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BLS / ACLS Cheat Sheet

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BLS Skills

  • 25% of exam
  • CPR AED Ventilation Choking Opioids

Cardiac Arrest

  • 25% of exam
  • Shockable Nonshockable Defib ETCO2 Hs/Ts

Arrhythmias

  • 20% of exam
  • Bradycardia Tachycardia SVT VT Pacing

ACLS Drugs

  • 15% of exam
  • Epinephrine Amiodarone Atropine Adenosine Access

Systems + Special

  • 15% of exam
  • ROSC ACS Stroke Pregnancy Teams

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 BL

  • Compressions Airway Breathing
  • Compressions first Open airway Breaths visible AED early

Pulse vs No Pulse BL

Pulse

  • Ventilate if apneic
  • Monitor closely
  • Recheck pulse

No Pulse

  • Start CPR
  • Attach AED
  • Minimize pauses
  • Pulse changes pathway

BLS Picker BL

  • 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 BL

  • 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 BL

Respiratory

  • Pulse present
  • Rescue breaths
  • Naloxone possible

Cardiac

  • No pulse
  • CPR/AED
  • Naloxone secondary
  • Ventilate vs compress

CPR Quality BL

  • 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 BL

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 BL

  • 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 BL

OPA

  • Unconscious
  • No gag
  • Mouth route

NPA

  • Gag present
  • Nasal route
  • Avoid facial trauma
  • Gag reflex matters

AED + Defib BL

  • 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 BL

  • 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 BL

  • 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 AR

  • Hypoxia hypovolemia hydrogen hyperkalemia hypothermia toxins tamponade tension thrombosis
  • Hs metabolic Ts obstructive Treat reversible Search during CPR

Shockable vs Nonshockable AR

VF/pVT

  • Defibrillate
  • CPR immediately
  • Epi after shocks

PEA/asystole

  • No defib
  • Epi early
  • Find causes
  • Shock rhythm only

Arrest Picker AR

  • 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 AR

  • 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 AR

  • Shock CPR rhythm drugs causes
  • Shock CPR 2 min Rhythm check Hs/Ts

Shockable Arrest AR

  • 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 AR

  • 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 AR

  • 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 RH

Synchronized

  • Pulse present
  • Unstable tachy
  • Avoid T wave

Defib

  • Pulseless rhythm
  • VF/pVT
  • Unsynchronized shock
  • Pulse decides shock

Rhythm Picker RH

  • 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 RH

  • 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 RH

Stable

  • BP adequate
  • 12-lead
  • Drugs/consult

Unstable

  • Hypotension
  • Altered/ischemic
  • Sync cardiovert
  • Perfusion drives urgency

Brady + Tachy RH

  • 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 DR

Atropine

  • Symptomatic brady
  • Raises rate
  • May fail blocks

Adenosine

  • Regular SVT
  • Rapid push
  • Transient pause
  • Slow vs SVT

ACLS Drugs DR

  • 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 DR

Amiodarone

  • Refractory VF/pVT
  • Stable VT option
  • Infusion possible

Adenosine

  • Regular narrow
  • Diagnostic WCT cautiously
  • Not AF control
  • Arrest VT vs SVT

Access + Monitoring DR

  • 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 SY

  • Face Arm Speech Time
  • Face droop Arm drift Speech abnormal Time critical

ROSC vs Ongoing Arrest SY

ROSC

  • Pulse returns
  • ETCO2 rises
  • Post-arrest pathway

Ongoing

  • No pulse
  • Continue CPR
  • Repeat algorithm
  • Switch after ROSC

Systems Picker SY

  • 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 SY

  • 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 SY

  • Team Equipment Algorithm Monitor
  • Assign roles Prepare equipment State pathway Track rhythm

Post-ROSC SY

  • 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 SY

  • 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 SY

  • 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

BLS, ACLS, & PALS

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