ACLS study guide: our blueprint, a 7-day plan and the provider manual

Blueprint

An ACLS blueprint: seven topics, our estimate

The ACLS written exam is built around case questions, and almost every case lands in one of seven topic areas. Cardiac arrest leads, bradycardia and tachycardia with a pulse come next, and CPR and airway are close behind. Rhythm recognition and pharmacology look small on their own because most strip and drug questions hide inside the arrest and tachycardia cases.

Contents

The guides in this study guide

Two depth guides are live; four more topics are planned. Each topic already has a section to study from:

• ACLS algorithms

  Cardiac arrest (VF/pVT, PEA and asystole), bradycardia and tachycardia, drawn as flowcharts.

  Live · est. Cardiac arrest 20% + brady/tachy 18%

• H's and T's

  The reversible causes of arrest and how a question stem hides them.

  Live · est. inside cardiac arrest

• Tachycardia with a pulse

  SVT, wide-complex rhythms, torsades and atrial fibrillation.

  Planned guide · est. part of 18%

• Bradycardia with a pulse

  Atropine, pacing and infusions, case by case.

  Planned guide · est. part of 18%

• Rhythm recognition

  Strips side by side: shockable or not.

  Planned guide · est. 12% with pharmacology

• ACS and stroke

  Reperfusion windows, stroke scales and the CT question.

  Planned guide · est. 14%

• Tachycardia and bradycardia with a pulse: the tachycardia flowchart and the bradycardia flowchart.
• Rhythm recognition: the labeled strips on the precourse page.
• ACS and stroke: the ACS section and the stroke section.

7 days

A 7-day ACLS study plan

Seven days is enough for most people renewing a card and for many taking ACLS for the first time. Each day is about an hour: read one topic, then test it.

1. 01Day 1: the precourse self-assessment

   Every student completes the precourse self-assessment before class. Do the precourse practice cards first, then the real one; the line is 70%, and you can retake it until you reach the line.

2. 02Day 2: cardiac arrest

   VF and pulseless VT, then PEA and asystole, on the cardiac arrest flowchart. Finish with the H's and T's cards.

3. 03Day 3: bradycardia and tachycardia

   One question first for both: is the patient stable? Then bradycardia and tachycardia.

4. 04Day 4: ACS, stroke and post-arrest care

   Time windows and targets: ACS, stroke, then care after ROSC.

5. 05Day 5: CPR, airway and the team

   The numbers on the card above, then two Megacode cases read out loud as if you were leading.

6. 06Day 6: one full practice test

   Take the 60-card practice test in one sitting and look at the per-topic bars on the score card.

7. 07Day 7: your weakest topic

   Reread the lowest bar from day 6, then take the practice questions in that topic only. Stop when two sets in a row feel routine.

A quick ACLS review, if you only have one evening

Spend it on cardiac arrest: the shockable and non-shockable branches, when the first epinephrine goes in for each, and the reversible causes. Then do twenty practice cards. Arrest cases sit at the center of the Megacode too, so this hour pays twice.

BLS

CPR, airway and team dynamics

This topic carries more of the exam than most people expect: high-quality CPR, the airway and how the team talks are tested in the written exam and again in the skills tests, which include a high-quality BLS (adult CPR and AED) skills test, an airway management skills test and the Megacode. BLS provider skills are expected before you start, so these questions assume you know BLS and ask what changes once an advanced team arrives.

From the 2025 AHA Guidelines for adult basic and advanced life support. Study notes for the course exam, not treatment instructions.

Chest compression fraction (CCF)

CCF is the share of the arrest during which someone is actually compressing the chest. Every pause counts against it: a slow rhythm check, a long pulse check, stopping to place an airway that could have gone in during compressions. In the exam, the answer that keeps compressions going while something else happens is usually the right one, and the 2025 Guidelines say the advanced airway can wait if placing it would interrupt CPR.

Team dynamics and closed-loop communication

Team questions read like common sense until you are under time pressure. The pattern the exam rewards: the leader gives one order to one named person, that person repeats it back, and reports when it is done (“Epinephrine 1 mg in”). That is closed-loop communication. Expect questions on swapping compressors at each rhythm check, on what to do with an order you think is wrong (say so, with the reason), and on the leader keeping their hands free.

The Megacode page runs these roles through practice cases.

Manual

The ACLS provider manual

The ACLS Provider Manual is the AHA’s student book for the course; its full title is the Advanced Cardiovascular Life Support Provider Manual. The current edition follows the 2025 AHA Guidelines for CPR and Emergency Cardiovascular Care. It covers the systematic approach to a patient, high-quality BLS, team dynamics and systems of care, and the ACLS cases one by one: respiratory arrest, ACS, stroke, cardiac arrest, post-arrest care, bradycardia and tachycardia.

Do you need the provider manual?

Probably yes. Many Training Centers expect each student to have the current manual, in print or as an eBook, before class, and the written exam is open resource at most Training Centers, so the provider manual and your notes are usually allowed. Your enrollment email or your instructor will say which applies. You get it from your Training Center or the AHA online shop (opens the AHA site).

Is the 2020 provider manual still usable?

Not for this exam. Instructors moved to 2025 materials by March 1, 2026, and the older book teaches the earlier drug-access, post-arrest oxygen and temperature rules. A borrowed 2020 or 2015 manual is fine for background reading; when it disagrees with a 2025 source, go with 2025.

FAQ

Questions people ask