PALS Certification 2026: Who Needs It, Cost & Renewal

Pediatric Advanced Life Support (PALS) trains healthcare professionals to identify and manage life-threatening emergencies in children and infants — because managing a child’s respiratory failure or cardiac arrest is different from adult care. Learners build skills in pediatric assessment; managing cardiac, respiratory, and shock emergencies; interpreting cardiac rhythms; and team-based resuscitation. Whether you are certifying for the first time, renewing before your card expires, or checking whether your role requires it, this guide covers what you need to know.

What is PALS certification?

PALS is one of the advanced clinical certifications from the American Heart Association (AHA). Unlike BLS and ACLS, PALS focuses on the specialized skills needed to treat critically ill or injured infants and children. It assumes BLS proficiency and builds on it — covering algorithms, rhythm recognition, airway management, vascular access, and pharmacology specific to pediatric emergencies, across three core categories: respiratory failure, shock, and pediatric cardiac arrest.

On successful completion, you receive an official AHA PALS Provider eCard, valid for two years from the date of completion and accepted by hospitals and clinical employers nationwide.

Who needs PALS certification?

PALS is intended for healthcare professionals who respond to respiratory, cardiovascular, and cardiopulmonary emergencies in children and infants — across emergency response, emergency medicine, critical care, and intensive care. The roles most commonly required to hold current PALS:

Course format: in-person vs. blended

PALS is offered in two formats — traditional instructor-led classroom or blended learning — both teaching the same content and producing the same certification card. The right choice depends on your schedule, learning style, and what your employer accepts.

Full classroom (instructor-led)

The entire course is taught in person by an AHA-certified instructor who simulates pediatric emergencies and uses video to teach and test skills, usually 12–14 hours over two days. It is ideal for first-time providers, those who want maximum hands-on time, or anyone who prefers a guided environment. The written assessment and skills evaluation happen in the same block.

HeartCode PALS (blended learning)

HeartCode PALS is the AHA’s official blended format: complete an adaptive online portion at your own pace (the path adjusts to your performance and confidence in each topic), pass the written exam with 84% or higher, then complete a hands-on skills session (30–90 minutes) with an AHA instructor or HeartCode-compatible manikin to receive your card. The PALS Provider Manual eBook is included. It suits experienced professionals seeking efficient recertification.

Both formats teach the same core content, aligned to the 2025 AHA Guidelines: high-quality CPR per BLS recommendations; recognition and management of respiratory distress, failure, and arrest; differentiating compensated from decompensated (hypotensive) shock; pediatric rhythm recognition; team dynamics and closed-loop communication; identification and treatment of pediatric shock (distributive, hypovolemic, cardiogenic); post–cardiac arrest management; and pediatric pharmacology. The skills evaluation includes megacode scenarios where you lead or participate in a simulated resuscitation — algorithm knowledge without practiced execution is not enough to pass.

How to get certified and how to renew

Getting certified for the first time

1. Confirm your employer’s requirements. Verify what your institution accepts before choosing a format — some accept only AHA-issued PALS cards.

2. Confirm your BLS proficiency. PALS assumes you can perform high-quality infant and child CPR. A BLS card is not always required at enrollment, but your pediatric BLS skills are evaluated as a mandatory component.

3. Complete the pre-course self-assessment. You must pass the PALS pre-course self-assessment with 70% or higher, available in your manual or the AHA student portal.

4. Choose your format and register. Find an AHA-authorized Training Center or purchase HeartCode PALS directly. Bring a government-issued photo ID for in-person classes.

5. Complete the course and receive your eCard. Pass both the written assessment (84%+) and the skills assessment; the eCard is issued the day of completion and valid for two years.

Renewing before your card expires

The card is valid for two years. The renewal course is shorter than initial certification, focused on keeping you current with the latest pediatric emergency care. The three main renewal pathways for 2025–2026:

When your card expires, so does your certification. Most Training Centers still allow a renewal-format course for a recently expired card, so you may not need to repeat the full initial course — but if your card has been expired more than two years, confirm which format applies with the Training Center.

Cost, where to take it, and BLS vs. ACLS vs. PALS

Costs vary by format, Training Center, and region. Typical 2025–2026 ranges:

Many employers cover PALS costs for clinical staff, especially where it is a hire requirement, and many hospitals are AHA-authorized Training Centers. Find courses at the AHA course locator, or purchase HeartCode PALS from ShopCPR with the skills check at any authorized Testing Center.

All three are AHA emergency-cardiovascular-care certifications covering different populations and skill levels. BLS is the foundation for both ACLS and PALS, and many providers in emergency and critical care hold all three, since they meet both adult and pediatric emergencies in a single shift — including flight and transport nurses and PACU nurses managing pediatric cases.

Frequently asked questions

How long does PALS certification last?

Two years from the date of course completion. The expiration date appears on your AHA PALS eCard, and most hospitals track it automatically. A lapsed card means you are not currently certified and may be removed from the schedule until you renew.

Can I complete PALS entirely online?

The cognitive portion of HeartCode PALS is online at your own pace, but the hands-on skills session cannot be skipped for an AHA card. Fully online non-AHA certifications exist but are not accepted at most hospitals — confirm your employer’s requirements first.

Do I need current BLS before taking PALS?

You are not always required to show a BLS card at enrollment, but you must be proficient in infant and child CPR, which is evaluated during the PALS skills session. If your CPR skills are rusty, review BLS content beforehand.

What is the passing score for the PALS written exam?

84%, the same threshold as ACLS. The pre-course self-assessment requires 70% to attend. Both scores must be met — one before, one during the course.

Is PALS the same as NRP?

No. NRP (Neonatal Resuscitation Program) is a separate certification from the AAP and AHA, focused on resuscitating newborns at delivery. PALS covers infants and children in broader clinical emergencies. NICU and labor-and-delivery providers often need both.

What happens if my PALS card expires?

There is no grace period — an expired card means lapsed certification, which most employers enforce through credential tracking. Most Training Centers allow renewal-format courses for recently expired cards; contact yours if you are past expiration.

How often are PALS guidelines updated?

The AHA updates guidelines roughly every five years through the ILCOR evidence review. The current edition is the 2025 AHA Guidelines, revising the 2020 edition — which is why renewal matters beyond just keeping a card current.

The bottom line

PALS certification is the standard credential for providers who manage critically ill infants and children in emergency, critical care, and transport settings — for those roles it is a hire requirement enforced through a strict two-year renewal cycle. The course is practical by design: both formats teach real algorithms, weight-based pharmacology, and team-based resuscitation through simulated pediatric emergencies. If you are certifying for the first time, confirm your employer’s format requirements and verify your BLS proficiency before registering; if you are renewing, schedule four to six weeks ahead of expiration to avoid a lapse. And if you are still working toward your RN license, Testavia’s NCLEX-RN prep resources build the clinical judgment that pediatric emergency care depends on.