Advanced Life Support

Course Description

Advanced Life Support focuses on the concepts and applications of treatment and monitoring for the critical care patient as it relates to respiratory care and the health profession in general.

Within the SCNS taxonomy, RET is the Respiratory Care prefix. Daytona State publishes this at 3 credits, offered spring and summer, giving approximately 45 contact hours at the prefix's lecture convention — matching its lower-division counterpart RET2244C (Life Support), also published at 3 credits and 45 hours.

This is where respiratory care is at its most consequential. In a cardiac arrest or a peri-arrest emergency the respiratory therapist is frequently the airway person, and the decisions are made in seconds by a team that must function without discussion. That is why advanced life support is taught as algorithms and rehearsed rather than reasoned from first principles at the bedside — the algorithm exists so that a room full of frightened people does something coordinated and correct.

Daytona State does not publish a lecture and laboratory split for its RET courses. The prefix runs at three conventions: unsuffixed lecture courses at 15 contact hours per credit (RET1295 and RET2350 at 3 credits and 45 hours, RET2483 at 2 credits and 30), C-suffixed courses at 20 (RET1025C, RET1026C, RET1264C and RET1450C all at 3 credits and 60 hours), and clinical practice at 60 (RET1874 at 4 credits and 240 hours, RET1875 at 3 and 180). This course is unsuffixed and lecture-based, and is priced at the lecture convention.

Learning Outcomes

Required Outcomes

• Describe the chain of survival and its components.
• Perform high-quality cardiopulmonary resuscitation.
• Describe the determinants of CPR quality and why they matter.
• Manage an airway using basic adjuncts.
• Describe advanced airway options and their indications.
• Assist with and confirm endotracheal intubation.
• Confirm airway placement using waveform capnography.
• Interpret capnography and relate it to resuscitation quality.
• Provide ventilation appropriate to the situation and avoid over-ventilation.
• Recognise and interpret cardiac rhythms relevant to arrest and peri-arrest.
• Describe defibrillation and its indications.
• Describe cardioversion and pacing and their indications.
• Apply the adult cardiac arrest algorithm.
• Apply peri-arrest algorithms for bradycardia and tachycardia.
• Describe the reversible causes of arrest and how they are addressed.
• Describe medications used in advanced life support and their indications.
• Describe vascular and intraosseous access at an awareness level.
• Function effectively as a member of a resuscitation team.
• Communicate using closed-loop communication.
• Describe team leadership and role allocation in a resuscitation.
• Describe post-resuscitation care and its priorities.
• Describe monitoring of the critical care patient.
• Participate in debriefing after a resuscitation.
• Document a resuscitation accurately.

Optional Outcomes

• Describe paediatric advanced life support.
• Describe neonatal resuscitation.
• Describe extracorporeal support at an awareness level.
• Describe ethical issues in resuscitation, including do-not-resuscitate orders.
• Describe simulation-based training and its role.
• Obtain ACLS and PALS provider certification.

Major Topics

Required Topics

• The chain of survival
• High-quality CPR
• Determinants of CPR quality
• Basic airway management
• Advanced airway options
• Assisting with intubation
• Waveform capnography confirmation
• Interpreting capnography
• Ventilation and avoiding over-ventilation
• Cardiac rhythm recognition
• Defibrillation
• Cardioversion and pacing
• Adult cardiac arrest algorithm
• Peri-arrest algorithms
• Reversible causes of arrest
• Resuscitation medications
• Vascular and intraosseous access
• Resuscitation team function
• Closed-loop communication
• Team leadership and roles
• Post-resuscitation care
• Critical care monitoring
• Debriefing
• Documentation

Optional Topics

• Paediatric advanced life support
• Neonatal resuscitation
• Extracorporeal support
• Resuscitation ethics
• Simulation-based training
• ACLS and PALS certification

Resources & Tools

• Egan's Fundamentals of Respiratory Care — the standard text of the profession and the one to keep.
• Pilbeam's Mechanical Ventilation — the standard ventilation reference.
• NBRC (nbrc.org) — free examination content outlines and eligibility rules; read the eligibility page before enrolling anywhere.
• CoARC (coarc.com) — free accreditation lookup and programme outcome data, including credentialing success rates.
• AARC (aarc.org) — the American Association for Respiratory Care; clinical practice guidelines and inexpensive student membership.
• Florida Board of Respiratory Care (floridasrespiratorycare.gov) — free; the authority on Florida licensure.
• American Heart Association — BLS, ACLS, and PALS provider courses; hold current certification before you need it for a job application.
• Your clinical preceptors — the most valuable resource in the programme; ask why, not just how.

Career Pathways

• Respiratory therapist — SOC 29-1126.
• Hospital adult critical care — the largest employment setting and the highest acuity.
• Emergency department and rapid response.
• Neonatal and paediatric intensive care — a demanding speciality with its own credential.
• Pulmonary function laboratory and diagnostics.
• Sleep medicine and polysomnography — a related pathway with its own credential.
• Cardiopulmonary rehabilitation.
• Home care and long-term ventilator management — a growing sector.
• Transport and flight respiratory care — higher acuity and higher pay.
• Patient and community education — asthma, COPD, and smoking cessation programmes.
• Clinical education and programme instruction, and management, after experience.
• Continue to a bachelor's or master's — increasingly expected for leadership and education roles.

