BLS Skills
25%of exam
Cardiac Arrest
25%of exam
ShockableNonshockableDefibETCO2Hs/Ts
Arrhythmias
20%of exam
BradycardiaTachycardiaSVTVTPacing
ACLS Drugs
15%of exam
EpinephrineAmiodaroneAtropineAdenosineAccess
Systems + Special
15%of exam
ROSCACSStrokePregnancyTeams
Quick Facts
- Owner
- AHA
- Cards
- BLS/ACLS
- Validity
- 2 years
- BLS course
- About 4.5 hours
- ACLS course
- 13.25-16.5 hours
- BLS format
- ILT/HeartCode
- ACLS format
- ILT/HeartCode
- Skills
- Hands-on required
- Guideline
- 2025 AHA
- Use
- Exam prep only
CAB
Compressions Airway Breathing
Compressions firstOpen airwayBreaths visibleAED early
Pulse vs No Pulse
Pulse
- Ventilate if apneic
- Monitor closely
- Recheck pulse
No Pulse
- Start CPR
- Attach AED
- Minimize pauses
Pulse changes pathway
BLS Picker
- Scene unsafe→Make safe(No entry)
- Unresponsive gasping→Activate/AED(Start CPR)
- Pulse breathing→Recovery position(Monitor)
- Pulse no breathing→Rescue breaths(Adult 6 sec)
- No pulse→CPR/AED(Compressions first)
- Severe choking→FBAO cycles(No blind sweep)
BLS Sequence
- Scene safe
- Protect rescuers
- Tap/shout
- Check response
- No response
- Activate help
- Send runner
- Get AED
- Pulse check
- Max 10 sec
- No pulse
- Start CPR
- AED arrives
- Use immediately
- After shock
- Resume compressions
Respiratory vs Cardiac Arrest
Respiratory
- Pulse present
- Rescue breaths
- Naloxone possible
Cardiac
- No pulse
- CPR/AED
- Naloxone secondary
Ventilate vs compress
CPR Quality
- Rate
- 100-120/min
- Adult depth
- 2-2.4 inches
- Recoil
- No leaning
- Pauses
- Under 10 sec
- Compressor
- Switch 2 min
- Surface
- Firm flat
- Hands
- Lower sternum
- Fraction
- Maximize compressions
Adult vs Pediatric CPR
Adult
- 30:2 always
- 2-2.4 inches
- AED standard
Pediatric
- 15:2 two rescuers
- One-third depth
- Peds pads preferred
Age changes ratios
Ventilation
- Adult pulse
- 1 breath/6 sec
- No airway
- 30:2 adult
- Advanced airway
- Continuous compressions
- Chest rise
- Visible only
- Too fast
- Hyperventilation harm
- Bag mask
- Seal first
- OPA
- No gag
- NPA
- Gag present
OPA vs NPA
OPA
- Unconscious
- No gag
- Mouth route
NPA
- Gag present
- Nasal route
- Avoid facial trauma
Gag reflex matters
AED + Defib
- Pads
- Bare dry chest
- Adult pads
- Right upper/left lateral
- Pediatric pads
- Use if available
- Pads touching
- Use AP
- Analyze
- Nobody touches
- Shock advised
- Clear then shock
- No shock
- Resume CPR
- Manual defib
- Biphasic per device
Pediatric BLS
- Child depth
- About 2 inches
- Infant depth
- About 1.5 inches
- One rescuer
- 30:2
- Two rescuers
- 15:2
- Infant technique
- Two thumbs preferred
- Peds pulse
- 1 breath/2-3 sec
- Witnessed collapse
- Call/AED first
- Unwitnessed alone
- CPR 2 min
Choking + Opioid
- Adult severe FBAO
- Back blows/thrusts
- Infant severe FBAO
- Back blows/chest thrusts
- Unresponsive FBAO
- Start CPR
- Blind sweep
- Avoid
- Opioid pulse
- Ventilate plus naloxone
- Opioid pulseless
- CPR plus naloxone
- Naloxone
- Never delays CPR
- Agonal gasps
- Not normal
Hs and Ts
Hypoxia hypovolemia hydrogen hyperkalemia hypothermia toxins tamponade tension thrombosis
Hs metabolicTs obstructiveTreat reversibleSearch during CPR
Shockable vs Nonshockable
VF/pVT
