ACLS algorithm overview | ACLS-Algorithms.com
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ACLS Algorithm Overview

Each ACLS algorithm is designed to simplify the process for the management and treatment of patients experiencing a cardiovascular emergency or progressing toward a cardiovascular emergency.

Most often these emergencies are related to an arrhythmia which must be identified and then treated with the appropriate ACLS algorithm.

Selection of the appropriate ACLS algorithm and path within the algorithm is determined by the type of arrhythmia present and the severity of the patient’s condition. Typically, the severity is classified as stable or unstable and this dictates interventions.

ACLS Algorithm #1: Cardiac Arrest

The most important and most frequently used ACLS algorithm is the cardiac arrest algorithm.

View the cardiac arrest algorithm diagram. When done close the diagram.

Cardiac Arrest Diagram

The cardiac arrest algorithm has two main branches. The left branch is used for the treatment of ventricular fibrillation and pulseless ventricular tachycardia. The right branch is used for the treatment of asystole and PEA.

Learn more about the cardiac arrest algorithm.

ACLS Algorithm #2: Bradycardia

The bradycardia algorithm is used for the treatment of both stable and unstable bradycardia.

View the bradycardia algorithm diagram. When done close the diagram.

Bradycardia Diagram

The two most common types of bradycardia that require emergency intervention are 2nd° heart block type II and 3rd° heart block. Both of these bradyarrhythmias can lead to decreased blood perfusion. These bradyarrhythmias should be treated using the bradycardia algorithm.

The two most important interventions for the treatment of symptomatic bradycardia are the administration of atropine and the initiation of transcutaneous pacing.

Learn more details about the bradycardia algorithm.

ACLS Algorithm #3: Tachycardia

The tachycardia algorithm is used for the management and treatment of stable and unstable tachycardia.

View the tachycardia algorithm diagram. When done close the diagram.

Tachycardia Diagram


SVT or supraventricular tachycardia is the most common tachyarrhythmia that is treated with the tachycardia algorithm. There are several types of SVT, and the most common is AVNRT. AVNRT is treated with vagal maneuvers and adenosine.

One important thing to remember about the tachycardia algorithm is that if any tachyarrhythmia is unstable, cardioversion will always be performed.

Learn more about the tachycardia algorithm.

ACLS Algorithm #4: Acute Coronary Syndrome (ACS)

The acute coronary syndrome (ACS) algorithm is used for the treatment and management of acute coronary syndrome.

The most important early intervention that is needed within the acute coronary syndrome algorithm is to obtain a 12-lead ECG. The 12-lead ECG interpretation will determine which interventions are performed.

View the Acute Coronary Syndrome Algorithm. When done close the diagram.

ACS Algorithm Diagram


The most important branch of the acute coronary syndrome algorithm is the far left branch. This branch is used for the treatment of STEMI or ST-segment elevation myocardial infarction. ST-segment elevation indicates that the patient is having an MI.

The two most important interventions that are needed once ST-segment elevation is observed is either PCI or fibrinolytic therapy.

Acute Coronary Syndrome Video Review

ACLS Algorithm #5: Suspected Stroke Algorithm

The final ACLS algorithm reviewed here is the suspected stroke algorithm. The suspected stroke algorithm is designed to streamline and simplify the process of early management and care of the patient with ischemic stroke. Ischemic stroke is the most common form of stroke.

View the Suspected Stroke Algorithm. When done close the diagram.

Suspected Stroke Diagram


The most important diagnostic intervention within the suspected stroke algorithm is the non-contrast CT scan. The non-contrast CT scan rules out hemorrhagic stroke.

Hemorrhagic stroke is not treated within the ACLS suspected stroke algorithm. The most important intervention once ischemic stroke is ruled in is fibrinolytic therapy.

Learn more about the stroke algorithm.

This ACLS algorithm overview, along with all of the pages of this website take the AHA ACLS algorithms and make them easy to understand and apply.

Learn more about the course…

Comments

  1. Jasmine says

    I have a question: if the tachycardia has a patient that has BP over 90 systolic but has chest pain and AMS, is that unstable or stable?
    On algorithm, BP under 90 is not only criteria for unstable- thanks for clarifying.

