ALS 1 vs ALS 2: Which Course Do You Actually Need?

ALS 1 vs ALS 2: Which Course Do You Actually Need?

Most clinicians ask this question the wrong way round. They look at the two courses, notice that one is a day and one is two days, and assume the longer one is the better one. Then they either overspend on a course pitched above their role, or they undershoot and find out at credentialing that the certificate in their file is not the one their position description asked for.

The Australian Resuscitation Council does not treat these as a beginner course and an advanced course on a ladder. They are two different courses for two different jobs in the same room. Once you see it that way, the choice usually settles itself in about a minute.

The One Question That Settles It

Picture the last arrest you attended, or the next one you are likely to attend. When the room fills up and someone is running the resuscitation, which of these describes you?

• You are taking direction. Someone else is calling the rhythm, the drug and the timing, and your job is to do your part of it well and safely.
• You are giving direction. You are the one interpreting the rhythm, deciding what happens next, allocating roles and handing over afterwards.

If you are taking direction, ALS 1 is built for you. The ARC description of ALS 1 lists the ability to work as an effective team member in a cardiac arrest as one of its course outcomes. If you are giving direction, you need ALS 2. The ARC description of ALS 2 lists the ability to lead a team, work as a team member and use structured communication including giving an effective handover.

That single difference in wording is the whole distinction, and it is the part that gets lost when people compare the two courses on length and price. ALS 2 does not simply cover more content at a faster pace. It is the course that teaches you to run the room.

There is a second filter worth applying, and it is about frequency rather than role. The ARC says ALS 1 is ideal for people in healthcare with limited or infrequent exposure to crisis events. It also says that ALS 2 assumes a higher level of expected knowledge and recent clinical exposure to critical or crisis events at the start of the course. If you have not been in a resuscitation in two years, ALS 2 will not be a gentle reintroduction. It will be two very long days.

ALS 1 and ALS 2 Side by Side

Here is what the ARC actually specifies for each course, alongside the current Intouch Healthcare fees.

Aspect	ALS 1	ALS 2
Length	One day	Two days
Designed for	Clinicians with limited or infrequent exposure to crisis events, who need to manage the immediate period of crisis	Clinicians expected to apply advanced resuscitation skills as part of their clinical duties, or to teach them regularly
Typical candidates named by the ARC	Medical students, nurses and other healthcare providers outside critical care	Doctors, nurses in ED, CCU, ICU, HDU and acute admissions units, resuscitation and medical emergency team members, and paramedics
Your role in the arrest	Work as an effective team member	Lead a team, and work as a team member
Defibrillation taught	Manual and AED modes	Manual defibrillation
Arrhythmia management	Cardiac arrest management using the ANZCOR ALS algorithm	Management of life threatening arrhythmias in addition to arrest management
Special circumstances	Not a core focus	Asthma, anaphylaxis and pregnancy among others
Post resuscitation care	Not a core focus	Preparing and planning for post resuscitation care
End of life decision making	Not covered	Covered
Structured handover	Included as part of team member skills	Taught explicitly as a structured communication skill
Prerequisite	Existing CPR skills and competence	Existing CPR skills and competence, plus a higher level of assumed knowledge and recent clinical exposure to crisis events
Preparation sent	Manual at least two weeks before	Manual one month before, plus a pre course multiple choice paper
Fee at Intouch Healthcare	$749 incl. GST	$1,750 incl. GST

ALS 1 in Detail: Managing the Immediate Period of Crisis

ALS 1 is a one day course aimed at giving candidates the skills and knowledge to manage a patient through the immediate period of crisis. That framing matters. It is not a shortened version of ALS 2. It is a course about the first critical stretch of a deteriorating patient or an arrest, and it stops where a well run team handover would normally begin.

