ACLS (Advanced Cardiac Life Support) and PALS (Pediatric Advanced Life Support) are advanced certifications designed for healthcare providers who manage life-threatening emergencies in adult and pediatric patients. Both build on a foundation of Basic Life Support and require passing a written exam and demonstrating clinical skills in simulated emergency scenarios. Certifications are valid for two years and are available in traditional classroom and blended learning formats.
What Is the Difference Between BLS, ACLS, and PALS?
Basic Life Support, Advanced Cardiac Life Support, and Pediatric Advanced Life Support are three distinct levels of emergency care training. Understanding where each fits helps healthcare providers and aspiring medical professionals choose the right certification path.
Basic Life Support is the starting point. It covers high-quality CPR, AED use, and relief of airway obstruction for adults, children, and infants. BLS is designed for a wide range of professionals including lifeguards, coaches, teachers, dental assistants, and anyone who may be first on scene. It is the foundational certification that all healthcare providers are expected to hold before advancing.
ACLS and PALS are built on top of that BLS foundation. They are not entry-level courses. They require a current BLS certification before enrollment and are intended for professionals who work in high-acuity clinical environments where patients may be in cardiac arrest, respiratory failure, or shock.
The key distinction between ACLS and PALS is the patient population. ACLS focuses on adult emergencies including cardiac arrest, acute coronary syndromes, and stroke. PALS focuses on critically ill infants and children, using age-specific assessment tools and treatment algorithms.
BLS Certification: The Foundation You Need First
Before enrolling in ACLS or PALS, providers must hold a current BLS certification. BLS training covers CPR for all age groups, use of an automated external defibrillator, rescue breaths, and the early recognition of life-threatening emergencies. Without those foundational skills, the clinical scenarios and written exam in ACLS and PALS courses would be extremely difficult to complete successfully. If you have not yet completed BLS training, that is the right place to start.
Which Healthcare Providers Need ACLS or PALS Certification?
ACLS certification is required for healthcare providers working in critical care, emergency medicine, and other high-acuity settings. This includes paramedics, emergency physicians, nurses working in ICUs or emergency departments, anesthesiologists, dentists performing sedation, and pharmacists working in hospital settings. If your role puts you in direct contact with patients who may experience cardiac arrest or another acute cardiovascular emergency, your employer or licensing body will likely require ACLS.
PALS certification is required for anyone who responds to pediatric emergencies. This includes pediatric nurses, pediatric intensivists, emergency department staff, pediatricians, and paramedics who respond to calls involving infants and children. ICU staff working in pediatric units and ER personnel are also required to hold PALS certification.
Both certifications are essential for professionals who want to advance to leadership roles within a resuscitation team. The courses train not just individual clinical skills, but also the team dynamics, communication frameworks, and structured team leadership roles that determine outcomes in a real code room.
What Is ACLS Certification and What Does It Cover?
Advanced Cardiac Life Support certification equips healthcare providers with the skills to manage life-threatening emergencies in adults. The course goes well beyond CPR. Providers learn to recognize and manage cardiac arrest, acute coronary syndromes, stroke, and other cardiovascular emergencies using a structured algorithmic approach.
A major component of ACLS training is EKG interpretation. When a patient is in an arrhythmia, the team leader must identify the type of arrhythmia before any intervention can be initiated. The two arrhythmias that respond to shock treatment with an automated external defibrillator are ventricular fibrillation and ventricular tachycardia. ACLS providers learn to read the rhythm, integrate it with the patient’s vital signs, and make rapid treatment decisions.
Pharmacological interventions are also central to ACLS training. Epinephrine is the most commonly used drug in cardiac arrest management, supporting cardiac output and promoting blood flow. Amiodarone, an antiarrhythmic medication, is used in severe cases of irregular heartbeat when other interventions have not been effective. Providers also learn to identify and address reversible causes of cardiac arrest using the Hs and Ts framework: Hypoglycemia, Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hyperkalemia, Hypothermia, Toxins, Trauma, Cardiac tamponade, Pulmonary embolism, Tension pneumothorax, and Thrombosis.
Studies indicate that having ACLS-certified teams can increase patient survival rates by up to 30% during active cardiac arrest. That number reflects not just individual clinical knowledge, but the collective benefit of structured team leadership, closed-loop communication, and rapid coordinated response.
ACLS Course Format and Completion Requirements
ACLS is available in two learning formats: traditional classroom and blended learning. The traditional all-in-class provider course takes 14 hours to complete. The blended learning format combines a self-paced online section with a 10-hour in-class session.
