ACLS Cheat Sheet 2026: The Numbers to Know Under the 2025 Guidelines

ACLS Cards · Updated November 3, 2026 · Adult · 2025 guidelines · Clinical review pending

If you're heading into an ACLS course or renewal in 2026, your cheat sheet should be built on the 2025 Guidelines for CPR and Emergency Cardiovascular Care, published in October 2025. A lot of sheets still in circulation teach the 2020 numbers. This page lists the core adult numbers a current sheet should have and how to tell if yours is out of date.

How to spot an outdated sheet

Look for a guideline year first. If there isn't one, check a few numbers that changed in 2025:

Post-arrest oxygen target. A current sheet says SpO₂ 90–98%^{pending review, ref P1}. Older sheets say 92–98%^{pending review, ref P1}.
Vascular access in arrest. Current: try IV first; use IO if IV fails or isn't feasible^{pending review, ref A10}.
Endotracheal drugs. Current sheets have removed the endotracheal drug route^{pending review, ref A11}.
Atrial fibrillation cardioversion. Current: start at ≥200 J for AF and 200 J for flutter^{pending review, ref G1}, instead of escalating up from a low energy.
"SVT". The 2025 tachycardia material says narrow-complex tachycardia^{pending review, ref G10} instead.

Any one of those still showing the old version is a sign the rest of the sheet hasn't been updated either. See the full list of 2025 changes.

High-quality CPR

Metric	2025 number
Compression rate	100–120/min^{pending review, ref C1}
Compression depth (adult)	at least 2 in (5 cm); avoid more than 2.4 in (6 cm)^{pending review, ref C2}
Chest compression fraction	at least 60%; high-performing teams reach above 80%^{pending review, ref C4}
Pauses for pulse/rhythm check	10 s or less^{pending review, ref C5}
Switch compressors	every 2 min (about 5 cycles), sooner if tired^{pending review, ref C6}
Ventilation with an advanced airway	1 breath every 6 s (10/min) with continuous compressions^{pending review, ref C9}
ETCO₂ during CPR	below 10 mm Hg suggests poor quality; aim for at least 10, ideally 20 or more^{pending review, ref C13}

There's no longer a fixed breath volume to memorize: give just enough for visible chest rise^{pending review, ref C8}.

Cardiac arrest

Item	2025 number
Epinephrine	1 mg IV/IO every 3–5 min^{pending review, ref A1}. Nonshockable rhythms: as soon as feasible^{pending review, ref A2}. Shockable rhythms: after initial defibrillation attempts fail^{pending review, ref A3}.
Amiodarone (VF/pVT)	300 mg, then 150 mg^{pending review, ref A4}
Lidocaine (alternative)	1–1.5 mg/kg, then 0.5–0.75 mg/kg^{pending review, ref A5}
Biphasic defibrillation	manufacturer's recommended energy (often 120–200 J); if unknown, the device maximum; later shocks the same or higher^{pending review, ref A6}
Monophasic defibrillation	360 J^{pending review, ref A7}
After a shock	resume CPR immediately; no pulse check right after the shock^{pending review, ref A9}

Bradycardia and tachycardia

Item	2025 number
Bradycardia threshold	heart rate typically below 50/min^{pending review, ref B1} (and causing symptoms)
Atropine	1 mg IV every 3–5 min, max 3 mg^{pending review, ref B2}
Dopamine infusion	5–20 mcg/kg/min^{pending review, ref B3}
Epinephrine infusion	2–10 mcg/min^{pending review, ref B4}
Tachycardia threshold	heart rate typically 150/min or more^{pending review, ref T1}
Wide QRS	0.12 s or more^{pending review, ref T2}
Adenosine	6 mg rapid push with a flush, then 12 mg^{pending review, ref T3}
Amiodarone (stable wide-complex)	150 mg over 10 min, repeat as needed; then 1 mg/min for 6 h^{pending review, ref T6}
Synchronized cardioversion	narrow regular 100 J; monomorphic VT 100 J; AF ≥200 J; flutter 200 J^{pending review, ref T8} (device-dependent)

Walkthroughs: bradycardia algorithm explained and tachycardia algorithm explained.

Post-cardiac arrest care

Target	2025 number
Oxygen	100% FiO₂ until a reliable measurement, then SpO₂ 90–98%^{pending review, ref P1}
Ventilation	PaCO₂ 35–45 mm Hg^{pending review, ref P2}
Blood pressure	MAP 65 mm Hg or higher^{pending review, ref P3}
Temperature control	32–37.5 °C for at least 36 h if not following commands^{pending review, ref P5}
Glucose	avoid below 70 and above 180 mg/dL^{pending review, ref P8}
Prognosis	multimodal, at least 72 h after normothermia / off sedation^{pending review, ref P11}

What makes a cheat sheet actually useful

It says which guidelines it follows and cites them, so you can check it.
It's organized the way you'll think in the room: pulse or no pulse, then shockable or not, then stable or unstable. Not one giant table.
It's adult-only or clearly separated. Mixing pediatric doses onto an adult sheet is how errors happen.
A clinician has reviewed it. Ask who, and when.
It reminds you it's a study aid. Your institution's protocols and your device's settings win in real care.

Our ACLS Cheat Sheet Pack is being built to those rules: 12 original pages on the 2025 guidelines, with every number source-cited for clinician review. It isn't on sale yet. Meanwhile, the free high-quality CPR sheet is a full page from the pack.

Source: 2025 Guidelines for CPR and Emergency Cardiovascular Care (Circulation, October 2025), as summarized in the pack's source checklist. Original wording and layout; no guideline figures reproduced.