The ARC lists six areas of content for ALS 1

• Recognition, assessment and management of the critically ill patient using a structured ABCDE approach, with the explicit aim of preventing a cardiac arrest rather than only responding to one.
• Airway management skills.
• Basic life support.
• Defibrillation skills, in manual mode or AED mode or both.
• Cardiac arrest management using the ANZCOR advanced life support algorithm.
• Working as an effective team member in a cardiac arrest.

Notice how much of that list is about the period before the arrest. The structured ABCDE approach aimed at prevention is doing a lot of work here, because for most clinicians outside critical care, the realistic contribution is spotting the patient who is heading for trouble and escalating early, not managing refractory ventricular fibrillation at hour one.

The ARC also notes that the course can deliver targeted training to a specific candidate group or organisational requirement, which is why ALS 1 certification often works well as a whole ward or whole of practice booking. A team that trains together on its own equipment and its own escalation pathway gets more out of the day than five people sent to five separate public courses.

Preparation is lighter than ALS 2. Candidates are sent a manual at least two weeks before the course to begin preparing for the face to face component. There is reading to do, but it is a fortnight rather than a month, and there is no pre-course paper to hand in on arrival.

ALS 2 in Detail: Advanced Skills and Leading the Room

ALS 2 is a two day course focused on developing advanced skills in managing the deteriorating patient and cardiac arrest. The ARC is direct about who it is designed for: healthcare professionals who would be expected to apply those skills as part of their clinical duties, or to teach them on a regular basis.

The named participant groups are doctors, nurses working in critical care areas such as emergency, coronary care, intensive care, high dependency and acute admissions units, clinicians in the resuscitation or medical emergency team, and paramedics. If you recognise your own working week in that list, ALS 2 is almost certainly your course.

The content adds several distinct layers on top of ALS 1.

• Treatment of cardiac and respiratory arrest including manual defibrillation, rather than defibrillation in either manual or AED mode.
• Management of life threatening arrhythmias, which is a genuinely separate skill from running an arrest algorithm and is where a lot of the two day intensity sits.
• Preparing and planning for post resuscitation care, covering what happens in the period after circulation returns.
• Care of the deteriorating or arrested patient in special circumstances such as asthma, anaphylaxis and pregnancy, where the standard algorithm needs modifying.
• Leading a team, working as a team member, and structured communication skills including giving an effective handover.
• Consideration of end of life decision making, which is the part candidates rarely expect and frequently say was the most useful part of the two days.

The ARC describes the ALS 2 course as very intensive, and the preparation reflects that. The manual arrives a month before the course, and candidates must complete a pre course multiple choice paper to guide their preparation. That paper is a study aid rather than a hurdle, but people who skip the reading tend to spend day one catching up rather than learning.

Existing CPR skills and competence are an essential prerequisite for both courses. Neither course teaches you to do compressions from scratch.

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Do I Need to Do ALS 1 Before ALS 2?

No. ALS 1 is not a formal prerequisite, and the ARC says plainly that it is not essential to complete ALS 1 before ALS 2. You can book ALS 2 directly.

Whether you should is a different question. The ARC pairs that statement with a caveat: ALS 2 carries a higher level of expected knowledge and assumes recent clinical exposure to critical or crisis events at the start of the course. Nothing stops you enrolling without either. It simply means the course is pitched at someone who already has them.

A practical way to test yourself is to ask what you would do with a monitor showing a broad complex tachycardia in a patient with a pulse. If the answer comes to you reasonably quickly, ALS 2 will stretch you productively. If it does not, ALS 1 first will give you a foundation that makes the eventual ALS 2 course far more valuable, and you will spend the two days learning rather than surviving.

There is one important asymmetry to be aware of before you decide to wait. ALS 1 does not create a shortcut into ALS 2. Holding a current ALS 1 certificate does not make you eligible for the shorter ALS 2 recertification pathway later, because that pathway requires a current ALS 2 certificate. Doing ALS 1 first is a reasonable choice for readiness, but it is not a cheaper route to the same destination.

I Am a Ward Nurse. Is ALS 2 Overkill?

