ALS Insights – Life Support Institute of Australia

Your patient has an implanted defibrillator, and mid-code, it starts firing. Is it working? Is it safe to keep your hands on the chest? And what do you actually do about it? In this episode, we break down what's really happening when an ICD fires during CPR — including a documented case where a device fired repeatedly on a rhythm that was actually asystole the whole time, because chest compres...

Should every patient go to the cath lab after cardiac arrest? "Rush everyone" is the wrong answer — and this episode explains why. We walk through the post-ROSC coronary decision: considering ACS in every post-arrest patient, how the 12-lead ECG drives it, immediate angiography for ST-elevation, and what the COACT and TOMAHAWK trials showed for patients without ST-elevation — plus the hi...

ROSC is not the finish line — it fires the starting gun on a second wave of injury that most clinicians never see coming. In this episode we dive deep into post-arrest haemodynamic management: why the post-arrest brain loses cerebral autoregulation entirely and becomes 100% dependent on systemic blood pressure, what MAP ≥65 mmHg means at the bedside, and how to approach post-arrest hypotension — f...

In pre-arrest arrhythmia management, one clinical question sits above all others — and your answer to it determines whether you have time to think or need to act right now. In this episode we break down the haemodynamic stability assessment: what "unstable" actually means in an ALS algorithm (it's narrower than most clinicians assume), the four adverse features that define it, and wh...

One Cent Miracles: How Aspirin Matched the Power of Clot Busters In emergency medicine, some of the most powerful interventions don’t come from expensive drugs or high-tech equipment — they come from a simple pill that costs cents. In this episode we dive into the landmark ISIS-2 trial that changed cardiology forever. Aspirin alone reduced mortality by 23% — nearly matching the powerful clot-buste...

Why You Should Stop Using Pulse Checks to Gauge CPR Quality In the middle of a cardiac arrest, it’s tempting to reach for a pulse to see if your compressions are working. But what if that reassuring pulse you feel isn’t what you think it is? In this episode, we explore why manual pulse checks during CPR are often unreliable. Evidence shows they can be misleading in up to 50% of cases, frequently d...

Adrenaline (epinephrine) is a key drug in ANZCOR-aligned ALS for cardiac arrest — but what's really happening? Its alpha-adrenergic effects cause vasoconstriction, boosting coronary and cerebral perfusion to improve ROSC chances. The beta-adrenergic side ramps up heart rate and contractility... which can spike myocardial oxygen demand and contribute to poorer neurological outcomes in survivors. We...

Is induced hypothermia dead? In this episode, we dive into the shifting paradigm of Advanced Life Support (ALS) post-resuscitation care. Following the TTM-2 trial and updated ILCOR/ANZCOR guidelines, the focus has shifted from deep therapeutic hypothermia (32–34°C) to strict fever prevention and targeted normothermia (36°C) for comatose post-cardiac arrest patients. We discuss the evidence, the da...

Episode 4 of ALS Insights: now we bring it all together with the One-Stop Shock Protocol – the advanced, ANZCOR-aligned team flow that minimizes interruptions and delivers the shock safely and fast. Builds directly on Episodes 1–3 (high-quality CPR, AED mechanics, shock physiology) to show how to integrate rhythm analysis, clear commands, hands-off safety, and immediate post-shock CPR. Perfect for...

Episode 3 of ALS Insights: a deeper physiological look at why AED shocks actually stop the heart during VF/pulseless VT. Explains ion channel effects, depolarization, critical mass theory, and how stopping chaotic rhythm allows the SA node to restart. ANZCOR-aligned insights for paramedics, nurses, and doctors. Builds on Episode 2's mechanics with more science. From Life Support Institute – flexib...

Episode 2 of ALS Insights: a clear, ANZCOR-aligned explanation of how an AED really works in cardiac arrest. Covers pad placement, impedance detection, energy delivery, biphasic waveforms, safety checks, and common myths. Ideal refresher for paramedics, nurses, rural/remote healthcare workers, and anyone needing CPD hours. From Life Support Institute – flexible online ALS course (10 CPD hours, per...

First episode of ALS Insights: a practical breakdown of high-quality CPR according to current ANZCOR guidelines. Focus on compression depth, rate, recoil, and team coordination in cardiac arrest. Perfect refresher for paramedics, nurses, rural/remote healthcare workers, and anyone needing CPD hours. Brought to you by Life Support Institute – creators of the flexible online ALS course (10 CPD hours...