Both formats require participants to complete all sections of the course, including practical scenarios and a written exam. Passing both components is required to receive the ACLS completion card. The certification is valid for two years.
ACLS Provider vs. ACLS Renewal: What’s the Difference?
The ACLS provider course is for those completing initial certification. The renewal course is available to providers who are already certified and confident in their skills. Renewal training is shorter: 8 hours of in-class training for the traditional format, or 6 hours in-class following the online section for the blended learning format.
Renewal courses still require passing the written exam and demonstrating clinical competency. Simply completing the hours is not sufficient for recertification.
Blended Learning Course Options for ACLS and PALS
Both ACLS and PALS are offered in blended learning formats that give busy healthcare providers flexibility. The blended learning course splits instruction between a self-directed online module and a structured in-class session where skills are practiced and assessed. For ACLS, the in-class component is 10 hours for initial certification and 6 hours for renewal. For PALS, the in-class component is 9 hours for initial certification and 5 hours for renewal. The online sections can be completed at the learner’s own pace before attending the in-class day.
Build the BLS Foundation Your Advanced Training Requires
ACLS and PALS both require a current BLS certification. Complete or renew your BLS with hands-on, instructor-led training before your next advanced course.
What Is PALS Certification and Who Needs It?
Pediatric Advanced Life Support certification provides healthcare providers with a systematic approach to assessing and resuscitating critically ill infants and children. The course teaches providers to recognize and manage respiratory distress, respiratory failure, shock, and cardiac arrest in pediatric patients using age-appropriate algorithms and equipment.
PALS training is built around the PALS treatment algorithms, which guide providers through a structured assess-identify-intervene sequence. Providers learn to recognize the early warning signs of deterioration before a child reaches full cardiac arrest, which is where early recognition has the greatest impact on outcomes.
Key skill areas covered in PALS include high-quality CPR for infants and children, airway management, management of respiratory emergencies including upper and lower airway obstruction, vascular and intraosseous access, recognition and treatment of shock, arrhythmia recognition, and post-cardiac arrest care.
The course also places significant emphasis on high-performance teams. In a pediatric code, every member of the team has a defined role. PALS training teaches providers how to lead and participate in those teams effectively, with clear communication frameworks, mutual support, and role clarity that directly affects patient outcomes.
PALS Provider Course: Format and Completion Requirements
The PALS provider course is available in traditional and blended learning formats. The traditional course requires 14 hours of in-class training. The blended learning course requires completing the online module followed by 9 hours of in-class training.
Participants must complete all course sections, including acting as team leader in at least two core case scenarios. Scenarios cover a range of pediatric emergencies: upper and lower airway obstruction, lung tissue disease, obstructive shock, and bradycardia. Participants must also pass the written exam to receive certification. PALS certification is valid for two years. Renewal is available for providers who are active in practice and confident in their skills, requiring 6 hours in-class for the traditional format or 5 hours in-class following the online section for the blended format.
The Systematic Approach in PALS Assessment
A core feature of PALS training is the Systematic Approach Algorithm, which guides providers through a rapid, structured assessment of any critically ill child. The algorithm uses an initial impression followed by a primary assessment, a secondary assessment, and targeted interventions. This evaluate-identify-intervene sequence allows providers to act quickly and consistently, even under the pressure of a pediatric emergency. Mastering this approach before arriving at a PALS course significantly improves performance in the clinical scenarios.
Train Your Whole Clinical Team Together
Coordinate BLS, ACLS, and PALS certification across your department with a private group session. Keep your team’s renewal dates aligned and reduce scheduling disruption.
How Do ACLS and PALS Work Together During a Medical Emergency?
In a hospital or emergency setting, ACLS and PALS represent parallel but distinct response pathways. An adult in cardiac arrest triggers an ACLS response. A child in respiratory failure or cardiac arrest triggers a PALS response. What both share is a commitment to structured team leadership, effective communication, and rapid algorithmic decision-making.
Both certifications train providers to manage a code room with defined communication frameworks, clear role assignments, and shared situational awareness. Effective team dynamics during a code are not incidental: research consistently links structured team leadership with improved patient survival outcomes.
Both certifications also share the same foundational principle: the Chain of Survival. Early recognition, early CPR, early defibrillation when indicated, and then escalation to ACLS or PALS-level interventions. The BLS skills providers learn first do not become irrelevant when they advance. They become the base on which every ACLS and PALS intervention is built.