- Defibrillate
- CPR immediately
- Epi after shocks
PEA/asystole
- No defib
- Epi early
- Find causes
Shock rhythm only
Arrest Picker
- VF/pVT→Defibrillate(Then CPR)
- PEA/asystole→CPR/epi(No shock)
- Shock failed→CPR 2 min(Epi timing)
- VF persists→Amio/lido(After shocks)
- Organized rhythm→Pulse check(Max 10 sec)
- ROSC appears→Post-arrest(Switch pathway)
Arrest Branches
- VF
- Shockable
- Pulseless VT
- Shockable
- PEA
- Not shockable
- Asystole
- Not shockable
- Shockable loop
- Shock CPR drugs
- Nonshockable loop
- CPR epi causes
- Rhythm check
- Every 2 min
- ROSC signs
- Pulse ETCO2 rise
Shock Loop
Shock CPR rhythm drugs causes
ShockCPR 2 minRhythm checkHs/Ts
Shockable Arrest
- First action
- Defibrillate fast
- After shock
- CPR 2 min
- Epi timing
- After failed shocks
- Antiarrhythmic
- Refractory VF/pVT
- Amiodarone
- 300 then 150
- Lidocaine
- Alternative antiarrhythmic
- Torsades
- Magnesium considered
- Search causes
- During CPR
Nonshockable Arrest
- PEA/asystole
- Do not shock
- Priority
- CPR plus epi
- Epi timing
- As soon feasible
- Atropine
- Not arrest drug
- Pacing
- Not routine arrest
- Fine VF
- Check leads
- Flatline
- Confirm asystole
- Causes
- Hs and Ts
Hs + Ts
- Hypovolemia
- Give volume
- Hypoxia
- Oxygen/airway
- Hydrogen
- Acidosis
- Hypo/hyperkalemia
- Electrolytes
- Hypothermia
- Rewarm
- Tension pneumo
- Decompress
- Tamponade
- Drain
- Thrombosis
- Coronary/pulmonary
- Toxins
- Antidotes
Sync vs Defib
Synchronized
- Pulse present
- Unstable tachy
- Avoid T wave
Defib
- Pulseless rhythm
- VF/pVT
- Unsynchronized shock
Pulse decides shock
Rhythm Picker
- Slow unstable→Brady algorithm(Atropine/pacing)
- Slow stable→Observe causes(ECG)
- Fast unstable→Sync cardiovert(Sedate if possible)
- Fast stable→QRS width(12-lead)
- Regular narrow→Vagal/adenosine(SVT likely)
- Polymorphic VT→Unsync shock(Magnesium if torsades)
Rhythm Recognition
- Narrow QRS
- Supraventricular origin
- Wide QRS
- Ventricular concern
- Regular narrow
- SVT likely
- Irregular narrow
- AF likely
- Regular wide
- VT until proven
- Irregular wide
- Danger rhythm
- Polymorphic VT
- Unsynchronized shock
- Stable rhythm
- Get ECG
Stable vs Unstable Tachy
Stable
- BP adequate
- 12-lead
- Drugs/consult
Unstable
- Hypotension
- Altered/ischemic
- Sync cardiovert
Perfusion drives urgency
Brady + Tachy
- Bradycardia
- Slow plus symptoms
- Atropine
- First-line reasonable
- Atropine fails
- Pace or infuse
- High-grade block
- Pacing early
- Stable tachy
- Assess QRS
- Unstable tachy
- Synchronized cardioversion
- Regular SVT
- Vagal/adenosine
- Wide stable
- Antiarrhythmic consult
Atropine vs Adenosine
Atropine
- Symptomatic brady
- Raises rate
- May fail blocks
Adenosine
- Regular SVT
- Rapid push
- Transient pause
Slow vs SVT
ACLS Drugs
- Epinephrine
- 1 mg q3-5
- Amiodarone
- VF/pVT refractory
- Lidocaine
- Amio alternative
- Atropine
- Symptomatic brady
- Adenosine
- Regular narrow SVT
- Magnesium
- Torsades
- Calcium
- Selected causes
- Bicarbonate
- Selected causes
Amiodarone vs Adenosine
Amiodarone
- Refractory VF/pVT
- Stable VT option
- Infusion possible
Adenosine
- Regular narrow
- Diagnostic WCT cautiously
- Not AF control
Arrest VT vs SVT
Access + Monitoring
