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Cheat sheet

BLS / ACLS Cheat Sheet

Practice QuestionsStudy Guide

BLS Skills

25%of exam

CPRAEDVentilationChokingOpioids

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

  1. Scene unsafe→Make safe(No entry)
  2. Unresponsive gasping→Activate/AED(Start CPR)
  3. Pulse breathing→Recovery position(Monitor)
  4. Pulse no breathing→Rescue breaths(Adult 6 sec)
  5. No pulse→CPR/AED(Compressions first)
  6. 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

  1. VF/pVT→Defibrillate(Then CPR)
  2. PEA/asystole→CPR/epi(No shock)
  3. Shock failed→CPR 2 min(Epi timing)
  4. VF persists→Amio/lido(After shocks)
  5. Organized rhythm→Pulse check(Max 10 sec)
  6. 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

  1. Slow unstable→Brady algorithm(Atropine/pacing)
  2. Slow stable→Observe causes(ECG)
  3. Fast unstable→Sync cardiovert(Sedate if possible)
  4. Fast stable→QRS width(12-lead)
  5. Regular narrow→Vagal/adenosine(SVT likely)
  6. 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

  1. ROSC→Post-arrest care(Airway/BP/ECG)
  2. ST elevation→Cath pathway(Reperfusion)
  3. Stroke symptoms→Stroke alert(LKW/glucose)
  4. Pregnant arrest→Left displacement(Early delivery)
  5. Hypothermic arrest→Rewarm(Modify expectations)
  6. 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. 1.Exam prep; follow protocols
  2. 2.Scene safe before contact
  3. 3.Pulse check max 10 seconds
  4. 4.Adult CPR rate 100-120/min
  5. 5.Adult depth 2-2.4 inches
  6. 6.Switch compressors every 2 minutes
  7. 7.After shock resume CPR
  8. 8.AED no shock resume CPR
  9. 9.VF/pVT: shockable arrest
  10. 10.PEA/asystole: CPR plus epi
  11. 11.Epi 1 mg q3-5
  12. 12.Amio/lido for refractory VF
  13. 13.Brady unstable: atropine/pacing
  14. 14.Tachy unstable: sync cardiovert
  15. 15.ROSC: airway BP ECG
  16. 16.Stroke: FAST plus glucose
  17. 17.ACS: rapid 12-lead ECG
  18. 18.Megacode: closed-loop communication

BLS, ACLS, & PALS

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