ACLS Systematic Approach
Every case on an ACLS course starts the same way: with a systematic approach that works whether the patient is talking to you or in cardiac arrest. It is what stops a team jumping to the wrong treatment.
The three steps
BLS assessment (responsive? breathing? pulse?) → primary assessment (airway, breathing, circulation, disability, exposure) → secondary assessment (focused history such as SAMPLE, and a search for reversible causes).
From the door: is the patient awake, breathing, and a normal colour? An unresponsive patient goes straight to the BLS assessment; a responsive patient moves to the primary assessment.
Check responsiveness, shout for help and get a defibrillator, check breathing and pulse together for no more than 10 seconds, and start CPR if there is no pulse. See the BLS algorithm.
A focused history — commonly remembered as SAMPLE: signs and symptoms, allergies, medications, past history, last meal, events — and a deliberate search for reversible causes: the H’s and T’s.
The approach is a loop: after every intervention, reassess. In the Megacode, instructors listen for the team leader saying the assessment out loud.
This guide summarises what the ACLS course teaches for education only. It is not a clinical protocol: follow the current American Heart Association guidelines, linked below, and your institution’s policies.
Other life support and first aid courses: BLS Course · PALS Course · First Aid Course · Training calendar
A structured sequence: BLS assessment, primary assessment (ABCDE) and secondary assessment.
Airway, breathing, circulation, disability and exposure.
Signs and symptoms, allergies, medications, past history, last meal and events.
For any unresponsive patient, before anything else.
In the secondary assessment, as the search for reversible causes.
Reading an algorithm is not the same as running one. Safety First Medical Services is an American Heart Association training centre on Al Reem Island, Abu Dhabi, with HeartCode, classroom and on-site ACLS and a two-year AHA ACLS Provider eCard.
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What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.
Last reviewed by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.