Professional emergency responders who work in hospitals, out-patient clinics and in the emergency medical field may be required to satisfactorily complete a course in Advanced Cardiovascular Life Support, or ACLS certification to continue employment in critical areas of patient care. In addition to Basic Life Support, healthcare professionals, such as doctors, nurses, respiratory therapists, paramedics, emergency medical technicians, and other critical personnel are required to demonstrate the recognition and corresponding protocol for the treatment of heart arrhythmias and the application of artificial breathing techniques. The certification is awarded after the completion of a written examination and the successful completion of the practical examination known as the Megacode.
What is an Advanced Cardiovascular Life Support, or ACLS Certification?
Professional healthcare providers must be proficient in emergency protocols and treatment of critically injured patients in the hospital or emergency situations in the field. The student must demonstrate the ability to manage a critical cardiac and respiratory patient that requires artificial breathing and management of acute cardiac failure and shock. ACLS certification is awarded after the written examination and the practical portion are successfully completed. The ACLS training class is about 13-14 hours in length and the recertification takes about 5-6 hours to complete.
What Can I Expect from the Written Portion of the ACLS Examination?
Students must diagnose and recognize cardiac arrhythmias that simulate life-threatening ECG strips. A cardiac EKG strip will be provided for interpretation. Some arrhythmias on the test include:
- Ventricular Fibrillation
- Ventricular Tachycardia
- Pulseless Electrical Activity
- Normal Sinus Rhythm
- Atrial Flutter
- Artial Fibrillation
- Second-Degree AV Block
Medication Administration Assessment
In addition to the correct diagnosis of cardiac arrhythmias, the student must choose the correct cardiac medication and dosage to successfully treat and convert the lethal heart arrhythmia to a normal sinus rhythm. Some of the drugs on the examination may include:
- Epinephrine 3 mg
- Amiodarone 150 mg
- Vasopressin 40 units
- Epinephrine 3 mg
- Lidocaine 0.5 mg/kg
- Nitroglycerin 10mcg/min
- Atropine 1mg
Knowledge and Demonstration of Using a Defibrillator
The written examination also includes successful management of a biphasic defibrillator with the effective application of shocks (joules) per the various protocols of ACLS algorithms.
- How many shocks are appropriate for ventricular fibrillation?
- What is the correct amount of joules for CPR on a child, infant or adult?
- What is the proper electrode (pad) placement for atrial defibrillation?
- What is the lead placement for cardiac conversion therapy?
What Can I Expect from the Practical Portion of the ACLS Examination?
Students must demonstrate and successfully run the practical part of the ACLS certification known as the Megacode per ACLS guidelines. A student is given a medical team and is responsible for assigning team members correctly and must demonstrate intubation (insertion of a breathing tube) and provide ventilation of a patient with an ambu-bag and the correct oxygen support. In addition, the student must diagnose the cardiac arrhythmia, administer the correct cardiac medication, maintain a vital blood pressure, assess the breathing status and provide continuous CPR with intermittent shocks (joules) from a defibrillator if the arrhythmia dictates the algorithm. Examples of a Megacode assignment may include the management of:
- Tachycardia ACLS Algorithm
- Pulseless Electrical Activity Algorithm
- Bradycardia ACLS Algorithm
- Ventricular Fibrillation ACLS Algorithm
Assessment and Management of the Breathing Status of a Patient
Ensure patient has a secured breathing tube and is receiving adequate oxygen from wall sources or ventilator. The student will be able to measure the oxygen levels in the blood via a pulse oximeter and adjust oxygen flow accordingly.
- Working knowledge of oxygen concentrators and wall sources
- Understands the basic operation of a ventilator
- Student understands how to use an ambu-bag correctly
Diagnosis and Management of Patient Symptoms
Students must recognize cardiac and neurological signs and symptoms of conditions related to ACLS guidelines. Part of the protocols for ACLS certification is to assess and manage post conditions of cardiac arrest, stroke, blood pressure problems and fluid volume discrepancies.
- IV fluids for low blood pressure
- Morphine IV for pain
- Nitroglycerin paste dosages and purpose
- Cardiac medications that treat affect fluid volume (Lasix)
Where can I get ACLS Certification?
- ACLS Certification Online – Click Here
- American Heart Association - Click Here
- American Red Cross – Click Here
Are there Practice Test Available?
How long does ACLS certification last?
The ACLS certification needs to be kept current and is valid for two years. ACLS re-certifications are due every two years.