Special Information

⚠⚠ The quality of chest compressions determines the outcome — and it degrades fast

• Everything else in a resuscitation is secondary to good compressions, and the evidence on this is unambiguous.
• Push hard, push fast, allow full recoil, and minimise interruptions. Incomplete recoil is the fault people do not notice themselves doing — leaning on the chest prevents refill and destroys the perfusion you are generating.
• Every pause costs perfusion pressure that takes several compressions to rebuild. Plan interruptions — rhythm checks, defibrillation, airway placement — so they are as short as possible.
• ⚠ Rotate compressors roughly every two minutes. Quality falls measurably with fatigue, and the person compressing is always the last to notice.
• Use feedback where available — devices, a metronome, or capnography — because perceived effort is a poor guide.
• ⚠ Do not over-ventilate. This is the classic error in a code: excessive rate or volume raises intrathoracic pressure, impedes venous return, and actively reduces the blood flow the compressions are producing.
• Capnography tells you how the resuscitation is going. A rising value can indicate return of circulation; a persistently very low one indicates poor compression quality or a poor prognosis.
• Confirm the airway with waveform capnography, not by auscultation alone — an unrecognised oesophageal intubation is fatal.

⚠ Resuscitation is a team performance, and the failures are usually communication failures

• Reviews of poor resuscitations rarely find a knowledge gap. They find unclear roles, orders nobody acknowledged, and information that was known to someone and never said.
• Use closed-loop communication. An order is directed to a named person, repeated back, and confirmed when done — "someone get the drug" means nobody will.
• Know your role and take it. Airway, compressions, monitor, drugs, recorder — ambiguity produces both duplication and gaps.
• Speak up if you see something wrong, including to the team leader. Say it clearly and once, and escalate if it is not acted on — hierarchy has contributed to real deaths.
• One person speaks at a time. A noisy room loses information.
• Share what you know. If you have information about the patient that the leader does not, say it early rather than waiting to be asked.
• Rehearse. Simulation exists because performance under stress reflects practice, not understanding.
• Debrief honestly afterwards, including what went badly, and treat it as learning rather than blame.

⚠⚠ Respiratory care is a high-acuity role — the interventions are immediately life-sustaining

• Respiratory therapists manage airways, ventilators, and oxygen delivery for patients who cannot breathe adequately for themselves. The margin between a correct and an incorrect intervention is measured in minutes.
• You will be called to emergencies. Codes, rapid responses, and intubations are part of the role, and the respiratory therapist is frequently the airway person in the room.
• Ventilator settings are prescribed within a plan of care, and the therapist's assessment informs them. Know your institution's protocols and the limits of what you may adjust independently.
• ⚠ Oxygen is a drug. It is prescribed, it has indications and hazards, and too much can be as harmful as too little in specific patient groups. Titrating without understanding why is dangerous.
• Escalate rather than wait. A deteriorating patient needs the physician now, and hesitating to call is a recurring contributor to poor outcomes.
• Document assessments, settings, and responses accurately and contemporaneously; the ventilator record is a clinical and legal document.
• Infection control is central — you work with airways and secretions, and ventilator-associated pneumonia is a measured, preventable harm.
• Speak up about safety concerns, including to senior clinicians. The therapist is frequently the person who notices the airway problem first.

⚠⚠ Credentialing and licensure — verify before you enrol

• The recognised credentials are the CRT and RRT, awarded by the National Board for Respiratory Care (NBRC). The RRT is the standard for hospital employment, and many employers will not hire at the CRT level.
• ⚠⚠ Eligibility to sit those examinations requires graduation from a programme accredited by CoARC (the Commission on Accreditation for Respiratory Care). Confirm a programme's accreditation before enrolling — the same trap already recorded here for CAPTE, CAAHEP, and ACOTE, and equally unrecoverable afterwards.
• Florida licenses respiratory therapists under Chapter 468, Part V, Florida Statutes, through the Department of Health's Board of Respiratory Care. Licensure follows credentialing, and practising without a licence is an offence.
• Specialty credentials exist — neonatal/paediatric, sleep, pulmonary function, and adult critical care among them — and they raise both capability and pay.
• Life support certifications are separate and expected: BLS always, and ACLS, PALS, and NRP depending on the setting. Many employers require them at hire or within a defined period.
• Licences renew with continuing education on a defined cycle.
• Background screening and health clearance are required for clinical placement and for licensure, and a criminal record can end this pathway before it starts — raise any concern early and privately.
• ⚠ Rule 11 applies. Verify accreditation, examination eligibility, and licensure requirements with CoARC, the NBRC, and the Florida Board rather than relying on this guide.

How Florida course levels affect transfer

The first digit of an SCNS number denotes the year of offering, not transferability. Courses at the 1000 and 2000 levels transfer transparently between Florida public institutions, and 3000 to 4000 is unproblematic since both are upper division. The boundary that actually matters is 2000 to 3000, where lower-division credit generally cannot satisfy an upper-division requirement — and it is live here, since Daytona State offers both associate-level and bachelor of applied science coursework in this prefix.

RET4245 is 3 credits and approximately 45 contact hours, offered spring and summer at Daytona State, with a laboratory fee.

Hold current ACLS certification alongside this course where possible — employers ask for it, and the course content maps onto it directly. See also this repository's RET2244C (Life Support) guide.