Here you will find ACLS pretest information, class information and key changes in the ACLS protocols. Below you will find helpful ACLS study guides to help you prepare for your ACLS provider course. While you are preparing for your class, go to our Healthcare Provider page to sign up for your ACLS class


ACLS PreTest


Before attending the ACLS certification class or ACLS renewal class, students must complete the mandatory precourse self-assessment located on the ACLS Student Website. You must achieve a score of 70% or higher, and have unlimited chances to pass the precourse self-assessment. Students must print their completion certificate and bring it to their ACLS class. The access code for the self-assessment can only be found in the ACLS course manual.

You will need to obtain an ACLS course manual to get the access code. You may also need the book the pass the self-assessment which includes a rhythm test, ACLS medications, and BLS

Class Info

To successfully pass the ACLS course, AHA ACLS requires you to successfully manage a megacode. A mega-code is hands-on, dynamic, in real time practice of treating a life-threatening cardiac emergency. The cardiac emergency will include ventricular fibrillation, ventricular tachycardia with or without pulses, asystole, pulseless electrical activity, bradycardia and more. In addition, you’re required to pass a written exam with a score of ≥ 84%. In managing a code or cardiac arrest, you will be required to recognize and correctly identify basic life-threatening rhythms or arrhythmias. You’ll be required to assess the patient’s general condition and effectively treat the patient according to ACLS algorithms and recommendations using the defibrillator and basic cardiac drugs.

During this course, you will have to perform roles that may be outside your standard scope of practice during the mega-code practice and testing portion of the class. You’ll be required to be a “team leader” in managing the code, requesting defibrillation, synchronized cardioversion, CPR, and the correct cardiac drug and dosage when indicated according to ACLS guidelines. In managing the mega-code, the team leader will assign their team members to specific roles and responsibilities including: CPR, respiratory management, use of the defibrillator/monitor, selecting drugs out of the code cart, recorder, etc

Here are some tips when doing the mega-code test with us

  • Always assess your patient at the beginning and after every rhythm change

  • Remember you can't see a rhythm or defibrillate a patient unless you hook them up to an ECG monitor and difib pads

  • Remember you are the team leader and have to tell everyone what you want done. example: administer oxygen, administer medications, start CPR, stop CPR, check pulse, set defibrillator, charge defibrillator, shock, set pacemaker, etc

  • Regardless of how many students in the class, you will be tested on 4-6 rhythms

  • You will be asked to demonstrate how to defibrillate, cardiovert, and transcutaneous pacing

  • We realize ACLS is stressful so we provide and calm and relaxing learning environment with the emphasis on learning not to make you look bad

Mega Code

Key Changes

Team Resuscitation: For adult patients, rapid response team (RRT) systems can be effective in reducing the incidence of cardiac arrest, particularly in the general care wards. 

Adult Basic Life Support and CPR Quality

Chest Compression Rate: In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compression’s at a rate of 100 to 120/min

Chest Compression Depth: During manual CPR, rescuers should perform chest compression’s to a depth of at least 2 inches (5 cm) for an average adult, while avoiding excessive chest compression depths (greater than 2.4 inches [6 cm])

Shock First vs CPR First: For witnessed adult cardiac arrest when an AED is immediately available, it is reasonable that the defibrillator be used as soon as possible. For adults with unmonitored cardiac arrest or for whom an AED is not immediately available, it is reasonable that CPR be initiated while the defibrillator equipment is being retrieved and applied and that defibrillation, if indicated, be attempted as soon as the device is ready for use

Chest Recoil: It is reasonable for rescuers to avoid leaning on the chest between compression’s, to allow full chest wall recoil for adults in cardiac arrest

Minimizing Interruptions in Chest Compressions: Rescuers should attempt to minimize the frequency and duration of interruptions in compressions to maximize the number of compressions delivered per minute

For adults in cardiac arrest who receive CPR without an advanced airway, it may be reasonable to perform CPR with the goal of a chest compression fraction as high as possible, with a target of at least 60%

Ventilation During CPR With an Advanced Airway: It may be reasonable for the provider to deliver 1 breath every 6 seconds (10 breaths per minute) while continuous chest compression’s are being performed (ie, during CPR with an advanced airway)

Adult Advanced Cardiovascular Life Support Summary of Key Issues:

Vasopressors for Resuscitation: Vasopressin in combination with epinephrine offers no advantage as a substitute for standard-dose epinephrine in cardiac arrest.

Vasopressors for Resuscitation: It may be reasonable to administer epinephrine as soon as feasible after the onset of cardiac arrest due to an initial nonshockable rhythm

ETCO2 for Prediction of Failed Resuscitation: In intubated patients, failure to achieve an ETCO2 of greater than 10 mm Hg by waveform capnography after 20 minutes of CPR may be considered as one component of a multimodal approach to decide when to end resuscitative efforts but should not be used in isolation

Post–Cardiac Arrest Drug Therapy: There is inadequate evidence to support the routine use of lidocaine after cardiac arrest. However, the initiation or continuation of lidocaine may be considered immediately after ROSC from cardiac arrest due to VF/pVT

Post–Cardiac Arrest Drug Therapy: ß-Blockers 2015 (New): There is inadequate evidence to support the routine use of a ß-blocker after cardiac arrest. However, the initiation or continuation of an oral or IV ß-blocker may be considered early after hospitalization from cardiac arrest due to VF/pVT

Post–Cardiac Arrest Care Summary of Key Issues

Targeted Temperature Management: All comatose (ie, lacking meaningful response to verbal commands) adult patients with ROSC after cardiac arrest should have TTM, with a target temperature between 32°C and 36°C selected and achieved, then maintained constantly for at least 24 hours

Hemodynamic Goals After Resuscitation: It may be reasonable to avoid and immediately correct hypotension (systolic blood pressure less than 90 mm Hg, mean arterial pressure less than 65 mm Hg) during post–cardiac arrest care