American Heart Association BLS (Basic Life Support) is a CPR and emergency response certification course designed for healthcare professionals and other high-stakes responders. It teaches the skills needed to recognize and treat cardiac arrest, breathing emergencies, and choking in adults, children, and infants. The certification card is valid for two years, and most hospitals, clinics, nursing programs, and EMS agencies require it as a condition of employment or enrollment.
Who Needs BLS Certification
BLS is categorized under the American Heart Association’s healthcare professional course offerings. Nurses, paramedics, EMTs, physicians, dentists, respiratory therapists, physical therapists, and medical or nursing students are the primary audience. Many allied health workers, lifeguards, and personal trainers also need it. If your employer or school asked you to get “BLS for healthcare providers,” this is the course they mean.
The AHA also offers a separate line of courses called Heartsaver, which covers CPR and AED use for people with little or no medical training, like office workers, teachers, or coaches who need a card to meet OSHA or workplace requirements. The key difference: BLS goes deeper into multi-rescuer scenarios, team coordination, and ventilation techniques that healthcare providers are expected to perform on the job. If you’re entering a healthcare field, Heartsaver won’t satisfy the requirement.
What the Course Covers
The BLS course teaches both single-rescuer and team-based life support skills. The core competencies break down into a few categories.
High-quality CPR is the centerpiece. For adults, that means chest compressions at a rate of 100 to 120 per minute, pressing down at least 2 inches (5 cm), allowing full chest recoil between compressions, and minimizing pauses. You practice cycles of 30 compressions followed by 2 breaths, with each breath delivered over 1 second until you see visible chest rise.
AED use covers how to operate an automated external defibrillator during cardiac arrest, including when to deliver a shock, when not to, and how to integrate the device without interrupting compressions longer than necessary.
Choking relief teaches you to clear a blocked airway in adults, children, and infants, with age-specific techniques (more on that below).
Bag-mask ventilation and rescue breathing are practiced for situations where a patient has a pulse but isn’t breathing normally. The current guideline calls for 1 breath every 6 seconds (10 breaths per minute) when a pulse is present.
Team dynamics round out the curriculum. You learn defined roles for a multi-person resuscitation team: a compressor, an airway manager, someone operating the monitor or defibrillator, a team leader making decisions, and a timer/recorder tracking interventions and compression interruptions. The compressor role rotates every 2 minutes to prevent fatigue from degrading compression quality.
The Adult Cardiac Arrest Algorithm
BLS follows a specific sequence that you’ll practice until it becomes automatic. It starts with verifying the scene is safe, then checking for responsiveness. If the person doesn’t respond, you shout for help and activate the emergency response system (calling 911 or alerting your facility’s code team). Someone retrieves an AED while you simultaneously check for breathing and a pulse. You have 10 seconds to confirm whether a pulse is present.
If there’s no pulse and the person isn’t breathing or is only gasping, you begin CPR: 30 compressions, 2 breaths, repeating continuously. When the AED arrives, you attach it and let it analyze the heart rhythm. If the rhythm is shockable, you deliver one shock and immediately resume CPR for 2 minutes before the AED checks again. If the rhythm is not shockable, you skip the shock and resume CPR for 2 minutes. This cycle continues until advanced providers take over or the person starts to move. In cases of suspected opioid overdose, naloxone is administered if available.
How Pediatric BLS Differs
Cardiac arrest in infants and children usually doesn’t start as a heart problem. It typically results from progressive breathing failure or shock, which makes early ventilation especially important in younger patients. The BLS course covers age-specific techniques for two groups: infants (under 1 year old, excluding newborns) and children (age 1 through puberty). Once a child shows signs of puberty, you follow adult guidelines.
Compression depth is shallower for smaller bodies. For infants, the target is at least 1.5 inches (4 cm). For children, at least 2 inches (5 cm). Both targets correspond to roughly one-third the depth of the chest. Infant compressions use a one-hand technique or the two-thumb encircling hands method, where you wrap both hands around the infant’s torso and compress with your thumbs. The older two-finger technique was removed from guidelines because it didn’t reliably achieve proper depth.
Compression-to-ventilation ratios also change with team size. A single rescuer uses 30:2 for all ages. But when two rescuers are working together on an infant or child, the ratio shifts to 15:2, delivering breaths more frequently to address the respiratory origin of most pediatric arrests.
Choking management differs by age as well. For infants with a severe airway obstruction, you alternate 5 back blows with 5 chest thrusts. Abdominal thrusts are not used on infants. For children, the sequence is 5 back blows alternating with 5 abdominal thrusts.
Course Formats and Time Commitment
The AHA offers two paths to certification. The full classroom course is instructor-led and hands-on from start to finish. It takes about 4.5 hours, including skills practice and testing.
The blended learning option, called HeartCode BLS, splits the course into two parts. You complete an online module first, which uses simulations, animations, and interactive scenarios and takes roughly 1 to 2 hours. Then you attend a separate hands-on skills session with an AHA instructor or use a voice-assisted manikin. The skills session runs 60 minutes to 2 hours depending on your experience level. Blended learning is popular with people who have tight schedules or who want to absorb the knowledge portion at their own pace before practicing physical skills.
For renewal, the classroom course takes about 3 hours. You’ll still go through skills practice and testing, but the material moves faster since you’ve been through it before.
What the Skills Test Looks Like
You can’t pass BLS with a written exam alone. Every student must demonstrate physical competence on a manikin while an instructor evaluates against a standardized checklist. The test covers adult CPR and infant CPR at minimum.
For adult CPR, the instructor checks that your hands are positioned on the lower half of the sternum, that you deliver 30 compressions at the correct rate (100 to 120 per minute), that you compress at least 2 inches deep, that the chest fully recoils after each compression, and that you resume compressions within 10 seconds of delivering breaths. Each breath must produce visible chest rise.
For infant CPR, you’ll demonstrate both single-rescuer technique (one-hand compressions with a 30:2 ratio) and two-rescuer technique (two-thumb encircling hands with a 15:2 ratio). Timing is precise: 30 infant compressions should take between 15 and 18 seconds, and 15 compressions in the two-rescuer scenario should take between 7 and 9 seconds. Compression depth must reach at least 1.5 inches. The same standards for chest recoil, breath duration, and minimal interruption apply.
If you don’t meet a benchmark, most instructors will let you practice and re-test during the same session. Failing the skills check outright is uncommon for people who engaged with the course material.