Three certifications. Overlapping acronyms. And depending on your role, your specialty, and your employer, the requirements are different for every one of them.
This is the definitive breakdown: what each certification covers, who needs it, and how to know which ones apply to your clinical role.
What Is BLS?
Basic Life Support (BLS) is the foundational certification for recognizing and responding to cardiopulmonary emergencies. It covers high-quality CPR for adults, children, and infants, AED use, and relief of foreign body airway obstruction.
BLS is the entry-level standard. It is required for virtually every clinical role across all healthcare settings — from nursing assistants to attending physicians.
Who needs BLS:
- Registered nurses (all specialties)
- Licensed practical nurses
- Medical assistants
- Dental hygienists and dentists
- Respiratory therapists
- Physical and occupational therapists
- Physicians (all specialties)
- Most clinical staff in any direct patient care setting
If you have direct patient contact, you almost certainly need current BLS certification.
What Is ACLS?
Advanced Cardiovascular Life Support (ACLS) builds on BLS with the algorithms, pharmacology, and team leadership skills required to manage cardiac arrest, acute coronary syndromes, stroke, and life-threatening arrhythmias in adult patients.
ACLS covers the full cardiac arrest algorithm, ACLS drug protocols and dosages, ECG rhythm recognition, post-cardiac arrest care, and stroke and acute coronary syndrome management. It is the standard for any clinician who may be called on to lead or participate in an advanced resuscitation effort.
Who needs ACLS:
- Emergency nurses and ED staff
- ICU and critical care nurses
- Cardiac care and step-down unit nurses
- Nurse practitioners (NPs) in acute care and emergency settings
- Certified Registered Nurse Anesthetists (CRNAs)
- Physician assistants in high-acuity settings
- Emergency physicians, hospitalists, and intensivists
- Paramedics and advanced EMTs
- Perioperative and procedural staff
Travel nurses placed in high-acuity settings are almost always required to hold current ACLS certification before placement.
What Is PALS?
Pediatric Advanced Life Support (PALS) applies ACLS-level resuscitation principles to pediatric patients — infants, children, and adolescents. It covers recognition and management of pediatric respiratory emergencies, shock, and cardiac arrest, including weight-based drug dosing and pediatric-specific algorithms.
Who needs PALS:
- Pediatric nurses and PICU staff
- Neonatal and pediatric ICU nurses
- Pediatric emergency nurses
- Pediatricians and pediatric hospitalists
- Family medicine physicians with pediatric patient populations
- NPs and PAs in pediatric or general acute care settings
- Pediatric transport and flight nurses
PALS is not required for every clinician — it is specifically required for roles where you may need to manage a critically ill pediatric patient.
BLS vs. ACLS vs. PALS: The Comparison
| BLS | ACLS | PALS | |
| Patient population | Adults, children, infants | Adults | Infants, children, adolescents |
| Scope | CPR, AED, airway obstruction | Cardiac arrest, arrhythmias, ACS, stroke | Respiratory failure, shock, cardiac arrest |
| Who requires it | All direct care clinicians | ED, ICU, CCU, anesthesia, acute care | Pediatric and PICU, peds emergency |
| Level | Foundational | Advanced | Advanced (pediatric) |
| ACI cost | $69 new / $49 renewal | $149 new / $109 renewal | $149 new / $109 renewal |
How to Know Which Certifications Your Role Requires
The fastest way to confirm your requirements is to check with your employer’s HR or education department directly. You can also reference your facility’s credentialing requirements or the job posting for your position — certification requirements are almost always listed.
As a general framework:
- All clinical staff in direct patient care: BLS
- Acute care, emergency, and critical care settings: BLS + ACLS
- Pediatric or mixed pediatric/adult critical care settings: BLS + ACLS + PALS
- Advanced practice providers (NP, CRNA, PA) in high-acuity settings: BLS + ACLS, often PALS
Can You Earn All Three Online?
Yes. ACI offers BLS, ACLS, and PALS — all 100% online, with no skills test required. Each course follows the 2020–2025 ILCOR and ECC guidelines and is accredited by the Postgraduate Institute for Medicine (PIM). AMA PRA Category 1 Credits™, ANCC, ACPE, and ADA credits are awarded.
Certifications are accepted in all 50 states and internationally, and are compliant with The Joint Commission’s standards on resuscitation education.
ACLS, and PALS recertification: $109 each. New certification: $149 each. BLS recertification $49, New $69
