What is PALS certification and who needs it?
PALS — Pediatric Advanced Life Support — is the American Heart Association's advanced resuscitation course for clinicians who respond to critically ill and injured infants and children. The provider course teaches a systematic assessment approach (evaluate–identify–intervene), high-quality paediatric basic life support, recognition and management of respiratory failure and shock before arrest, cardiac arrest and arrhythmia algorithms with weight-based drug and energy dosing, post-cardiac-arrest care, and effective resuscitation team dynamics. Assessment includes hands-on skills stations and a megacode in which you lead or participate in a simulated resuscitation, alongside a written examination. Provider cards are valid for two years. PALS is standard for emergency department, paediatric intensive care, paediatric ward, anaesthesia, transport and EMS clinicians, and is very commonly a condition of employment or credentialing.
- PALS is the American Heart Association's advanced paediatric resuscitation course, delivered through AHA Training Centers.
- Assessment combines a written examination with hands-on skills stations and a megacode simulation.
- Cards are valid two years; a current card allows the shorter update course rather than the full provider course.
- Online-only PALS does not satisfy the hands-on requirement and is not accepted by hospital credentialing.
PALS at a glance
| Cost | Set by the AHA Training Centre delivering the course, not centrally, so it varies by provider — ask the training centre for its current price |
| Duration | Provider course typically runs one to two days; the update/renewal course is shorter |
| Issued by | American Heart Association, through AHA Training Centers and instructors |
| Format | Instructor-led or blended (online cognitive portion plus in-person skills), with hands-on skills testing and a megacode |
| Expiry | 2 years |
| Who needs it | Emergency, paediatric, critical care, anaesthesia, transport and EMS clinicians who manage critically ill children |
| Prerequisite | Not formally required, but current BLS and ECG/pharmacology familiarity are practical necessities |
| Skills test | Hands-on skills stations plus a megacode simulation — online-only courses do not satisfy this |
Sources: American Heart Association, CPR and Emergency Cardiovascular Care · American Heart Association. Reviewed August 2026 by the GlobalCybers team.
PALS Course Assessment, Written Exam and Megacode
The megacode is the part that matters
PALS is assessed on two things: a written examination and hands-on performance. The written test covers the algorithms, dosing and recognition content. The megacode is a simulated paediatric resuscitation in which you must lead or contribute effectively — recognising the rhythm and the underlying problem, directing high-quality CPR, applying the right algorithm, and communicating as a team. Candidates who know the algorithms but cannot run the room do not pass.
Course structure and formats
How does PALS affect nursing and EMS roles?
PALS is a condition of working in specific units rather than a pay grade: emergency departments, paediatric intensive care, transport teams and many EMS services require a current card as a credentialing condition.
GlobalCybers reimburses certification fees after a successful permanent placement through our network.
What PALS Covers, Course Content
Systematic Assessment
The evaluate–identify–intervene cycle: initial impression, primary and secondary assessment, and diagnostic tests, repeated continuously rather than performed once.
Respiratory Emergencies
Distinguishing upper airway obstruction, lower airway obstruction, lung tissue disease and disordered control of breathing — because the intervention differs, and paediatric arrest is most often respiratory in origin.
Shock Recognition
Hypovolaemic, distributive, cardiogenic and obstructive shock, compensated versus hypotensive states, and the fluid and vasoactive strategies each demands.
Arrest & Arrhythmia Algorithms
Shockable and non-shockable arrest pathways, bradycardia with poor perfusion, and stable and unstable tachycardia — all with weight-based drug and energy dosing.
Team Dynamics
Closed-loop communication, clear role assignment, knowing your limitations and constructive intervention. The megacode assesses this as seriously as the clinical decisions.
Post-Arrest Care
Oxygenation and ventilation targets, haemodynamic support, temperature management and safe transport to definitive care after return of spontaneous circulation.
How do you get PALS certified, step by step?
Make sure your BLS and basics are solid
PALS does not formally require a current BLS card, but the course assumes you can perform high-quality CPR without instruction and are comfortable with basic rhythm recognition and pharmacology. Candidates who arrive without those fundamentals spend the course catching up rather than learning the paediatric content.
Book a course through an AHA Training Center
The American Heart Association delivers PALS through its network of Training Centers and instructors. Choose the full provider course if you are new or lapsed, or the shorter update course if your card is current. Blended options put the cognitive portion online with an in-person skills session.
Pass the written exam and the megacode
The written examination covers algorithms, dosing and recognition. The megacode requires you to actually manage a simulated paediatric resuscitation, including leading the team. Preparing the algorithms cold is necessary but not sufficient — practising the leadership role is what candidates most often neglect.
Renew every two years
Provider cards are valid for two years. Renewal through the update course is shorter than the full provider course, but only if your card is still current — let it lapse and you generally return to the full course. Employers usually track expiry dates as part of credentialing.
Required by Units, Not by Statute
No federal law requires PALS. What requires it is hospital credentialing and unit policy: emergency departments, paediatric intensive care units, paediatric wards, anaesthesia, transport and flight programmes and many EMS services make a current provider card a condition of working there, and accreditation expectations around competent resuscitation reinforce that. Because it is a credentialing condition, an expired card can take a clinician off the schedule immediately.
PALS, Frequently Asked Questions
PALS current? Units are hiring.
Emergency, paediatric critical care and transport teams need clinicians with current cards. Set your intent and let them find you.
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