Emergency & ACLS Reference

Quick-reference material for licensed nurses and students. Values are drawn from commonly cited clinical guidelines and nursing references — always verify against your facility protocols. About our editorial standards · Report a correction

BLS Algorithm (Adult)

1. Check scene safety
2. Check responsiveness
3. Activate EMS / get AED
4. Check pulse and breathing (no more than 10 seconds)
5. Start CPR: 30:2 ratio, rate 100–120/min, depth 2–2.4 inches
6. Use AED when available

ACLS Cardiac Arrest Algorithm

Shockable (VF/pVT)

CPR → Shock → CPR 2 min → Epinephrine every 3–5 min → Shock → Amiodarone

Non-Shockable (Asystole/PEA)

CPR → Epinephrine every 3–5 min → CPR 2 min → repeat

Reversible causes (H's and T's):

• H's: Hypovolemia, Hypoxia, Hydrogen ion (acidosis), Hypo/Hyperkalemia, Hypothermia
• T's: Tension pneumothorax, Tamponade (cardiac), Toxins, Thrombosis (pulmonary), Thrombosis (coronary)

Code Medications

Tachycardia Algorithm

Unstable (hypotension, chest pain, HF, shock): Synchronized cardioversion.

Stable:

• Narrow regular: Vagal maneuvers → Adenosine
• Narrow irregular: Rate control
• Wide regular: Amiodarone
• Wide irregular: Expert consult

Bradycardia Algorithm

1. Atropine 1 mg IV
2. Transcutaneous pacing
3. Dopamine 5–20 mcg/kg/min
4. Epinephrine 2–10 mcg/min

Rapid Response Triggers

• HR <40 or >130
• SBP <90
• RR <8 or >28
• SpO2 <90%
• Acute mental status change
• Chest pain
• New-onset seizure
• Significant bleeding

Stroke Assessment

FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 911.

Door-to-needle time <60 min for tPA.