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Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)

HCPCS code

Ambulance Service, Advanced Life Support, Emergency Transport, Level 1 (ALS 1 - Emergency) (A0427)

Name of the Procedure:

Common Name(s): ALS 1 Emergency Transport, Advanced Life Support
Technical Terms: Ambulance Service, Advanced Life Support, Level 1 Emergency Transport (A0427)


ALS 1 - Emergency Transport is an advanced pre-hospital medical intervention provided by trained paramedics or emergency medical technicians. This service involves the use of specialized medical equipment and skills to stabilize and transport patients experiencing critical health emergencies to a medical facility.


Medical Conditions or Problems Addressed:
  • Severe trauma or injuries
  • Cardiac emergencies (e.g., heart attack, cardiac arrest)
  • Severe respiratory distress or failure
  • Stroke
  • Serious allergic reactions
  • Other life-threatening conditions
Goals or Expected Outcomes:
  • Stabilize the patient's condition
  • Provide necessary medical interventions en route to the hospital
  • Ensure quick and safe transport to an appropriate medical facility for further treatment


Specific Symptoms or Conditions:
  • Unconsciousness or altered mental status
  • Severe chest pain
  • Breathing difficulties
  • Extensive bleeding or severe wounds
  • Signs of shock
  • Critical allergic reactions
  • Suspected spinal injuries
Patient Criteria:
  • Individuals in a life-threatening or critical condition
  • Patients who require immediate advanced medical interventions


Pre-Procedure Instructions:
  • No specific preparation required from the patient due to the emergency nature of the service
  • Family or bystanders should provide any relevant medical history or medication lists to the first responders if available
Diagnostic Tests or Assessments:
  • Initial assessment and vital signs check by emergency personnel upon arrival
  • Immediate evaluation for life-threatening conditions

Procedure Description

  1. Arrival of Ambulance: An ALS-equipped ambulance arrives on the scene.
  2. Initial Assessment: Paramedics quickly assess the patient’s condition.
  3. Life-Saving Interventions: Administering medications, performing CPR, deploying defibrillators, and other necessary advanced life support techniques.
  4. Patient Stabilization: Securing airway, managing bleeding, and splinting fractures.
  5. Transport: Carefully moving the patient onto a stretcher and securing them in the ambulance.
  6. Ongoing Care: Continued monitoring and treatment during transport to the hospital.
  7. Handover: Relaying patient information and condition to the hospital staff upon arrival. ##### Tools and Equipment Used:
    • Advanced medical kits (e.g., IV supplies, medications)
    • Defibrillators
    • Airway management tools
    • Oxygen supplies
    • Monitoring equipment
Anesthesia or Sedation:
  • Typically not used; pain management and sedation, if needed, may be administered as part of emergency care


  • Usually from 15 minutes to an hour, depending on the distance to the hospital and the severity of the patient’s condition.


  • Performed on-site (e.g., home, roadside) and en route to a healthcare facility such as a hospital emergency department.


  • Paramedics
  • Emergency Medical Technicians (EMTs)
  • Occasionally, support from specialized medical or firefighting personnel

Risks and Complications

Common Risks:
  • Minor injuries due to moving the patient
  • Potential for infection at IV sites
Rare Risks:
  • Complications from administered medications
Management of Complications:
  • Continuous monitoring and immediate intervention for any arising issues


Expected Benefits:
  • Immediate medical care during critical emergencies
  • Stabilization of life-threatening conditions
  • Quick transport to specialized medical facilities
Realization Time:
  • Immediate benefits during and after transport


Post-Procedure Care:
  • Continued treatment and monitoring in the hospital’s emergency department
  • Follow-up care based on hospital specialists’ recommendations
Expected Recovery Time:
  • Varies based on the underlying medical condition and its severity
  • Dependent on the specific medical condition; usually advised by hospital staff


Other Treatment Options:
  • Basic Life Support (BLS) services for non-critical conditions
  • Private vehicle transport in non-emergency situations
Pros and Cons:

Pros of ALS 1:

  • Provides advanced medical interventions in real-time emergencies

Cons of ALS 1:

  • Costly compared to BLS and private transport

Patient Experience

During the Procedure:
  • Patients may feel scared or anxious due to the emergency nature
  • Possible discomfort from medical interventions like IV insertions or splinting
  • Pain management provided as needed
After the Procedure:
  • Relief from symptoms if effectively managed en route
  • Continued care and treatment in a hospital setting for further recovery

Medical Policies and Guidelines for Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)

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