In many geographic regions, especially in rural areas, hospitals have limited access to subspecialists and modern diagnostic equipment. Regardless, the health care providers in these areas must be prepared to respond to medical emergencies that are diverse in nature. Different advanced life support courses have been developed to keep health care providers up-to-date in the treatment of critically ill or injured patients. While these courses are excellent summations of their respective subject matter, many comprehensive care providers cannot attain and maintain certification in all of the courses. In addition, some critical, medical conditions are not addressed in any of these courses.

The state of rural emergency care was on the minds of Dr. Darrell L. Carter, a family physician in Granite Falls, and Dr. Ernest Ruiz, then Chief of Emergency Medicine at Hennepin County Medical Center (HCMC), when they met at a retreat for ambulance medical directors in the early 1990s. They began to think about ways of providing knowledge and hands-on skills training in emergency medicine for rural health care providers. This led to the formation of a multi-disciplinary task force, under the umbrella of the Minnesota Academy of Family Physicians, to create an advanced life support course for rural providers.

The resulting curriculum, Comprehensive Advanced Life Support (CALS), is designed for physicians, mid-level practitioners, nurses, and allied health care professionals who work in settings where they are exposed to undifferentiated medical emergencies but often do not have the luxury of on-site subspecialty assistance. CALS’ comprehensive manual, interactive classroom segment, and hands-on laboratory experience provide an organized team approach to advanced life support training for front-line comprehensive care providers who must confront the broadest range of medical emergencies. The primary focus of the CALS curriculum is to teach the knowledge and skills necessary to effectively treat organ-threatening or life-threatening emergencies before serious organ injury or cardiac arrest occurs.

Resuscitation Triad The success of caring for critical patients is dependent on three essential pieces that can be summarized by the use of the resuscitation triad which includes:

• knowledge and competent clinical skills of the practitioners
• the use of appropriate equipment and
• a resuscitation system centered on the needs of the patient.

This triad is emphasized throughout the CALS program.

Universal Approach Course materials are organized according to "a universal approach to critically ill or injured patients" and is defined by the manner in which care providers approach patients.