Which medication is NOT typically administered during the ALS protocol?

In the context of Advanced Life Support (ALS), the administration of medications is highly focused on those that directly support cardiac function and resuscitation efforts during a cardiac arrest scenario. Adrenaline and amiodarone are both key agents used during ALS for specific indications: adrenaline is used to enhance coronary and cerebral perfusion during cardiopulmonary resuscitation (CPR), while amiodarone is indicated for the management of certain types of arrhythmias, particularly in cases of shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.

Sodium bicarbonate is sometimes considered in specific circumstances, particularly in cases of persistent acidosis or hyperkalemia; however, its routine use is not standard practice during cardiac arrest management unless those specific conditions are present.

Ibuprofen, on the other hand, is an analgesic and anti-inflammatory medication commonly used for pain relief and to reduce inflammation, but it does not play a direct role in cardiac arrest management or the resuscitation efforts outlined in ALS protocols. Therefore, it is not administered during ALS, as it lacks relevance in the acute management of life-threatening cardiac events. This is why it is the correct choice in this scenario.