According to The American Heritage Medical Dictionary, advanced life support (ALS) is defined as "emergency medical care for sustaining life, including defibrillation, airway management, and drugs and medications."
In Oklahoma, prehospital ALS providers include EMT-Intermediate (EMT-I), Advanced EMT (AEMT), and Paramedic. According to the 2014 Oklahoma State EMS Protocols, EMT-I and AEMT perform very similar interventions. The Paramedic Scope of Practice is the widest of all EMS providers. Below are a few examples of the interventions the different Oklahoma prehospital ALS providers can perform:
EMT-I & AEMT: (The minimum level of care on every Wadley's EMS ambulance)
- IV therapy with isotonic and hypertonic solution infusion
- Intraosseous line Endotracheal intubation
- Limited drug administration including IV dextrose for hypoglycemia
- Acquire and transmit 12-lead ECG for evaluation by a Cardiologist.
Paramedic (include the above mentioned interventions):
- Cardiac monitor usage such as cardiac monitoring and diagnostics (EKG without the need of evaluation by a cardiologist), manual defibrillation/electrical cardioversion, and pacing
- Chemical cardioversion via the use of anti-dysrhythmics
Cricothyrotomy (surgical airway)
- Medication-assisted endotracheal intubation; Wadley's EMS paramedics are able to perform a fully involved Rapid Sequence Intubation requiring the use of benzodiazepines and neuro-muscular blockers (paralytics)
- Wider scope of medication administration from analgesic medication, to antipsychotics, to anti-metic medication