For healthcare providers who work in settings that serve both adult and pediatric patients, holding both certifications is common practice. Emergency departments, community hospitals, and critical care transport teams regularly require staff to maintain both ACLS and PALS alongside their current CPR/AED certification.
How to Prepare for Your ACLS or PALS Course
Arriving well-prepared for ACLS or PALS makes a significant difference in both performance and confidence during the in-class sessions.
For ACLS preparation, focus on reviewing current BLS skills for adults, familiarizing yourself with EKG rhythms and the difference between shockable and non-shockable rhythms, reviewing the ACLS algorithms for cardiac arrest and post-cardiac arrest care, understanding the pharmacology of epinephrine and amiodarone, and reviewing airway management techniques including advanced airway devices.
For PALS preparation, focus on reviewing BLS skills for infants and children, studying the Systematic Approach Algorithm and the evaluate-identify-intervene sequence, learning the PALS treatment algorithms for respiratory and shock emergencies, familiarizing yourself with pediatric drug dosages and the drugs used in PALS algorithms, and understanding the differences in pediatric anatomy and physiology that affect assessment and airway management.
Both courses are more approachable when providers come in with a strong BLS foundation. If your BLS certification has lapsed or you are due for renewal, completing BLS training before enrolling is strongly recommended.
Key Takeaway
ACLS and PALS are the advanced certifications that prepare healthcare providers to manage the most critical emergencies in adult and pediatric patients. Both build on a current BLS certification, are valid for two years, and are available in traditional and blended learning formats. Mastery of team leadership, algorithmic decision-making, and effective communication in the code room are what separate providers who hold these certifications from those who do not.
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Frequently Asked Questions: ACLS and PALS Certifications 2025
Q1: What is the difference between ACLS and PALS?
A: ACLS (Advanced Cardiac Life Support) is designed for healthcare providers managing life-threatening emergencies in adults, including cardiac arrest, acute coronary syndromes, and stroke. PALS (Pediatric Advanced Life Support) is designed for providers managing emergencies in infants and children, with a focus on respiratory distress, shock, and pediatric cardiac arrest. Both certifications require a current BLS certification before enrollment, are valid for two years, and are available in traditional and blended learning formats.
Q2: Who needs ACLS certification?
A: ACLS certification is required for healthcare providers working in critical care, emergency medicine, and other high-acuity settings. This includes paramedics, emergency physicians, ICU and emergency department nurses, anesthesiologists, dentists performing sedation, and pharmacists in hospital settings. Any provider who may be responsible for managing a cardiac arrest or acute cardiovascular emergency in an adult patient should hold ACLS certification. Most hospital employers and licensing bodies require it for roles in these settings.
Q3: Who needs PALS certification?
A: PALS certification is required for healthcare providers who respond to pediatric emergencies. This includes pediatric nurses, pediatricians, emergency department staff, pediatric intensivists, and paramedics who respond to calls involving infants and children. ICU staff working in pediatric units and ER personnel are also typically required to hold PALS. Any provider whose scope of practice includes the assessment and treatment of critically ill infants or children should maintain a current PALS certification.
Q4: Do I need BLS before taking ACLS or PALS?
A: Yes. A current BLS certification is required before enrolling in either ACLS or PALS. Both courses build directly on the CPR and AED skills taught in BLS training. Arriving without a solid BLS foundation makes the clinical scenarios and written exam significantly more difficult. If your BLS certification has lapsed or you have not yet completed BLS training, that should be your first step before pursuing ACLS or PALS.
Q5: How long is ACLS certification valid?
A: ACLS certification is valid for two years from the date of completion. After two years, providers must complete a renewal course to maintain their certification. Renewal courses are shorter than the initial provider course but still require passing the written exam and demonstrating clinical competency in simulated scenarios. Renewal is available in traditional and blended learning formats, with in-class components of 8 hours (traditional) or 6 hours (blended).
Q6: How long is PALS certification valid?
A: PALS certification is valid for two years from the date of completion. Providers who are actively using their skills can complete a PALS renewal course rather than repeating the full provider course. Renewal requires 6 hours of in-class training for the traditional format or 5 hours in-class following the online component for the blended format. All renewal participants must pass the written exam and complete the required clinical skills demonstrations to receive a renewed certification.
Q7: What is blended learning for ACLS and PALS?
A: Blended learning is a course format that combines a self-paced online module with a structured in-class skills session. For ACLS, the in-class component is 10 hours for initial certification and 6 hours for renewal. For PALS, the in-class component is 9 hours for initial certification and 5 hours for renewal. The online section can be completed at the learner’s own pace before the scheduled in-class day. Blended learning is a flexible option for healthcare providers with demanding clinical schedules who still need to meet certification requirements.
