ACLS Cheat Sheet 2026

The 30 highest-yield ACLS facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. What does a delta wave on an ECG indicate? → Wolff-Parkinson-White (WPW) syndrome with ventricular pre-excitation
2. When providing basic life support to an adult, the proper procedure is: → CAB - Compressions, Airway, Breathing
3. In the ACLS algorithm, after the second shock for refractory VF/pulseless VT, which drug combination is given? → Epinephrine 1 mg IV and consider amiodarone 300 mg IV after the third shock
4. Which rhythm on ECG shows regular narrow QRS complexes at 150 bpm with a 'sawtooth' baseline pattern? → Atrial flutter with 2:1 block
5. What is the primary advantage of video laryngoscopy over direct laryngoscopy in emergency intubation? → Provides an improved glottic view, particularly in difficult airways
6. Torsades de pointes is a form of polymorphic VT associated with: → Prolonged QT interval
7. What would you do if a 79-year-old man was in SVT, had a blood pressure of 80/50, complained of chest pain, and wanted to pass out? → Synchronized cardioversion
8. During a cardiac arrest scenario with a non-shockable rhythm (Asystole/PEA), what is the correct timing and dosage for Epinephrine administration? → As soon as possible, 1 mg every 3-5 minutes
9. What is the BLS Chain of Survival's appropriate order? → Check responsiveness, call EMS and get AED, chest compressions, and early defibrillation
10. What is the preferred initial airway adjunct for an unconscious adult patient who lacks a gag reflex during ACLS? → Oropharyngeal airway (OPA)
11. Which of the following is a contraindication to nasopharyngeal airway insertion? → Suspected basilar skull fracture
12. Which of the subsequent procedures takes place prior to the BLS Assessment? → Ensure the safety of the scene.
13. True or False: Pulse checks need to last at least 10 seconds. → FALSE
14. Which of the ensuing assertions is accurate? → There is no evidence to support the use of "defibrillation" to treat asystole.
15. What ventilation rate is recommended during two-rescuer CPR with bag-mask ventilation (no advanced airway)? → 1 breath after every 30 compressions (30:2 ratio)
16. Which of the following is the most appropriate indication for initiating Targeted Temperature Management (TTM) in a patient who has achieved ROSC? → The patient is comatose and not following verbal commands.
17. Wenckebach (Mobitz Type I) second-degree AV block is characterized by: → Progressive PR interval lengthening until a QRS is dropped, then the cycle repeats
18. True or False: For symptomatic bradycardia, 0.5 mg IV of atropine is the initial dosage that is advised. → FALSE
19. Suctioning attempts in ACLS scenarios should typically be: → ten seconds or less
20. A patient has a wide-complex tachycardia at 180 bpm with no pulse. What is the correct ACLS intervention? → Unsynchronized defibrillation (shock)
21. Which device provides the MOST reliable protection against aspiration during advanced airway management in ACLS? → Endotracheal tube (ETT)
22. In third-degree (complete) heart block, what is the relationship between P waves and QRS complexes? → P waves and QRS complexes are completely dissociated with no consistent relationship
23. A patient has third-degree (complete) heart block. Which ECG finding is characteristic? → P waves and QRS complexes with no relationship to each other (AV dissociation)
24. The ideal chest compression fraction is: → As high as possible
25. Adult chest compressions are performed as follows: → Approximately 100–120 compressions per minute
26. For adult resuscitation, the most crucial algorithm to understand is: → Cardiac Arrest
27. During a cardiac arrest resuscitation, when should defibrillation be performed in relation to epinephrine administration? → Defibrillation takes priority and should not be delayed for drug administration
28. When should 50% dextrose be avoided absent a diagnosis of hypoglycemia? → Both A and B
29. What is the recommended initial energy dose for defibrillation of ventricular fibrillation (VF) using a biphasic defibrillator? → 120–200 J
30. Which of the following best describes the two-thumb encircling technique during bag-mask ventilation? → It is preferred over the C-E clamp in two-rescuer CPR for better mask seal