PALS vs. ACLS: Understanding the Differences

PALS and ACLS are both life-saving techniques designed by the American Heart Association. They are both clinical interventions implemented to resuscitate patients or artificially sustain life. However, paramedics and health care providers use them with different patient populations under life-threatening circumstances. Let’s discuss the difference between ACLS and PALS.

What is Advanced Cardiac Life Support?

ACLS stands for Advanced Cardiac Life Support. It refers to healthcare professionals’ guidelines for treating life-threatening emergencies, ranging from arrhythmias to cardiac emergencies. Successful Advanced Cardiac Life Support treatment generally requires a team of trained individuals. Typical team roles include:

• Leader
• Back-up leader
• 2 CPR performers
• Airway management/respiratory specialist
• IV access and medication administration specialist
• Monitor/ defibrillator attendant
• Pharmacist
• Lab member to send samples
• Recorder to document the treatment.

For in-hospital events, these members are frequently physicians, mid-level providers, nurses, and allied health providers. In contrast, for out-of-hospital events, these teams are usually composed of a small number of EMTs and paramedics.

What is PALS?

PALS stands for Pediatric Advanced Life Support. It refers to protocols to guide responses to life-threatening clinical events involving children and infants. When treating pediatric patients with severe illnesses or injuries, every action can be the difference between life and death, and the goal of PALS is to save their life. The guidelines in Pediatric Advanced Life Support have been developed from a thorough review of available protocols, case studies, and clinical research, reflecting the consensus opinion of experts in the field.

What’s the Difference Between PALS and ACLS?

The primary difference between ACLS and PALS is the treatment recipient. ACLS treats adults, while PALS treats children. For urgent care or emergency care, ACLS is an essential clinical intervention for any emergency medical team. Therefore, one of ACLS’s primary functions is treating adults’ cardiac arrest or other cardiopulmonary emergencies. However, the American Heart Association also emphasizes the need to begin ACLS interventions in “peri-arrest,” or early stages leading up to the full cardiac arrest, when adults exhibit symptoms of impending cardiopulmonary events. Some main ACLS techniques include ventilation, tracheal intubations, defibrillations, and intravenous (IV) infusions.

PALS Certification

PALS courses teach medical professionals how to provide life support and treat pediatric patients. The American Heart Association authorizes this course), which you cannot take through online certification. The certification classes for PALS and PALS recertification are usually held in a hospital, and they are organized several times a year. If you want to take this course, you’ll likely need to plan everything and remember to apply on time. A PALS certificate or provider card usually lasts for two years.

If you work for a healthcare institution, they will provide PALS classes for you, so you don’t need to finance it.

What Are the PALS Completion Requirements?

To get PALS certification, you must participate in the classroom course and complete all learning stations. You must pass the written certification exam by at least 84 percent and skills tests, such as 1 and 2-Rescuer Child BLS. You must also pass the PALS core case scenarios as a team leader in cardiac and respiratory cases. Other case scenarios that you also need to pass are:

• Lower airway obstruction
• Upper airway obstruction
• Lung tissue disease
• Obstructive shock
• Bradycardia

In addition, you need to go through skills stations, such as infant CPR, child CPR, and AED, management of respiratory emergencies, vascular access, and heart rhythm disturbances. Upon successful completion of the PALS course, including achieving a score of 84% or higher, you will receive a valid completion card for two years.

What are the Course Materials for PALS?

When you enroll in a PALS certification course, you must study the updated course materials. As of 2017, the edition adheres to the 2015 Guidelines of the American Heart Association for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

The course covers Basic Life Support, PALS treatment algorithm, pediatric emergencies, concepts of a systematic approach to pediatric, effective resuscitation, and team dynamics. The instructors will use PALS DVD sets, instructor manuals, provider manuals, PALS posters, and emergency crash card cards.

How to Be Prepared for the PALS Course?

Before taking the PALS certification course, you must understand the course requirements. You need to master the Basic Life Support skills for infants and children and understand the different airway management tools. Having sufficient knowledge of the medications used in PALS flowcharts and algorithms is also essential.

