Systematic approach of ACLS |


  1. says

    Hi Jeff, Good Day! I have a question, and it pertains to the Systematic Approach module/process. Specifically, the question relates to the patient “disability”/neuro status. My question is that in some places, the D within the ALS survey confers to “Disability”, and in others in confers search for “Differential Diagnosis”. I have gone through this process approx 20 times in my career, and I seem to recall at one point, the issues were coupled together under the ALS survey. in “D”. I know there is a new wide emphasis on differential diagnosis, particularly as it pertains to treating PEA. Just want to be sure I work it in, though I know I would be prompted if I didn’t. Again, you are a nurse sports star for all the help that you have given us all through the years. BEST!

    • ACLS says

      Honestly, the American heart Association acronyms can be confusing because they change them regularly.

      The D for defibrillation is used for the BLS assessment.

      The D within ACLS stands for disability and is used within the primary assessment.

      They are not coupled together.

      Kind regards,

  2. Van Nguyen says

    I was going through the interactive videos through American Heart and getting things wrong. I knew then, that I had to go back to basics and review. I’ve used this site before, and it really helped me to learn. Taking the quizzes here and reading the answers was so much more interesting than simply reading a book. Thank you.

  3. Joseph Cloud says

    I have been taking the ACLS certification since 1997. I never,ever pay for review sites. However found this site, and was surfing through it. I had no trouble putting out some cash for this informative site. Thanks for making my review simple.


    Hi Jeff,

    I have several questions mate:

    1. In dealing with patients with a hump (Kyphosis), how do you perform High quality chest compression then?
    2. Is consent necessary for severe choking patients?
    3. If an EMS team found that cessation of CPR is the only option for a patient, who is legally bound to declare that the ‘patient is dead.’ Should they phone a doctor? or should they just write the time of death and address it to the practitioner at a later time.


    Peter Feliciano

    • Jeff with admin. says

      Question 1:
      You will perform chest compressions to the best of your abilities. Situations where there are physical abnormalities can complicated positive outcomes. If you have waveform capnography capabilities you can monitor the quality of your chest compressions. This would be one way to hopefully overcome the physical abnormalities by adjusting continuously to you’re reading on the capnography monitor. The patient would need to be intubated for capnography monitoring to be an option.

      Question 2:
      Consent is not necessary for the choking victim. Most countries have laws to protect good samaritans who have proper training that provide CPR and other life-support skills like the Heimlich maneuver.

      Question 3:
      Typically, in the hospital setting, a physician is required to pronounce a patient deceased. Usually paramedics and other EMS providers will be communicating with the dispatch that will give them guidance as well.

      Kind regards,

  5. Clem Stalcup says

    I have been doing ACLS since 1990. This site is an amazing find. This is the second recertification I have used this site to review for . Thanks so much. An amazing tool..

  6. chidichimoc says

    Thanks Jeff for this site. It is fantastic. I’m studying to became ACLS instructor.
    Thank a lot for topics, videos and questions and your comments.

  7. Tracey Miller says

    This even sounds ridiculous to me but I’ll bring it up anyway!
    Obviously BLS before ACLS, in BLS the AHA manual states
    C: circulation; A: airway; B: breathing as a way to remember the steps but when you read the systematic approach, “BLS Assessment is the First step in treating an Emergency-
    4 main assessment steps to remember”…
    1. Check responsiveness
    2. Activate EMS & get AED
    3. Circulation
    4. Defib
    What happened to the ” C-A-B” ?
    Its where they “kinda Trick you” in the tests…
    Also, realizing of course, you’re not going to just run up to someone & just start doing Compressions before you ask if they’re OK !
    Sorry its kinda silly but curious your answer/thoughts!

    • Jeff with admin. says

      C-A-B has to do with the assessment actions that are carried out during BLS.

      C-Circulation is the first assessment that is performed.

      If there is circulation then the A-Airway is assessed for being open and clear.

      When and open and clear airway is established, then B-breathing is assessed.

      This CAB sequence ensures that CPR begins as quickly as possible. If there is no pulse (C-circulation) then CPR begins immediately.

      Does that make sense? Please let me know if you have any other questions.

      Kind regards,

  8. Soichan Mathew says

    In this topic BLS assessment,Primary assessment and secondary assessment picture is cannot open

  9. pamela mccarty says

    Jeff, Third re-certification! I always come here first. This is the best study guide a person could ask for. Agreed, the website gets better and better. Pam

  10. Jeffrey Johnson says

    Just getting started again (4th recertification) and this site just keeps getting better. Thanks Jeff for making this so practical and enjoyable.

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