Often, yes, and the ARC says so more gently than most course providers will.

Its guidance is that medical students, nurses and other healthcare providers not covered by the critical care and medical emergency team groups may be encouraged to complete ALS 1, and that those with a particular interest in resuscitation should then consider attending an ALS 2 course where appropriate. That is a sequence, not a dismissal. It is the ARC acknowledging that a general ward nurse and an intensive care nurse are preparing for genuinely different roles in the same emergency.

There are three situations where a ward based clinician should still book ALS 2 rather than ALS 1.

• Your position description, role statement or credentialing policy names ALS 2 specifically. In that case the requirement decides it, regardless of how often you attend arrests.
• You are on the medical emergency team or the resuscitation team, even if your substantive ward is a general one. Responding to arrests across a hospital is a critical care role in everything but the roster.
• You are moving toward a critical care post, a transfer role or a rural position where you will be one of very few clinicians available. Book for the job you are about to do, not the one you are leaving.

Outside those three, ALS 1 is not the lesser option. It is the correctly matched one, and a clinician who is genuinely good at early recognition and escalation prevents more arrests than they will ever run.

I am a GP, Rural Generalist or Practice Nurse. Which One Do I Book?

This group has the hardest version of the decision, because the honest answer depends on two separate things and only one of them is about clinical content.

The first is what your college or credentialing body currently asks for. Several colleges recognise ARC advanced life support courses for continuing professional development, and some roles carry specific resuscitation requirements attached to scope of practice or to a particular procedural credential. Those requirements change, and they differ between colleges, so the only reliable step is to check the current position directly with your own college or professional body before you book. A course that does not satisfy the requirement you are trying to meet is an expensive day off.

The second is how isolated you are when something goes wrong. A GP in a metropolitan practice with an ambulance eight minutes away is running a very different scenario from a rural generalist who may be the most senior clinician in the building for the next hour. The metropolitan practice needs excellent recognition, early escalation and confident use of an AED while help arrives, which is the ALS 1 skill set. The rural clinician may need to manage an arrhythmia, make a decision about ongoing resuscitation and prepare a patient for retrieval, which is squarely ALS 2.

If you sit somewhere between those two pictures, ask yourself how long you would realistically be alone with the patient. Anything beyond a few minutes pushes the decision toward ALS 2.

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Will ALS 1 Satisfy My Hospital’s Credentialing Requirement?

Sometimes, the only way to know is to ask the question precisely. This is worth doing before you book rather than after, because course fees are rarely refundable close to the date and the certificate you hold is not convertible.

Two words cause most of the trouble here. Many position descriptions and policies say a clinician must hold current advanced life support certification without specifying a level. Others say ALS 2. Those are very different requirements, and a recruiter or roster coordinator will often not know which one their own policy means.

Ask your nurse educator, medical education unit or credentialing officer three specific questions, and ask for the answer in writing or by email.

• Does the requirement mean an ARC ALS 1 certificate, an ARC ALS 2 certificate, or either?
• Does it have to be an Australian Resuscitation Council accredited course, or will the organisation accept an alternative resuscitation program?
• Is the requirement attached to the position itself, or to a particular duty such as being on the medical emergency team roster?

That third question catches people out most often. A clinician can meet the requirement for their substantive role with ALS 1 and then be told they need ALS 2 before joining the arrest roster. Knowing that in advance lets you book once instead of twice. It is also worth confirming that the provider you are considering is a genuine ARC accredited course centre, because the ARC cautions that some providers run alternative courses it does not endorse, which may not meet credentialing requirements.

Three Real Scenarios, and What We Would Recommend

Abstract criteria only get you so far. These are the three conversations we have most often when someone rings to ask which course to book.

The Medical Ward Nurse With Four Years Experience

She attends perhaps two arrests a year, and in both of them her job was compressions and then fetching equipment. She wants to feel less useless when the team arrives. ALS 1. Her realistic contribution is early recognition, a fast escalation call and competent team member work in the first ten minutes, and that is exactly what the course is built around. ALS 2 would not be wasted on her, but she would spend most of it learning to lead a team she is not going to lead.

