’spCountypFire/EMSpDepartment
Ritap V.p Burke,p PhD,p MPH
AssistantpProfessorpofpResearchpSurgerypandpPreventivepMedicinepatpKeckpSchoolpofpMedicinepofpthepUniversitypofpSouther
npCaliforniapandpthepTraumapProgrampatpChildren’spHospitalpLospAngeles;pCo-
chairpofpthepChildrenpinpDisasterspWorkingpGrouppandpthepPediatricpTraumapSociety
Acknowledgments
|p iii
, Pascalp Cassan,p MD
Head,pGlobalpReferencepCentrepforpFirstpAid,pInternationalpFederationpofpRedpCrosspandpRedpCrescentpSocietiesp(Pa
ris)
Wendellp E.p Jones,p MD,p MBA,p CPE,p FACP
ChiefpMedicalpOfficer,pVeteranspIntegratedpServicepNetworkp17;pAssistantpProfessorpofpInternalpMedicinepatpthepUniv
ersitypofpTexaspSouthwestern
Stamatiosp Lerakis,p MD,p PhD,p FACC,p FAHA,p FASE,p FASNC,p FCCP
ProfessorpofpMedicinep(Cardiology),pRadiologypandpImagingpSciencespatpEmorypUniversitypSchoolpofpMedicine;pDire
ctorpofpCardiacpMRIpandpInterventionalpEchocardiographypatpEmorypUniversitypHospital;pAdjunctpProfessorpofpBiomed
icalpEngineeringpatpEmorypUniversitypandpGeorgiapInstitutepofpTechnology
Andrewp MacPherson,p BSc,p MD,p CCFP-EM,p FCFP
Emergency,pTraumapandpEMpPhysician,pAssociatepProfessor,pDepartmentpofpEmergencypMedicine,pUniversitypofpBritis
hpColumbia;pCanadianpRedpCross
Irap Nemeth,p MD
AssistantpProfessorpofpEmergencypMedicine,pAssociatepMedicalpDirector,pEMSpandpLifeFlight,pDepartmentpofpEmerg
encypMedicine,pUMasspMemorialpMedicalpCenter
Josephp W.p Rossano,p MD
Chief,pDivisionpofpCardiology,pCo-
ExecutivepDirectorpofpthepCardiacpCenter,pJenniferpTerkerpEndowedpChairpinpPediatricpCardiologypandpAssociat
epProfessorpofpPediatricspatpthepChildren’spHospitalpofpPhiladelphiapandpthepPerelmanpSchoolpofpMedicinepatp
thepUniversitypofpPennsylvania
Content Direction
p
Thepdevelopmentpofpthispprogrampwouldpnotphavepbeenppossiblepwithoutpthepleadership,pvaluablepinsightspandpde
dicationpofpthepsubjectpmatterpexperts,pwhopgenerouslypsharedptheirptimeptopensurepthephighestpqualitypprogram:
Bobp Page,p M.Ed.,p NRP,p CCP,p NCEE
President,pEdutainmentp Consultingpandp Seminars,pLLC
Jannahp N.p Amiel,p MS,p BSN,p RN
NursepEducatorpandpConsultant|ptootRN™,pLLC
Jonathanp L.p Epstein,p MEMS,p NRP
SeniorpDirector
Science,pIndustrypandpGovernmentpRelationsp
AmericanpRedpCross
Stephaniep Olcese,p B.S.N.,p M.S.
Medicalp Writer
Program Development
p
Specialpthanksptopthepprogrampdevelopmentpteampforptheirpexpertisepandpmixpofppatiencepandppersistenceptopbringpthisp pro
grampthroughptopcompletion:pMelaniepCann,pDaniellepDiPalma,pSarahpKyle,pMaureenpPancza,pMaureenpSchultz,pLaur
apScott,pNicholepSteffenspandpJenniferpSurich.
ivp | AmericanpRedpCrossp|pAdvancedpLifepSupportpInstructorpTrainer’spGuid
e
