Inside a Code Blue: What to Expect in an ACLS Skills Session in Quincy, Bridgewater & Newton, MA
Written by Shelley Lynch, DNP, NP-BC, APRN, CCRN
What to Expect During Your ACLS Skills Session
When a patient becomes unresponsive, the response begins immediately. Compressions start. The cardiac monitor is assessed. Medications are prepared. Someone manages the airway while another person records each intervention. At the center of it all, a team leader must interpret information, set priorities, communicate clearly, and determine what happens next.
Advanced Cardiovascular Life Support training prepares healthcare professionals for these high-pressure situations. While CPR and defibrillation are essential components of ACLS, the course develops a much broader set of clinical, communication, and leadership skills.
For students completing a blended learning course, the in-person ACLS Skills Session is where that knowledge becomes action.
What Is an ACLS Skills Session and What Does It Evaluate?
Students taking a blended American Heart Association HeartCode® ACLS course first complete the cognitive portion of the course online. They then attend an in-person Skills Session to practice and demonstrate the hands-on techniques required during cardiac arrest and other cardiovascular emergencies.
The Skills Session is not simply a test of how well you memorized an algorithm. It evaluates your ability to recognize what is happening, choose the appropriate response, perform essential skills, communicate with a team, and adjust as a simulated patient’s condition changes.
Students have opportunities to practice, receive feedback, and become familiar with the expectations before completing the formal skills evaluation.
What to Bring and How to Prepare Before You Arrive
Students attending an ACLS Skills Session should be prepared for prerequisite verification.
You must bring:
Your online certificate of completion if you are taking a blended learning course
A valid government-issued ID
Reviewing the ACLS algorithms before your session can also help you feel more comfortable applying what you learned online. Come prepared to participate actively, ask questions, and work through realistic patient care scenarios.
In-Person ACLS Skills Sessions in Quincy, Bridgewater & Newton Center
Although the exact flow may vary, an in-person ACLS Skills Session generally includes hands-on practice, instructor coaching, real-time feedback, and a simulated megacode evaluation.
High-Quality CPR and Airway Practice
Strong ACLS performance begins with a solid foundation in Basic Life Support. Students practice chest compressions, bag mask ventilation, and airway management using manikins and training equipment.
Instructors and feedback-enabled manikins may evaluate important measures such as compression rate, depth, chest recoil, and ventilation. This allows students to make immediate adjustments and improve the quality of their technique.
Rhythm Recognition and Clinical Decision Making
Recognizing a rhythm is only the beginning. ACLS participants must connect what appears on the monitor with the patient’s overall condition and determine the next appropriate intervention.
During simulated scenarios, students may encounter cardiac arrest rhythms, bradycardia, tachycardia, and other cardiovascular emergencies. They practice determining when to continue CPR, deliver a shock, administer medication, manage an airway, or transition to another treatment pathway.
Medication Selection and Timing
ACLS training reinforces the appropriate use of medications during cardiovascular emergencies. Students must understand not only which medications may be indicated, but also their correct dosing and timing.
During a code, medication decisions must be coordinated with CPR, rhythm checks, defibrillation, and other interventions. Clear communication is essential to ensure that medications are prepared, administered, and documented correctly.
Defibrillation and Cardioversion
Students also practice coordinating electrical interventions when they are indicated. This includes operating the equipment safely, communicating with the team, and minimizing interruptions in chest compressions.
Knowing when to deliver a shock matters. So does making sure the entire team understands what is happening and is ready to proceed safely.
The Megacode Scenario
The megacode is a simulated cardiovascular emergency designed to bring multiple ACLS skills together. During the scenario, the student typically assumes the team leader role and directs the response as the patient’s condition evolves.
The team leader may be expected to:
Assign roles and responsibilities
Evaluate CPR quality
Interpret cardiac rhythms
Direct defibrillation or cardioversion
Manage medication timing
Coordinate airway support
Identify reversible causes
Adjust the treatment plan as the scenario changes
Transition to post-cardiac arrest care following return of spontaneous circulation
Official AHA algorithms and reference aids are generally permitted during the megacode. Students should follow their instructor’s guidance regarding the materials that may be used. The goal is not to recall every detail without assistance. It is to demonstrate that you can use established protocols to guide safe, organized clinical decisions.
