2020 Korean Guidelines for Cardiopulmonary Resuscitation - Part 4 - Adult advanced life support

Sep 23, 2026

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Adult advanced life support (ALS) forms a key component of the chain of survival during cardiac arrest, aiming to maintain systemic circulation and oxygen delivery while delivering high-quality basic life support. The document outlines ALS elements including advanced airway management, manual defibrillation, pharmacologic therapy with vasopressors and antiarrhythmic drugs, extracorporeal circulation support, and other measures to achieve ROSC. It summarizes updates from prior Korean CPR guidance, featuring double sequential defibrillation, ultrasound use, cerebral oxygen saturation monitoring, and in-hospital cardiac arrest prevention strategies such as RRT/medical emergency teams and early warning scores, including specialized COVID-19 recommendations.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages15

Reading Time38 min

AccessFree to download

Background of the 2020 guidelines for adult advanced life support

Adult ALS algorithms

Clin Exp Emerg Med 2021;8(S):S26-S40 [https://doi.org/10.15441/ceem.21.023](https://doi.org/10.15441/ceem.21.023) 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support Jaehoon Oh1, Kyoung-Chul Cha2, Jong-Hwan Lee3, Seungmin Park4, Dong-Hyeok Kim5, Byung Kook Lee6, Jung Soo Park7, Woo Jin Jung2, Dong Keon Lee3, Young Il Roh2, Tae Youn Kim2, Sung Phil Chung8, Young-Min Kim9, June Dong Park9, Han-Suk Kim10, Mi Jin Lee11, Sang-Hoon Na12, Gyu Chong Cho13, Ai-Rhan Ellen Kim14, Sung Oh Hwang2 ; on behalf of the Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care 1 Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea 2 Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea 3 Department of Anesthesiology and Pain Medicine, Sungkyunkwan University College of Medicine, Seoul, Korea 4 Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea 5 Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea 6 Department of Emergency Medicine, Chonnam National University College of Medicine, Gwangju, Korea 7 Department of Emergency Medicine, Chungnam National University College of Medicine, Daejeon, Korea 8 Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea 9 Department of Emergency Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea 10 Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea 11 Department of Emergency Medicine, Kyungpook National University College of Medicine, Daegu, Korea 12 Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea 13 Department of Emergency Medicine, Hallym University College of Medicine, Seoul, Korea 14 Department of Pediatrics, Ulsan University College of Medicine, Seoul, Korea eISSN: 2383-4625 Received: 7 March 2021 Revised: 7 March 2021 Accepted: 19 March 2021 Correspondence to: Kyoung-Chul Cha Department of Emergency Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju 26426, Korea [E-mail: chaemp@yonsei.ac.kr](E-mail: chaemp@yonsei.ac.kr) ORCID [https://orcid.org/0000-0003-1818-2466](https://orcid.org/0000-0003-1818-2466) BACKGROUND OF THE 2020 GUIDELINES FOR ADULT ADVANCED LIFE SUPPORT Adult advanced life support (ALS) is an important part of the chain of survival, promoting systemic circulation and oxygen supply during high-quality basic life support in patients with cardiac arrest. It includes advanced airway management, manual defibrillation, pharmacological therapy with vasopressors and antiarrhythmic agents, use of an extracorporeal circulation device, and other techniques to achieve return of spontaneous circulation (ROSC).1-3 Several milestone studies on ALS have been published since the publication of the 2015 Korean cardiopulmonary resuscitation (CPR) guidelines. These include a multicenter, randomized, double-blind, placebo-controlled study evaluating the effect of epinephrine in patients with out-ofhospital cardiac arrest (OHCA) as well as a comparative study on amiodarone, lidocaine, or placebo in patients with refractory shockable rhythm.4,5 A study comparing the use of a supraglottic airway (SGA) device and endotracheal intubation for advanced airway management during OHCA How to cite this article: Oh J, Cha KC, Lee JH, Park S, Kim DH, Lee BK, Park JS, Jung WJ, Lee DK, Roh YI, Kim TY, Chung SP, Kim YM, Park JD, Kim HS, Lee MJ, Na SH, Cho GC, Kim AE, Hwang SO; on behalf of the Steering Committee of the 2020 Korean Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. 2020 Korean Guidelines for Cardiopulmonary Resuscitation. Part 4. Adult advanced life support. Clin Exp Emerg Med 2021;8(S):S26-S40 [https://doi.org/10.15441/ceem.21.023](http

FAQs

What is the purpose of adult advanced life support (ALS) in cardiac arrest?

ALS supports systemic circulation and oxygen supply during high-quality basic life support, aiming to achieve return of spontaneous circulation (ROSC).

What key interventions are included in ALS?

ALS includes advanced airway management, manual defibrillation, pharmacologic therapy (vasopressors and antiarrhythmic agents), extracorporeal circulation devices, and additional techniques to restore ROSC.

What major updates are highlighted in the 2020 Korean adult ALS guidelines compared with 2015?

The 2020 guidance revises content based on new evidence and adds recommendations such as double sequential defibrillation, ultrasound application, cerebral oxygen saturation monitoring, rapid response team/medical emergency team establishment, and early warning scores.

Sep 23, 2026

Uploaded by awa