    Reply

    • ACLS says

      Your decision would depend upon what kind of tachycardia is identified. In all likelihood, this would be treated using the acute coronary syndrome algorithm unless a specific tachyarrhythmia that can be treated is identified.
      Kind regards, Jeff

      Reply

  2. David says

    Why is it that you cannot tap on each individual drug under primary heading “ACLS drugs” and learn about each drug. You use to be able to do this. Now you can only tap on the highlighted ‘red’ drugs to study. The idea simplicity. Now I have to go to the algorithm search there bounce back and forth.
    Should be able to tap each individual drug and study on the “ACLS Drug “ heading.

    David ICU/Cardiovascular Critical Care RN

    WONDERFUL web site
    Long time member and advocate to all new RN’s to purchase this web site!

    Reply

    • ACLS says

      Hi David,

      my apologies there for the difficulties with the navigation.

      This page is meant to be an overview and if you utilize the interactive course guide I think you will find that it is a much better way to navigate through all of the content.

      Kind regards, Jeff

      Reply

  3. Jenny says

    I feel like this is a dumb question but in an out patien procedure suit. MD, NP,RN only if a patient is severely bradycardic and atropine is not working and we dont have pacing available could we start an epi gtt with no pump? Is that appropriate?

    Reply

    • ACLS says

      An epinephrine drip in that situation would not be appropriate. You would want to treat the patient with BLS and call EMS. I would even hesitate to give atropine in that situation if you do not have the capability to further treat the patient if they continue to decline
      Kind regards, Jeff

      Reply

      • ryan says

        That’s a scary proposition. first an outpatient procedural unit should have an automated defibrillator at least and if you are giving sedation at a facility like that then you should have a full defibrillator that has pacing and cardioversion capabilities. YOU REALLY SHOULD PACE THAT PATIENT. If you didn’t have that for some reason then an epi or dopamine drip could be considered but i would never run it without a pump. Running that with drip chamber titrations would be a nightmare, you may see hypertension, tackicardia or more ectopy or rhythm changes if you infuse too fast. Also your atropine push will only give you a transient bump in heart rate. Your patient may become bradycardic again in a few minutes. Getting ems rolling to you may be advisable.

  4. Miranda Roberts Gosa says

    I used this site as a student in my Respiratory Care program a couple years ago and flew through ACLS and PALS. I just reviewed the BLS scenarios prior to renewal and they are awesome as well. I’m going to purchase both ACLS and PALS for my renewal. Thank you for offering this program! Is there anyway you all could incorporate NRP simulations and practice?

    Reply

    • ACLS says

      Hi Miranda,
      welcome back! I’m so glad that the site has been helpful for you. At the current time I do not have short term plans for adding NRP. If I get enough customers requesting NRP then that may become something that I work on in the future.
      Kind regards, Jeff

      Reply

  5. Nadia says

    I just finished taking the ACLS course at my hospital but am still unsure as to the frequency and timing of when to do a pulse check. I know that right after a shock, we must immediately proceed with compressions versus checking for a pulse, but can you advice as to when in the algorithm and how often we should be checking for a pulse and hence pause with compressions?

    Reply

    • ACLS says

      You will perform a pulse check after five cycles of CPR. The pulse check is performed with the rhythm check or after the rhythm check. Many people perform the pulse check with the rhythm check. This is the fastest way, but just realize that if the rhythm has not changed and a person remains in ventricular fibrillation then a pulse check is not necessary. You will first evaluate the rhythm quickly and then perform the pulse check.

      When there are enough team members available it is prudent to check both at the same time. It makes the whole process just a little bit quicker.

      Kind regards,
      Jeff

      Reply

  6. Ramesh Veeragandham says

    I am a physician and do not participate in regular codes. Have to renew my ACLS. Site is very helpful and terrific. Great job and Thank you.

    Ramesh

    Reply

  7. Marcia Heng says

    I have been using this site for several years and I must say, this page is a great addition! How you briefly describe the algorithms we use, color code them, and have links referencing each one. Brilliant for learning and putting it all together. Thank you for all you do!

    Reply

  8. Maria Cancel says

    hello, is there a way that I can click on the algorithm and print it out? I think I was able to do it last time. I am a visual learner and printing the pictures will help me..

    Reply

  9. joemart1 says

    Drop-down algorithms, videos, and practice tests are SO helpful? Just so well-organized, updated, and useful. Thanks again.

    Reply

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