Critical Clinical and Leadership Skills ACLS Builds Beyond Basic CPR
An ACLS Skills Session evaluates more than individual clinical tasks. It brings together several abilities that providers need during a real emergency.
Rhythm Interpretation
Students learn to connect rhythm recognition with clinical action. A rhythm must be considered alongside the patient’s symptoms, pulse, blood pressure, stability, and overall presentation.
Airway Management
Participants practice supporting oxygenation and ventilation while coordinating airway interventions with CPR and the broader resuscitation effort.
Prioritization
A code presents multiple needs at once. ACLS training helps providers identify which interventions require immediate attention and which steps should follow.
Closed Loop Communication
During closed-loop communication, a team leader gives an instruction, the team member repeats it back, and completion of the task is confirmed. This process helps prevent missed, misunderstood, or duplicated actions.
Team Leadership
The leader does not perform every task. The leader maintains situational awareness, delegates responsibilities, monitors the team’s progress, invites relevant input, and keeps everyone focused on the highest priorities.
Post Cardiac Arrest Care
ACLS care does not end when a pulse returns. Participants must be prepared to transition to post-cardiac arrest care, which may include continued airway and oxygenation support, blood pressure management, diagnostic evaluation, and coordination of the patient’s next level of care.
Leveraging the Official AHA ACLS App at the Point of Care
The AHA ACLS app is the American Heart Association’s officially endorsed digital health resource for clinicians delivering ACLS care at the bedside. Developed by Harvard-trained physicians in collaboration with the AHA and Massachusetts General Hospital, the app provides rapid access to four major ACLS pathways:
Cardiac arrest
Tachycardia with a pulse
Bradycardia with a pulse
Post-cardiac arrest care
The subscription-based app also includes drug therapy and dosing information, reversible causes, timers for CPR and other interventions, intubation logging, and tools for recording non-PHI information during an event. Its content has been updated to reflect the latest science from the 2025 AHA Guidelines for CPR and Emergency Cardiovascular Care.
The app can provide valuable support at the point of care, but it does not replace ACLS training, clinical judgment, or an organization’s emergency response protocols. Training gives providers the foundation to understand the algorithms, recognize when they apply, and use clinical resources effectively.
Learn From Greater Boston’s Top Clinical Instructors at ACLS Academy
It is normal to feel some nervousness before an ACLS Skills Session, especially if you are newer to emergency care or have not participated in a megacode recently.
At ACLS Academy, students are supported by certified AHA instructors who are also experienced healthcare professionals. They understand what it feels like to respond during a real clinical emergency and bring that perspective into the classroom.
Instructors provide hands-on coaching, answer questions, offer real-time feedback, and help students translate online learning into practical performance. The environment is designed to strengthen skills and identify opportunities for improvement, not to make the experience unnecessarily intimidating.
This approach reflects ACLS Academy’s philosophy: For Providers, by Providers.
Book Your ACLS Skills Session in Quincy, Bridgewater, or Newton Center
An ACLS Skills Session gives healthcare professionals the opportunity to practice complex decisions in a realistic but supportive environment. Students develop more than the ability to perform CPR or follow an algorithm. They practice interpreting rhythms, managing airways, coordinating medications, communicating with a team, leading under pressure, and supporting a patient after cardiac arrest.
These are skills that become stronger through practice.
Register for an upcoming ACLS course or Skills Session.
Learn More
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ACLS Academy is an American Heart Association Training Center providing high-quality healthcare and emergency response education in Quincy, Bridgewater, and Newton Center, Massachusetts. Guided by our “For Providers, by Providers” philosophy, ACLS Academy offers ACLS, ACLS EP, BLS, PALS, PALS Plus, PEARS, ASLS, NRP, TNCC, ENPC, Heartsaver CPR and AED, First Aid, Stop the Bleed, Bloodborne Pathogens, Fetal Heart Monitoring, ECG and pharmacology preparation, and AHA instructor courses. Our experienced instructors combine current guidelines, hands-on practice, and real-world clinical insight to help healthcare professionals strengthen their knowledge, skills, and confidence.