What Is the Difference between ACLS and PALS?

K'Lee Banks
K'Lee Banks
Paramedics must often perform ACLS or PALS while still on the scene of an accident before they can transfer a critically injured patient.
Paramedics must often perform ACLS or PALS while still on the scene of an accident before they can transfer a critically injured patient.

Advanced cardiovascular life support (ACLS) and pediatric advanced life support (PALS) are life-saving techniques designed by the American Heart Association® (AHA®). Both ACLS and PALS function as central patient management tools in emergency situations. While ACLS and PALS are both clinical interventions implemented to resuscitate patients or artificially sustain life, paramedics and health care providers use them with different patient populations under varying life-threatening circumstances. Emergency clinical interventions operate on the “ABC” principle to prioritize needs: airway, breathing, and circulation.

An EMT may used the ACLS technique to insert a breathing tube into a child's trachea.
An EMT may used the ACLS technique to insert a breathing tube into a child's trachea.

The primary difference between ACLS and PALS is the recipient of treatment: ACLS treats adults, while PALS treats children. For urgent care or emergency care, advanced cardiovascular life support is an essential clinical intervention for any emergency medical team or health care facility to have in place. One of the primary functions of ACLS is treating cardiac arrest or other cardiopulmonary emergencies in adults. The AHA® also emphasizes the need to begin ACLS interventions in “periarrest” or early stages leading up to full cardiac arrest, when adults exhibit symptoms of impending cardiopulmonary events. Some of the main ACLS techniques include ventilations, tracheal intubations, defibrillations, and intravenous (IV) infusions.

Paramedics often use ACLS to sustain an adult patient until they can reach the hospital.
Paramedics often use ACLS to sustain an adult patient until they can reach the hospital.

Emergency medical personnel and health care facilities dedicated to pediatric care for infants and children should have pediatric advanced life support systems established. Trained medical professionals who use PALS may perform a number of crucial life-saving techniques on sick or injured children. When a child is unable to breathe or is unconscious, ACLS techniques may include ventilating the child using a bag-valve mask or inserting an endotracheal tube into the child’s trachea or windpipe. During a cardiac event or other life-threatening situation, a child may require defibrillation with cardioversion — a brief electric shock — or insertion of a needle directly into the child’s bone marrow for immediate access to begin infusing intravenous fluids.

ACLS is a protocol for handling patients who are experiencing cardiac arrest.
ACLS is a protocol for handling patients who are experiencing cardiac arrest.

Whether paramedics and health care providers treat children, adults, or both, some form of life support system should be functional and readily available to address urgent care and emergency care situations. ACLS and PALS fulfill these needs by providing interventions geared toward each patient population. While advanced cardiovascular life support primarily caters to adults in cardiac arrest and cardiopulmonary emergencies, pediatric advanced life support ensures the smallest patients receive the qualified emergency care they need during life-threatening situations. The primary goal of both ACLS and PALS is to attempt to save the lives of those in need of urgent or emergency care.

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    • Paramedics must often perform ACLS or PALS while still on the scene of an accident before they can transfer a critically injured patient.
      Paramedics must often perform ACLS or PALS while still on the scene of an accident before they can transfer a critically injured patient.
    • An EMT may used the ACLS technique to insert a breathing tube into a child's trachea.
      An EMT may used the ACLS technique to insert a breathing tube into a child's trachea.
    • Paramedics often use ACLS to sustain an adult patient until they can reach the hospital.
      Paramedics often use ACLS to sustain an adult patient until they can reach the hospital.
    • ACLS is a protocol for handling patients who are experiencing cardiac arrest.
      ACLS is a protocol for handling patients who are experiencing cardiac arrest.
    • Doctors whose work focuses on children must be trained in PALS.
      Doctors whose work focuses on children must be trained in PALS.
    • Advanced cardiovascular life support may be administered to a patient who has no discernible pulse.
      Advanced cardiovascular life support may be administered to a patient who has no discernible pulse.