The Emergency Registrar

He runs resuscitations most weeks and is expected to lead them. ALS 2, without hesitation, and he is precisely the candidate the ARC describes. The arrhythmia management, post resuscitation planning and end of life decision making content maps directly onto his week. Skipping to ALS 1 to save a day and several hundred dollars would leave him with a certificate that does not describe what he actually does.

The Aged Care Clinical Manager

She is the senior clinician on site overnight, arrests are rare but she would be alone with one until the ambulance arrives, and her residents frequently have advance care directives in place. This one is genuinely finely balanced. ALS 1 covers the immediate crisis skills she needs in the first critical minutes. ALS 2 adds the end of life decision making content, which in her setting is not a peripheral topic but close to the centre of the job. We usually suggest she look hard at what her organisation expects of her overnight and decide from there, and if her facility is training a group, an onsite ALS 1 for the whole team often does more good than one person holding ALS 2.

Booking the Right Course With Intouch Healthcare

Intouch Healthcare has instructors accredited by the Australian Resuscitation Council. We run ALS 1, ALS 2 and ALS 2 Recertification courses face to face in Brisbane, on the Sunshine Coast, Gold Coast and more areas.

• ALS 1: $749 incl. GST, one day, for clinicians who need to manage the immediate crisis and work well within a resuscitation team.
• ALS 2: $1,750 incl. GST, two days, for clinicians expected to lead a resuscitation or apply advanced skills as part of their duties.

By this point you know which of the two matches your role. If you take direction during an arrest and attend them occasionally, it is ALS 1. If you are expected to lead the room, or you work in critical care, on the medical emergency team or in a setting where you will be the most senior clinician present, it is ALS 2.

Book it for the role you actually hold. Tell us your profession and your preferred location by contacting us directly, and we will confirm your seat and get your pre-course materials out to you with time to read them properly. We will never move you up to the two day course when the one day course is what your role calls for. Intouch Healthcare is led by AHPRA registered Nurse Practitioners, our instructors are ARC accredited and they run resuscitations themselves, and you can read more about our team.

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Frequently Asked Questions

Q: Is ALS 1 a nursing course and ALS 2 a doctors course?

No, and this is one of the more persistent myths about the two courses. The ARC names doctors, critical care nurses, resuscitation and medical emergency team members and paramedics as appropriate ALS 2 participants, so a large proportion of ALS 2 candidates are nurses. The sorting factor is the role you are expected to play during a resuscitation and how often you are in the room, not your profession.

Q: Can I sit ALS 2 straight away without doing ALS 1 first?

Yes. ALS 1 is not a formal prerequisite and the ARC states it is not essential to complete it first. The practical caveat is that ALS 2 assumes a higher level of knowledge and recent clinical exposure to critical or crisis events from day one, so going straight to ALS 2 suits clinicians who are already regularly involved in resuscitation rather than those returning after a long gap.

Q: Does ALS 1 count toward ALS 2 or make recertification cheaper later?

No. A current ALS 1 certificate does not make you eligible for the shorter one day ALS 2 recertification course, because that pathway requires a current ARC ALS 2 certificate. ALS 1 is a sensible readiness step, but it is not a discounted route to ALS 2.

Q: What preparation does each course involve?

ALS 1 candidates receive a manual at least two weeks before the course. ALS 2 candidates receive the manual a month before and complete a pre course multiple choice paper to guide their preparation. The ARC describes ALS 2 as very intensive, so the longer lead time reflects a heavier reading load rather than an administrative formality.

Q: Do both courses require existing CPR skills?

Yes. Prior skills and competence in CPR are an essential prerequisite for both ALS 1 and ALS 2. Neither course teaches basic CPR technique from scratch, so arrive with current CPR skills regardless of which level you book.