BLS and ACLS Survey

BLS and ACLS Surveys


Foundational to every ACLS Algorithm is the BLS survey. The BLS Survey is the first step that you will take when treating any emergency situation, and there are 4 main assessment steps to remember. These four steps are designated by the numbers 1, 2, 3, and 4.

This is an outline of the 4 steps in the BLS Survey :
(1) Check responsiveness by tapping and shouting, “Are you all right?” Scan the patient for absent or abnormal breathing (scan 5-10 seconds).
(2) Activate the emergency response system and obtain a AED. If there is more than one rescuer, have the second person activate emergency response and get the AED/Defibrillator.
(3) Circulation: Check for a carotid pulse. This pulse check should not take more than 5-10 seconds. If no pulse is palpable begin CPR.
(4) Defibrillation: If there is no pulse, check for a shockable rhythm with the AED or defibrillator as soon as it arrives. Follow the instructions provided by the AED or begin ACLS Protocol.
For a more in-depth review of BLS refer to the American Heart Association’s BLS Provider Manual.

Remember to assess first then perform appropriate actions, and after each action…reassess.

The ACLS Survey uses the ABCD model to systematize the ACLS process. The ABCD’s of the ACLS Survey are:
(A) Airway: Maintain airway and use advanced airway if needed. Ensure confirmation of placement of an advanced airway and secure the advanced airway device.
(B) Breathing: Give bag-mask ventilation, provide supplemental oxygen, and avoid excessive ventilation. Also, adequacy of ventilation and oxygenation should be monitored during this step.
(C) Circulation: Obtain IV access, attach ECG leads, identify and monitor arrhythmias, giving fluids if needed, and use defibrillation if appropriate.
(D) Differential diagnosis: Look for reversible causes and contributing factors for the emergency.

The ACLS survey is included in every ACLS algorithm and like the BLS Primary Survey, it helps to systematize the resuscitation process and improve patient outcomes.

Use the links to the left for further details of ACLS Protocol and specific interventions in each ACLS algorithm.

The objective of the review of these ACLS Algorithms is to help prepare you for the ACLS written test and the ACLS Megacode. After reviewing, you can test your skills and knowledge by accessing the ACLS Megacode Simulator and ACLS practice exams.


  1. etirado says

    After taking this course online can I get certified online or do I have to go somewhere to get certified.

  2. Hien says

    I still in doubt why we perform CPR with two rescuers for adult the ratio is still 30:2, but for child and infant the ratio is 15:2. Appreciate if you can explaint why it is different ratio compression between adult and Child or Infant with two rescuers?

    Thank you very much

    • says

      Adults, children, and infants have different needs when it comes to CPR. Infants and children have a greater ventilatory demand. Their ventilatory needs are normally higher than that of an adult. For 2 rescuer CPR, providing a ratio of 15:2 would give the child a greater number of breaths per minute and thus help ensure that their respiratory need is met.
      Kind regards,

  3. johannarocco says

    I like the font, the design of the pages, pleasurable to the eye and the mind.
    I’m understanding the material. I’m getting it.
    Thank you for this informative and thoughtful site.

  4. CordeAmare says

    My understanding on the 2010 changes is Circulation comes before Airway & Breathing on BLS Survey- an emphasis on Chest Compression. Does that pattern apply as well to the ACLS model? Or does the ABCD model stays intact? Thanks

    • says

      For BLS the sequence is CAB. For ACLS the ABCD model remains intact. In 2010, when the guidelines came out, there was some confusion among students about this, and this is why I created this page emphasizing the difference.

      Kind regards,

  5. tetratetra says

    You Know, It’s always agood idea to start out with the basics. What is a cycle? Do 5 cycles add up to 2 minutes? If not, which is most important?

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