The Advanced Life Support in Obstetrics (ALSO) program: fourteen years of progress.

Background: The Advanced Life Support in Obstetrics (ALSO®) program is a highly structured, evidence-based, two-day course designed to provide healthcare professionals with the knowledge and skills to manage the emergency conditions that can occur during childbirth. Objectives: To document the number of ALSO®-trained clinicians and instructors in the United States and internationally and to promote ALSO® training among prehospital and disaster medicine professionals. Methods: Records maintained by the American Academy of Family Physicians (AAFP) for each country where ALSO® is taught were reviewed for: (1) the years and locations of the ALSO® courses; (2) the number of ALSO®-trained caregivers; and (3) the number of ALSO® instructors. Results: Between 1991 and 2005, 54,071 ALSO®-trained caregivers and 2,251 instructors have completed provider and instructor ALSO® courses in 25 countries. Of these, 17,755 caregivers and 1,220 instructors are from outside the United States. Conclusion: The ALSO® program is a popular, multi-disciplinary course for preparing maternity caregivers to manage obstetric emergencies. Limited evidence suggests it can be effective and efficient in enhancing the knowledge and skills of prehospital and disaster medicine clinicians. Hong Kong provides a model in which emergency physicians have taken the lead in promoting the ALSO® course. As the ALSO® program expands, additional research is needed to assess its impact on educational and health outcomes.