ACLS

Editorial Team / Admin · Dec 21, 2014

The two day course consists of classroom time with videos, lecture, and a written test. The mega code is indeed like walking into a patient room and finding them unresponsive. Each person may have the opportunity to fill each role in the code team during the code- running it, medications, defibrillator, etc., and don't worry if your "patient" during the mega code dies- very few manage to survive, at least in my facility's ACLS classes.

marpe9 · Dec 21, 2014

Thank you for the information. What happens if we fail the course?

SierraBravo · Dec 21, 2014

Our instructors were very supportive and helped guide us along if we got stuck. If you fail the written exam our institution allows you to remediate once. ACLS can be overwhelming, especially for a new nurse. But don't worry, if you read the book and pay attention to the videos and lecture you will be fine. For the mega code, you will rotate to different stations on the patient (i.e. meds, compressions, etc..) so each person has an opportunity to do each set of skills. The instructor will select a rhythmn on the monitor and you will have to recognize it and respond appropriately. We were allowed to use the algorhythm cards during the mega code.

Katie71275 · Dec 21, 2014

Day 1 we did a pretest with rhythms and went over information as well as practiced on the dummies. Day 2 we did a practice mega code and then the real thing and then the test. For the mega code, our patient may be a patient or visitor found unresponsive and they changed rhythms multiple times throughout and you had to know how to treat them(meds, cardiovert, defibrillator, etc). It wasn't as bad as I thought it was going to be. We couldn't use any algorithm cards during the code, but our team could help a little.

marpe9 · Dec 21, 2014

Thanks guys. What happens if we fail the megacode or are unable to ID a rhythm? :// sorry for all the questions. Just extremely nervous.

firstinfamily, RN · Dec 23, 2014

Usually if you fail the test you can re-take it, once. I am not sure about failing the mega code. Study the EKG rhythms, and look for identifying marks----elevated heart rate versus very slow heart rate. There are good review courses on line (free) by going to the American Heart Assoc. web site. ACLS can be very overwhelming, but it truly prepares you for getting a patient through a code. You still will not be able to save everyone, but you will feel more comfortable in a code situation with the ACLS knowledge. Focus on the primary EKG's V-tach(pulseless and with pulse), V-Fib, Second and Third degree blocks, know what PEA is and how to treat it---look for causative factors etc. Just prepare yourself and you will do fine. I always had to decipher the book into a format that was more learner friendly for me and I usually made up index cards to help me study, review the cardiac meds and understand when you give what and total amount of allowable dose. You are there to learn, and it should be a good learning experience for you!!!

classicdame, MSN, EdD · Dec 23, 2014

If you fail just the test you must repeat within 2 weeks. If you fail test and megacode you repeat course.

In the back of your book is the checklists your instructors will use to check your competency. Go thru them line by line. Then cover the second line and try to determine what it SHOULD be. Check that answer and if correct, go to the next line. If not correct, look it up in the book so you learn the rationale behind each step and it's order. You only need to know the shockable rhythms. The others will just require you to continue CPR. Good luck!

RunBabyRN · Dec 24, 2014

Thanks guys. What happens if we fail the megacode or are unable to ID a rhythm? :// sorry for all the questions. Just extremely nervous.

We had a guy who just kept stumbling through the megacode, and the instructor let him try again after a few of us went.

I think all of us were new to this when I did it. Don't worry- if you study, you'll be okay. Did they give you access to the online modules? There are codes you run (one toward the end is particularly tough to pass), and it REALLY drills it all into you.

akulahawkRN, ADN, RN, EMT-P · Dec 24, 2014

ACLS is a lot easier than it used to be. There used to be more meds for each algorithm and now there are a very few meds. The two day course basically introduces you to running a code and gets you familiar with the drugs, dosages, EKG rhythms, and what you do for each. There are only a very few shockable rhythms and there are a few times you might want to use the pacer.

The one very good thing about ACLS is that it puts everyone on a common page as it's basically a recipe that everyone knows how to follow. The other thing that's good about ACLS is because everyone knows the "recipe" it allows you to search for correctable causes of the problem.

Posters above have described the general flow of the 2 day course. If you're relatively new or are taking the course for the first time, try to partner up or be in a group with people that have taken the course before or have already have been well-drilled in the information. Don't discount Paramedics as this stuff is very much what they do and often they're very much used to being team lead. You'll get to practice being team lead and you'll do more of it during your Megacode.

As far as the Megacode goes, don't stress about it. By the time you get to doing it, you've seen all the material you'll need to pass it and it's actually pretty straightforward, nothing tricky about it. You'll have a patient, monitor, drugs, etc and chances are really good that you'll see several rhythm changes during the code. You'll have seen those rhythms before and there won't be any that are a surprise to you.

While failing ACLS is possible, few people do. Those that do really don't do their homework, don't study, don't pay attention in class, and don't perform well at all in the Megacode as a result.

applewhitern, BSN, RN · Dec 24, 2014

ACLS has been "dumbed down" compared to what it once was. Perhaps you have heard rumors from older nurses about how hard it is. It USED to be hard, but they have taken so much stuff away from it, it is pretty simple and easy now. A lot of the code meds have been discontinued, and you no longer have to intubate. We used to do a mega-code by ourselves, but now it is done mostly in groups. Just read the book and write down everything the instructors say.

akulahawkRN, ADN, RN, EMT-P · Dec 24, 2014

ACLS has been "dumbed down" compared to what it once was. Perhaps you have heard rumors from older nurses about how hard it is. It USED to be hard, but they have taken so much stuff away from it, it is pretty simple and easy now. A lot of the code meds have been discontinued, and you no longer have to intubate. We used to do a mega-code by ourselves, but now it is done mostly in groups. Just read the book and write down everything the instructors say.

You're very much right about that. It's a lot simpler than it was. Some of that has to do with some meds now in use being able to be used in multiple situations. Intubation is one of those skills that is easy in theory and dropping a tube in a mannequin is pretty easy. Doing it for "real" is a bit more difficult. One of the reasons I usually suggest that people partner up with a Paramedic is that they're usually pretty well drilled in this stuff. Their licensing exam has a practical portion where they run a megacode on their own. They're going to know the drugs, dosages, rhythms, when to shock, and so on. For them, a formal ACLS class is usually a formality by the time they're taking the class for certification/recognition.

When I first took ACLS, the VF algorithm meds were, in order, epi, Lido, Bretyllium, Mag sulfate, and Procainamide. Because of the timing of the drug admin, it took quite a while to reach the end. That's just an example... From what I recall, it used to be even more difficult and actual failure was very much possible.