More FAQs: Advanced Life Support Training
Q8: What topics are covered in ACLS training?
A: ACLS training covers cardiac arrest management, EKG interpretation, recognition and treatment of arrhythmias, acute coronary syndromes, stroke, post-cardiac arrest care, pharmacological interventions including epinephrine and amiodarone, advanced airway management, and the Hs and Ts framework for identifying reversible causes of cardiac arrest. The course also trains providers in team leadership and communication frameworks for managing a code. Both written knowledge and hands-on clinical skills are assessed.
Q9: What topics are covered in PALS training?
A: PALS training covers the systematic assessment of critically ill infants and children, recognition and management of respiratory distress and respiratory failure, shock recognition and treatment, pediatric cardiac arrest management, airway management, intraosseous and vascular access, PALS treatment algorithms, arrhythmia recognition, post-cardiac arrest care, and high-performance team dynamics. The course uses simulated case scenarios to develop both individual clinical skills and team leadership abilities in pediatric emergency situations.
Q10: Can I take ACLS and PALS at the same time?
A: Yes. Some providers complete both certifications in the same training period, particularly those transitioning into roles that require both, such as emergency department or critical care transport positions. ACLS and PALS are separate courses with distinct content and separate completion cards. Each requires its own written exam and clinical skills assessment. Completing both does require a current BLS certification as the common prerequisite, and providers should be comfortable with BLS skills before attempting either course.
Q11: What is the Systematic Approach Algorithm in PALS?
A: The Systematic Approach Algorithm is a structured framework used in PALS to guide providers through the rapid assessment and treatment of critically ill infants and children. It begins with an initial impression, moves through a primary assessment of airway, breathing, circulation, disability, and exposure, then proceeds to a secondary assessment and targeted interventions. The evaluate-identify-intervene sequence allows providers to act consistently and efficiently under the pressure of a pediatric emergency. Mastering this algorithm is a central goal of PALS training.
Q12: What is the Chain of Survival and how does it relate to ACLS and PALS?
A: The Chain of Survival is a framework that describes the sequence of actions needed to maximize survival from cardiac arrest. The links include early recognition, early CPR, early defibrillation when appropriate, and then escalation to advanced life support interventions through ACLS or PALS. BLS training covers the first three links. ACLS and PALS pick up at the advanced intervention stage. Both certifications reinforce all links in the chain, because a strong resuscitation outcome depends on the entire sequence being executed correctly.
Q13: What are the Hs and Ts in ACLS?
A: The Hs and Ts are a memory framework used in ACLS to identify reversible causes of cardiac arrest. The Hs include Hypoglycemia, Hypovolemia, Hypoxia, Hydrogen ions (acidosis), Hyperkalemia, and Hypothermia. The Ts include Toxins, Trauma, Cardiac tamponade, Pulmonary embolism (Thromboembolism), Tension pneumothorax, and Thrombosis (myocardial infarction). During a code, the ACLS team leader works through this checklist to ensure no treatable cause is missed. Identifying and correcting a reversible cause can change the outcome of a resuscitation.
Q14: How do ACLS and PALS training improve team performance?
A: Both ACLS and PALS training place significant emphasis on high-performance team dynamics. Providers learn to communicate using closed-loop communication, maintain clear role assignments, and support one another during complex resuscitations. A core focus of both courses is managing a code room with defined communication frameworks and structured team leadership roles. Research consistently links this kind of structured team approach with improved patient survival rates. The skills developed in simulated scenarios are directly transferable to real emergency situations.
Q15: How do I maintain my ACLS and PALS certifications long-term?
A: Both ACLS and PALS certifications must be renewed every two years. Renewal courses are available in traditional and blended learning formats and are shorter than the initial provider courses. To stay current, providers should actively use their skills in practice, review updated guidelines as they are released, and register for renewal before their certification lapses. Holding current certifications in BLS, ACLS, and PALS together represents the complete advanced life support credential set for most hospital-based and pre-hospital healthcare providers.
Sources & Expert Review
This article was written by Ashkon Pourheidary (B.Sc. Hons Neuroscience, Canadian Red Cross certified since 2011) and reviewed for clinical accuracy. Course format and hour requirements are based on current guidelines for ACLS and PALS provider and renewal courses.
For current Canadian resuscitation guidelines, refer to the Heart and Stroke Foundation of Canada. Coast2Coast First Aid & Aquatics is a certified Canadian Red Cross Training Partner.