- IV
- First attempt
- IO
- If IV fails
- Flush
- After IV drugs
- ET drugs
- Not preferred
- ETCO2
- CPR quality
- Sudden ETCO2 rise
- Possible ROSC
- Low ETCO2
- Improve compressions
- Ultrasound
- Avoid CPR delay
FAST
Face Arm Speech Time
Face droopArm driftSpeech abnormalTime critical
ROSC vs Ongoing Arrest
ROSC
- Pulse returns
- ETCO2 rises
- Post-arrest pathway
Ongoing
- No pulse
- Continue CPR
- Repeat algorithm
Switch after ROSC
Systems Picker
- ROSC→Post-arrest care(Airway/BP/ECG)
- ST elevation→Cath pathway(Reperfusion)
- Stroke symptoms→Stroke alert(LKW/glucose)
- Pregnant arrest→Left displacement(Early delivery)
- Hypothermic arrest→Rewarm(Modify expectations)
- Toxic arrest→Antidote search(Hs/Ts)
Exam Frame
- BLS card
- Healthcare provider
- ACLS card
- Advanced provider
- BLS tracks
- In/out hospital
- ACLS learners
- Code participants
- Completion
- Course plus skills
- eCard
- Valid 2 years
- Blended
- Online plus skills
- Classroom
- Instructor led
TEAM
Team Equipment Algorithm Monitor
Assign rolesPrepare equipmentState pathwayTrack rhythm
Post-ROSC
- Airway
- Secure oxygenation
- Ventilation
- Avoid hyperventilation
- BP
- Treat hypotension
- ECG
- Find STEMI
- Temperature
- Prevent fever
- Seizures
- Treat promptly
- Glucose
- Avoid extremes
- Disposition
- Critical care
ACS + Stroke
- ACS
- ECG within 10
- STEMI
- Reperfusion pathway
- Aspirin
- If no contraindication
- Nitro
- Watch BP
- Stroke screen
- FAST
- Last known well
- Treatment clock
- Glucose
- Mimic check
- CT
- Bleed screen
Team Dynamics
- Leader
- Assign roles
- Compressor
- Quality focus
- Airway
- Ventilation focus
- Monitor
- Rhythm/defib
- Meds
- Access/drugs
- Recorder
- Times/events
- Closed loop
- Read back
- Debrief
- Improve system
Common Traps
Agonal breathing trap
Gasping is abnormal ≠ Start arrest pathway
Pulse delay trap
Max 10 seconds ≠ Unsure means CPR
Post-shock trap
Do not pulse-check ≠ Resume CPR immediately
No-shock trap
AED no shock ≠ Resume CPR immediately
Ventilation trap
Visible chest rise ≠ Avoid overventilation
Opioid trap
Naloxone helps breathing ≠ CPR still first
PEA trap
Organized rhythm ≠ Still pulseless arrest
Asystole trap
Confirm leads ≠ Do not defib
Brady block trap
Atropine may fail ≠ Pacing may be needed
Tachy shock trap
Pulse gets sync ≠ Pulseless gets defib
Adenosine trap
Regular SVT only ≠ Avoid unstable delay
Team trap
Silent tasks fail ≠ Close every loop
Last Minute
- 1.Exam prep; follow protocols
- 2.Scene safe before contact
- 3.Pulse check max 10 seconds
- 4.Adult CPR rate 100-120/min
- 5.Adult depth 2-2.4 inches
- 6.Switch compressors every 2 minutes
- 7.After shock resume CPR
- 8.AED no shock resume CPR
- 9.VF/pVT: shockable arrest
- 10.PEA/asystole: CPR plus epi
- 11.Epi 1 mg q3-5
- 12.Amio/lido for refractory VF
- 13.Brady unstable: atropine/pacing
- 14.Tachy unstable: sync cardiovert
- 15.ROSC: airway BP ECG
- 16.Stroke: FAST plus glucose
- 17.ACS: rapid 12-lead ECG
- 18.Megacode: closed-loop communication
Buy on Amazon
Take courses on UdemySame family resources
Explore More AHA CPR & Resuscitation
Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.
More From This Family
Videos and articles for deeper review.