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When taking your Advanced Cardiac Life Support (ACLS) Certification or Recertification course, you’ll find that it often prompts you to remember information that will be useful and relevant to the actual ACLS exam.

Health Ed Solutions, which offers the Advanced Cardiac Life Support class developed by Union College, offers the following tips to help you get the most out of your ACLS coursework and prepare for the ACLS exam.

1. Master your algorithms using mnemonic devices as memory aids. An algorithm is a set of procedures that will help you find the solution to a problem. In ACLS situations, mnemonic devices can help you remember the next logical step in an algorithm and how best to proceed. Here are a couple of examples using information you’ll find in an ACLS course:
   • For patients in asystole, also referred to as “flat line,” use “PEA:” problem search, epinephrine, atropine.
   • For patients displaying bradycardia, an unusually low heart rate, remember “Pacing Always Ends Danger:” TCP, atropine, epinephrine, dopamine.
   • When facing patients with cardioversion, an unusually rapid heart rate, remember to “Oh Say It Isn’t So:” O2 saturation monitor, suctioning equipment, IV line, intubation equipment, sedation and possibly analgesics.

   Mnemonic devices help trigger the brain and memory for faster recall, which can be especially important in emergency situations. The most common mnemonic devices in ACLS are the five T’s and five H’s. Both stand for reversible causes that signal the need for ACLS. All ACLS exams will require you to know and understand this important information.

   The five H’s

   • Hypovolemia
   • Hypoxia
   • Hydrogen ion (acidosis)
   • Hyper- or hypokalemia
   • Hypothermia

   The five T’s

   • Tablets (drug overdoses, accidental poisoning)
   • Tamponade, cardiac
   • Tension pneumothorax
   • Thrombosis, coronary (acute myocardial infarction)
   • Thrombosis, pulmonary, embolism

2. Know your pharmaceuticals. When performing ACLS, intravenous (IV) drugs are sometimes needed, and it’s important to know which drugs are pertinent in which situations.

   • Atropine: Treats bradycardia (low heart rate) or asystole (no heart rate) by blocking the vagus nerve.
   • Lidocaine: Used to treat ventricular arrhythmia (irregular heart rate) most generally seen in a patient’s left ventricle, the source of oxygenated blood.
   • Admiodarone: Used when a patient is in v-fib (when the heart never fills due to incomplete contractions) or v-tac (when the heart is pumping too fast).
   • Vadopression: Administered to increase cardiac output and circulation.
   • Mag Sulfate: An anti-arrhythmia drug used to counteract a variety of arrhythmias.
   • Procainamide: An anti-arrhythmia drug used to counteract a variety of arrhythmias.
   • Epi: Increases cardiac output by momentarily decreasing blood flow to your limbs, which increases the blood output from the heart.
   • Adenosine: An anti-arrhythmia drug that treats cardiac arrest in a life-threatening situation.

   Health Ed Solutions offers an ACLS Pharmacology Guide, available free to all ACLS students for use when preparing for the ACLS exam. 

3. It all comes back to CPR. The foundation for effective and beneficial ACLS is providing sound CPR, or cardiopulmonary resuscitation. Having a keen understanding of the ABCs of CPR can increase your ability to perform ACLS and save a life.
   • A-Airway. In order to breath, or in the case of CPR, to breath for another individual, you must secure a viable airway. Usually by checking for any airway obstruction and placing the adult patient's head into a "neutral" position so that the chin is essentially centered.
   • B-Breathing. Look, listen and feel for ventilation, or breathing. Look for rise and fall inthe chest, which would indicate the patient is breathing. If breathing is inadequate, one should initiate rescue breathing or CPR.
   • C-Circulation. To check for circulation, one should feel for a pulse by palpating one of several "pulse points" on the body; either the carotid or the radial artery. If inadequate circulation is present, then one should initiate resuscitative, CPR efforts.

   Though mnemonics and other memory aids can certainly help in your mastery of ACLS material, the best preparation tool for anyone taking the ACLS exam is confidence. Course materials provide practical information and offer sample questions to place you squarely in the mindset of a first responder. It’s important to use these materials to not only understand ACLS, but also as an ACLS study guide to prepare effectively and thoroughly for the exam.

   Health Ed Solutions' ACLS course offers case studies, example ACLS exam questions, and is designed for healthcare professionals seeking initial certification or recertification. 

The information included in this article is based on the 2020 guidelines for CPR, first aid and advanced cardiovascular care. Read more about how the 2020 guidelines impact ACLS training online.