What is the Difference Between BLS and ACLS?

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  • Originally Written By: Kathleen Strecker
  • Revised By: C. Mitchell
  • Edited By: A. Joseph
  • Last Modified Date: 11 November 2019
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There are a number of important differences between basic life support (BLS) and advanced cardiac life support (ACLS), but some of the most significant include the training and certification requirements, the tools and skills used, and the role, if any, of drugs and pharmaceutical interventions. BLS usually is, as its name would suggest, quite basic. People who hold BLS certifications are usually trained in simple resuscitation and rescue techniques; this sort of training is often recommended for people like lifeguards, childcare workers, and hospital administration staff. ACLS is based on the same techniques, but takes them a step further, often requiring more expertise and knowledge of the care provider. ACLS training typically also includes more invasive procedures and the use of life-saving medications, and is usually designed for medical professionals.

Basic Concept

Both BLS and ACLS courses and programs have the same core aim, namely to provide immediate care to people suffering from health emergencies. The main goal of BLS is usually stabilization. People with this sort of training can help clear a victim’s airways, can help him or her start breathing again, and can help restart the heart, all of which can be the difference between life and death while waiting for medical responders to arrive on the scene.


ACLS training usually starts with the BLS basics, but builds upon them in order to provide a more comprehensive response plan. It’s typically the case that ACLS courses presume and usually require participants to have some baseline medical training and some understanding of anatomy and emergency medical care beyond what could be expected of a layperson.

Training and Certification Process

Another major difference between BLS and ACLS concerns how each course is offered and how people are able to earn certification in each. In most places, BLS courses and certification opportunities are open to the general public. They’re often offered by community centers, public health organizations, and local hospitals. Most of the time, training takes about a day; participants are usually required to attend lectures, demonstrate and practice skills in a hands-on setting, and pass a written quiz or short test. Certification is usually good for a year, and is often required for people in jobs that interface directly with those considered “at risk” for possible health crises. Lifeguards are a common example; teachers, childcare workers, and babysitters are others for whom this sort of certification can be advantageous.

ACLS training is usually more intensive, and is more commonly offered as a two-day course. Enrollment is also usually restricted to people who are already involved in healthcare, or who can prove a basic competency with emergency medicine. Licensed healthcare professionals working in emergency treatment, intensive care or critical care, such as physicians, nurses or paramedics, are eligible to obtain ACLS certification, which might be a requirement for their employment.

This sort of certification usually lasts for two years, at which point licensees can apply for recertification. In the case of BLS, renewing usually means just taking the class and the tests over again. The sort of re-upping required for ACLS typically takes a different form from the basic, or initial, class. The content differs in part because it is expected that professionals seeking renewal of their ACLS certification are actively working in the field and frequently encountering emergency situations that can broaden or at least inform their working knowledge.

Tools and Skills Used

Another significant difference relates to the basic tools and skills required to be successful at each level. In general, BLS is designed for the average person to perform without access to any specialized equipment. Trainees are taught how to use their hands and forearms to make chest compressions, how to use their fingers to sweep a victim’s airway, and how to use their mouths to perform rescue resuscitation. ACLS, by contrast, does this and more: it teaches participants how to use more advanced tools like intubation bags, syringes, and intravenous drug delivery systems. Much of this is based on the presumption that those who are going to be using ACLS are going to be doing so in environments, like clinics or hospitals, where these sorts of tools are more readily available.

Role of Pharmaceutical Interventions

The use and role of medications is another significant point of divergence. BLS training does not involve any discussion of medication or pharmacological interventions, in part because more trainees aren’t qualified to make the sorts of medical determinations necessary to safely and effectively use drugs in an emergency setting. This isn’t usually true of those seeking ACLS credentials. Portions of most ACLS trainings focus on appropriately using intravenous drugs and hypodermic injections in an emergency context. Again, this presupposes access — not always possible in a true emergency — but someone with ACLS training is usually at least aware of what sorts of medical interventions are appropriate, whereas someone with only a BLS credential isn’t likely to know.


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