In addition, you need to be familiar with the Systematic Approach Algorithm and the “evaluate-identify-intervene” sequence. The AHA has created a website for students and instructors where you can access online preparation and other resources. The website also contains videos on how to manage shocks, arrhythmias, and respiratory distress.

Advanced Cardiac Life Support Certification

Like PALS, the American Heart Association also authorizes ACLS certification courses. While Basic Life Support training teaches you skills like CPR, AED, and First-Aid, any more advanced techniques will be discussed in the ACLS certification course. For example, it will teach you how to make EKG interpretations to determine whether defibrillation is possible, read various intravenous lines, and differentiate between drugs that can help stabilize a patient’s condition in critical circumstances. Aside from the AHA, there are also authorized training centers that offer online ACLS certification courses, and the ACLS instant provider card lasts for two years before you need to get an online ACLS recertification course.

Read- What’s the Difference Between ACLS And CPR Certifications?

Chain of Survival for ACLS

The chance of survival from sudden cardiac arrest depends on a series of critical interventions. The American Heart Association has used the term “Chain of Survival” to describe this sequence. The first part of the ACLS chain of survival includes early access, and early CPR is the next link.

The second half of the chain includes early defibrillation through an AED and finishes with the ACLS methods. A good understanding of the chain of survival will allow responders to reduce the expected mortality rate as opposed to other reactions.

EKG Interpretation for ACLS

One of the primary skills of Advanced Cardiac Life Support is the ability to interpret electrocardiograms or EKGs. For example, when a heart is in an arrhythmia, it needs to be determined if defibrillation is possible by determining the type.

Ventricular fibrillation and Ventricular tachycardia respond well to such shock treatment. When this is done using an Automated External Defibrillator, the portable machine is connected to the downed person and determines the situation. Under advanced cardiovascular life support, the team leader will have to make those decisions using the output on the EKG and integrating this with the patient’s vital signs.

Do I Need Both Certifications?

Getting these certification courses will depend on where you work. But in general, both ACLS and PALS are needed to ensure you’re fully certified, especially if you have plans to work in critical care or emergency care units. Each course usually takes several days to finish, so it won’t require extensive preparation to complete these two courses. If you are confident that you have the necessary knowledge and experience, you can technically take the exam and skills check. Typically, there is no time limit on taking and passing the exam.

Also Read- Why BLS Training Is Essential For Your Safety?

PALS and ACLS Recertification

People who obtain PALS and ACLS Certification should know that each certificate lasts two years. Once you complete your PALS or ACLS Certification Course, you are good for two years after completion. Once the expiration date passes, your certificate and wallet card is no longer valid and active.

In case you’ve exceeded the two years, don’t worry. You can take the PALS and ACLS Recertification Course at any point, and make sure to renew your provider card. Getting recertified is made easy nowadays with online recertification courses. PALS and ACLS recertification gives you the most updated procedures and guidelines, using the same criteria and training as classroom courses.

Are ACLS and PALS Required for Nurses?

PALS and ACLS are requirements for nurses and do not have to be obtained before applying for a job. Healthcare companies offer these certifications to employees while employed. Most job offers indicate that individuals must get their Basic Life Support before starting on the unit, and PALS and ACLS must be completed within 3-6 months of employment. However, graduate nurses may have some leeway with this.

While obtaining these certifications are imperative for all nurses, they do not necessarily make you more marketable by having before applying, especially if you are a new nurse. Basic life support for healthcare providers certification, PALS, and ACLS are considered essential for nursing jobs, which hospitals will offer free of charge to their employees.

For this reason, obtaining them before starting a new position is not recommended because you must pay upfront. If you want to earn these certifications before starting a new job, be wary and do your research, and be prepared to pay! Most employers will not compensate employees for money spent out of pocket for these certifications.

Read- 24 Careers that Require CPR and First Aid Certification.

Key Takeaway:

Whether paramedics and health care providers treat children, adults, or both, some life support systems should be functional and readily available to address urgent and emergency care situations. ACLS and PALS fulfill these needs by providing interventions geared toward each patient population. For example, while ACLS primarily caters to adults in cardiac arrest and cardiopulmonary emergencies, PALS ensures that minor patients receive the qualified emergency care they need during life-threatening situations.