Advanced Diving Accident Life Support Course (ADALS)

Introduction

The Advanced Diving Accident Life Support (ADALS®) Course, initiated as a collaborative project between the Finnish Society for Diving and Hyperbaric Medicine, the Finnish Defence Forces Diving Medical Unit, and the Finnish Society of Anaesthesiologists, was held for the first time in 2004. The course has been organized alternately in Finland and abroad.

The ADALS concept was created, as we realized that there was no comprehensive educational program aimed at healthcare professionals to enhance their preparedness in treating victims of various diving accidents. It also quickly became clear that the educational package needed to be directed at the entire emergency care chain, including rescuers and all those who encounter victims of diving accidents in their work.

Content

The ADALS course includes lectures, practical hands-on small group work, and initial and final exams based on pre-distributed material. The course includes 14 hours of classroom instruction. Online self-study is expected to take 15-20 hours.

The content of the course covers key themes in diving medicine and emergency care:

– Epidemiology of diving accidents 
– Diving physics and physiology as applicable, the significance of diving gases (hypoxia, oxygen toxicity, nitrogen narcosis), and carbon dioxide retention 
– Decompression illness (DCI) risk factors, diagnosis, and treatment 
– Principles and practice of oxygen therapy and hyperbaric oxygen therapy 
– Diver barotraumas (lungs, ears, paranasal sinuses) and their treatment 
– Drowning: pathophysiology and first aid 
– Diver thermal disorders – hypothermia and hyperthermia: pathophysiology and first aid 
– Resuscitation: up-to-date.

In small groups, participants practice airway management, advanced life support, treatment of tension pneumothorax in the field and various case scenarios. Due to time constraints, it is assumed that participants already have basic resuscitation skills.

The initial exam introduces the topic with multiple-choice questions and prepares participants for the final exam, which has a passing threshold of 70%. The exams are based on pre-distributed course material, which should be read well in advance of attending the course. Those who successfully complete the ADALS® course are awarded ADALS® provider status, as well as a diploma and course badge. According to international practice, ADALS® provider status is valid for four years, during which it can be renewed through refresher training or by retaking the entire course after the validity period.

The course is an excellent way for diving physicians or diving club doctors to update their knowledge of the emergency management in diving accidents. However, participation does not require a diving background. The course is also open to nurses, paramedics, firefighters and other healthcare professionals.

It is possible to receive CME credits; the University of Helsinki has granted max 16 hours of training credits for the course, depending on the specialty, provided the student passes the final exam. In 2025, the University of Helsinki awarded specialization credits for the following specialties: 16 hours: Emergency Medicine, Anesthesiology and Intensive Care, Cardiology, Otorhinolaryngology, Sports Medicine, Orthopedics and Traumatology, Occupational Health, General Surgery. 10 hours: Internal Medicine/Core Training and Neurology.