PDX Monthly has named Dr. David Westerdahl one of Portland’s Top Sports Medicine Doctors!
We’re currently hiring Medical Assistants, Athletic Trainers, and a Physician Associate/Assistant with MSK and orthopaedic experience to join our team. If you’re interested, please email your resume to drw@sportshealthnorthwest.com. Thank you!
My journey began in 2000, when I was a family medicine resident running codes in the hospital where I trained. Back then, the adrenaline of responding to a “Code Blue” was equaled only by the weight of responsibility.
In the years since, ACLS has been a constant thread—first in hospital medicine and later on the sidelines of collegiate and professional sports. The skills, structure, and mindset of ACLS have shaped how I approach emergency care, teamwork, and preparedness.
The Foundation: BLS and the Power of Early Action
ACLS rests on the bedrock of Basic Life Support (BLS). No matter how advanced our interventions become, the fundamentals—high-quality chest compressions and early defibrillation—remain the strongest predictors of survival in cardiac arrest.
As a resident, I quickly learned that the first minutes of a cardiac arrest are everything. Recognizing an unresponsive patient, initiating effective CPR, and applying an automated external defibrillator (AED) can truly mean the difference between life and death.
Today, AEDs are more accessible than ever, found in airports, gyms, schools, and sports arenas. Their widespread availability has transformed outcomes in out-of-hospital cardiac arrest. Immediate CPR paired with rapid AED use saves lives—often before advanced providers even arrive.
I encourage everyone, not just healthcare professionals, to learn hands-only CPR and become familiar with AEDs. These simple, teachable skills empower any bystander to act with confidence in a critical moment.
The Evolution of ACLS: Beyond Algorithms
ACLS protocols have changed dramatically over the past 25 years. Early on, the emphasis was on memorizing complex algorithms and medication dosages. While these remain important, the focus has shifted toward:
High-performance team dynamics
Clear, closed-loop communication
Minimizing interruptions in chest compressions
Using simulation to practice real-world scenarios
As a sideline physician, I see these principles come alive on the field. Whether responding to a collapse during competition or a medical emergency in the stands, success depends on rapid coordination with athletic trainers, EMS, and other responders. The ACLS mindset—anticipating the next step, delegating efficiently, and maintaining situational awareness—is just as vital on the sideline as it is in the ICU.
The Sideline Perspective: Preparedness in Sports Medicine
Working with collegiate and professional athletes has reinforced the essential nature of ACLS skills. Athletes may be fit, but they are not immune to sudden cardiac events. Conditions such as commotio cordis, hypertrophic cardiomyopathy, or undetected arrhythmias can lead to sudden collapse without warning.
Being prepared—clinically, mentally, and logistically—ensures that when seconds matter, we respond with precision and purpose. ACLS has given me the framework and confidence to act decisively whether on the field, in the locker room, or in the clinic.
Looking Ahead: Strengthening the Chain of Survival
After 25 years, the core message of ACLS remains unchanged: early recognition, immediate intervention, and seamless teamwork save lives. The tools evolve, the guidelines adjust, but the commitment to readiness endures.
I’m grateful for the mentors who trained me, the colleagues who’ve stood beside me during emergencies, and the patients and athletes whose experiences have shaped my practice. I remain committed to continuous learning and preparedness—because lives depend on it.
To everyone reading—healthcare providers, coaches, teachers, parents, and community members—learn hands-only CPR and how to use an AED. You may someday be the first link in someone’s chain of survival. And that link is often the most important one.
