ACLS vs. ATLS

Advanced Cardiac Life Support (ACLS) and Advanced Trauma Life Support (ATLS) are advanced, evidence-based protocols that help healthcare professionals respond to life-threatening emergencies. While they are often mentioned in the same context, they are designed for very different clinical situations: cardiac crises versus trauma care.

What is ACLS?

Advanced Cardiac Life Support is a professional certification that focuses on urgent, life-threatening cardiac conditions. ACLS builds on the concepts introduced in the Basic Life Support (BLS) course by teaching providers how to recognize and respond to internal medical emergencies that compromise the heart and lungs.

What is ATLS?

Since 1980, the Advanced Trauma Life Support program has taught attendees a systematic framework for evaluating and stabilizing patients with severe injuries. ATLS training teaches you to prioritize life-threatening trauma and take all steps necessary to prevent further harm.

Together, ACLS and ATLS give providers the tools to handle two of the most urgent and high-stakes scenarios in healthcare: cardiac emergencies and traumatic injuries.

Key Differences: ACLS vs ATLS

Although both ACLS and ATLS give healthcare professionals structured, evidence-based methods to respond in emergencies, they are designed for very different clinical situations.

Primary Life Threats

ACLS: The priority in ACLS is recognizing and treating sudden cardiac arrest, where the heart stops pumping blood; life-threatening arrhythmias, such as ventricular fibrillation or tachycardia, and airway or respiratory emergencies that threaten oxygen delivery to the brain and vital organs. The goal of ACLS is to restore circulation and breathing as quickly as possible and prevent secondary organ damage.

ATLS: In contrast, ATLS focuses on external physical trauma that leads to catastrophic injuries. Providers learn to manage blunt and penetrating trauma (e.g., car accidents, falls, gunshot wounds), uncontrolled hemorrhage that can rapidly cause shock and death, and fractures or injuries that complicate stabilization.

Assessment Priorities

ACLS: Guided by the “5 Hs and 5 Ts,” ACLS assessments center on identifying and correcting reversible cardiac causes. Providers rely heavily on ECG interpretation, cardiac monitoring, and rhythm-based interventions such as defibrillation.

ATLS: ATLS uses a systematic survey approach (broken into primary, secondary, and tertiary) to uncover and prioritize trauma-related injuries. Trauma scoring and rapid evaluation ensure that no life-threatening injury is missed while stabilizing the patient.

Protocols & Team Dynamics

ACLS: Protocols in ACLS are standardized, evidence-based algorithms that guide providers step-by-step during cardiac emergencies. These include delivering high-quality CPR, using defibrillation for shockable rhythms, securing the airway through advanced techniques, and administering medications through IV or IO access. Once circulation is restored, ACLS also covers post-return of spontaneous circulation (ROSC) care, such as optimizing oxygenation, blood pressure, and neurological protection. These protocols ensure that every provider on the team knows their role, from chest compressions to medication delivery, with the code team leader coordinating the sequence of interventions.

ATLS: ATLS protocols provide a systematic roadmap for stabilizing trauma patients. They emphasize airway protection in the presence of injury, rapid hemorrhage and shock control, and immediate fracture management through splinting or immobilization to prevent further damage. Unlike ACLS, which is often confined to controlled hospital environments, ATLS protocols extend into prehospital care settings like ambulances, helicopters, and in the field, where providers must make quick triage decisions and coordinate transfer to surgical teams. Team dynamics often involve surgeons, ER doctors, trauma nurses, and EMS personnel working together to maintain continuity of care from the scene of injury through stabilization in a facility and, if needed, into the operating room.

ACLS vs ATLS Skills in Hospitals & Prehospital Settings

ACLS and ATLS both give healthcare providers the tools to act quickly in emergencies, but they are applied in very different clinical and logistical contexts.

ACLS in EMS and Hospitals

In the prehospital setting, ACLS is primarily used by paramedics and EMS providers. In hospitals, ACLS is most often practiced in the ICU and emergency department, where code teams coordinate defibrillation, advanced ventilation, and post-resuscitation care. The focus is cardiac-centric: restoring circulation and preventing secondary injury to the brain and other vital organs.

ATLS in Trauma Transport and Field Care

In the prehospital environment, EMS providers and trauma teams emphasize spinal immobilization, airway control, and rapid hemorrhage management. The “golden hour” concept underlines the urgency of getting trauma patients stabilized and transferred to definitive care as quickly as possible. ATLS equips providers to identify hidden injuries, prevent shock, and maintain airway patency even in challenging environments.

Air vs. Ground Transport Use Cases

ACLS focuses on maintaining circulation and oxygenation using CPR, cardiac monitoring, and drug administration on patients during ground ambulance transfer. ATLS, by contrast, often determines whether ground or air transport is most appropriate for severely injured trauma patients. In rural or remote areas, helicopter or fixed-wing aircraft may be the fastest way to reach a trauma center within the “golden hour.”

Because transport teams may encounter either a cardiac emergency or a major trauma, certain roles demand competency in both protocols. Flight medics are a prime example as they may be called to resuscitate a patient in cardiac arrest one day and stabilize a severely injured crash victim the next. Similarly, trauma surgeons often need ATLS training for injury management, but ACLS certification ensures they are equally prepared to respond if a trauma patient develops a cardiac arrest in the operating room or ICU.

Team Coordination & Resource Allocation:

ACLS protocols revolve around tightly coordinated code teams in the ER or ICU. These teams are typically led by a physician or senior nurse who directs compressions, airway management, rhythm checks, and drug administration in precise sequence.

ATLS requires a broader, multidisciplinary approach. Trauma care teams often include surgeons, anesthesiologists, trauma nurses, and EMS providers who begin treatment in the field, continue resuscitation in the emergency department, and prepare injured patients for operative or critical care.

Training Course & Certification Requirements

When Do Healthcare Professionals Need ACLS vs ATLS?

When Will You Need ACLS?

ACLS certification is a standard requirement in hospital and critical care environments where cardiac emergencies are common. Professionals who typically need ACLS include:

• ICU, ER, operating room, and telemetry unit staff
• Cardiologists and anesthesiologists
• Respiratory therapists
• Nurses and physicians managing cardiac patients
• Designated code team members who respond to in-hospital cardiac episodes

When Will You Need Advanced Trauma Life Support? 

ATLS certification is required for healthcare professionals who stabilize patients with life-threatening injuries before surgical care can be delivered, including:

• Trauma surgeons and ER physicians
• EMS providers and paramedics
• Military medics and combat care teams
• Providers in high-volume trauma centers or field hospitals
• Clinicians working in austere or resource-limited environments

Choose the Right Life Support Certification

Life support training comes in different levels, and each prepares healthcare providers for specific clinical situations:

• BLS serves as the foundation for all other advanced certifications by covering CPR, AED use, and choking relief.
• ACLS focuses on specialized cardiovascular care for adults.
• PALS (Pediatric Advanced Life Support) is designed for providers caring for infants and children.
• ALS (Advanced Life Support) is an umbrella term that, depending on the region, can encompass ACLS, PALS, trauma protocols like ATLS, and advanced EMS care.

At the end of the day, the right certification really depends on your role and the types of patients you care for most often. If you’re ready to manage emergencies in the ICU or trauma cases in the field, you can take the next step with the right training course.

Explore AMC’s ACLS Certification and Recertification courses or learn more about ATLS through the American College of Surgeons.