Direct comparison
BLS vs ALS Ambulance: Equipment Differences
BLS vs ALS ambulance equipment, side by side: what the 2020 joint position statement lists for each level, what is shared, and what states decide.
Written and maintained by CASRAI Editorial Board
Last updated
Ask CASRAI · free to try
Ask about BLS vs ALS Ambulance: Equipment Differences
Ask your first 2 questions free below. Subscribers get 150 a day for $29 a month.
An AI assistant specialized in research administration. It cites the sources behind every answer, labels web answers and says when it can't answer.
Answers draw on CASRAI's guides and dictionary plus the federal and funder documents we index: Federal Register, Grants.gov, Regulations.gov and UKRI.
Works on this site and inside Claude, Cursor and the AI tools you already use.
Everything CASRAI publishes — this page, the dictionary, the guides and the news — stays free to read, with no account and no card.
How do BLS ambulance (EMR / EMT level), ALS ambulance (AEMT / Paramedic level) compare side by side?
The table below compares BLS ambulance (EMR / EMT level), ALS ambulance (AEMT / Paramedic level) across 12 procurement-relevant dimensions, from scope levels the list is built for through source.
Side-by-side comparison
| Dimension | BLS ambulance (EMR / EMT level) | ALS ambulance (AEMT / Paramedic level) |
|---|---|---|
| Scope levels the list is built for | Emergency Medical Responder (EMR) and Emergency Medical Technician (EMT). | Advanced EMT (AEMT) and Paramedic. |
| Equipment wording in the scope model | EMT: perform interventions "with the basic equipment typically found on an ambulance." EMR: "basic interventions with minimal equipment." | AEMT: "the basic and advanced equipment typically found on an ambulance." Paramedic: the same, "including diagnostic equipment approved by an agency medical director." |
| How the equipment list is structured | The base list every unit is recommended to carry. | Headed "All BLS equipment PLUS the following": the BLS list with additions. |
| Oxygen, airway and ventilation | Portable and on-board oxygen; titratable oxygen delivery devices (nasal, partial face, full-face mask); oropharyngeal and nasopharyngeal airways in neonate-to-adult sizes; manual and/or powered suction; self-inflating manual ventilation devices and masks; a device capable of non-invasive positive pressure ventilation. | Adds direct and/or video laryngoscopy equipment and Magill forceps, and supraglottic airways in neonate-to-adult sizes. Endotracheal tubes and cricothyrotomy supplies "may also be carried" but are not recommended as universally required on all ALS ground ambulances. |
| Cardiac equipment | Automatic external defibrillator (AED) with adult and pediatric or combination pads. | A device capable of automatic and/or manual defibrillation, cardiac rhythm monitoring (at least three leads), 12-lead ECG acquisition, and transcutaneous pacing. |
| Patient monitoring | Glucometer, pulse oximeter with sensors from neonate to adult, stethoscope, blood pressure cuffs, thermometer. | Adds continuous waveform capnography. |
| Bleeding and chest-injury supplies | Commercial arterial tourniquets, wound packing material, gauze, adhesive bandages and tape, occlusive (chest seal) dressings, irrigation fluid. | Adds chest decompression needles (or a commercial device) in adult, pediatric and newborn sizes. |
| Medications, vascular access and fluids | Medications that are germane to the agency's approved BLS protocols. | Medications for approved ALS protocols; devices and supplies for the oral, inhaled, intramuscular, intranasal, intravenous and intraosseous routes allowed in local scope; isotonic crystalloid fluids and administration tubing; a pressure-infusion device for IV fluids; a pediatric fluid-bolus limiting device. |
| Shared supplies: infection control, splinting, delivery | Sharps container, biohazard bags, cleaning and disinfecting products, contact/droplet/airborne precaution items (N95 and eye protection or PAPR); newborn delivery supplies; femoral and pelvic splinting; spinal motion restriction materials; trauma shears; blankets; fire extinguisher. | The statement lists no additional ALS items for infection control, newborn delivery, splinting, spinal motion restriction or the other general items: ALS units carry the BLS supplies. |
| Who sets the final list | The statement is a recommendation. States regulate EMS and set their own equipment lists; some items may be optional locally, and quantities are set by the medical director. | Same: the scope model is national guidance only, and each state keeps authority over the scope of practice of its licensed EMS clinicians. |
| Which description fits | Fits a unit staffed and permitted at the EMR/EMT level: the base equipment list, with an AED rather than a monitor/defibrillator. | Fits a unit staffed and permitted at the AEMT/Paramedic level: the BLS list plus the added monitoring, airway, vascular-access and medication equipment. |
| Source | Lyng J, et al., "Recommended Essential Equipment for Basic Life Support and Advanced Life Support Ground Ambulances 2020: A Joint Position Statement," Prehospital Emergency Care, 2021 (DOI 10.1080/10903127.2021.1886382), read 2026-11-01; NHTSA, National EMS Scope of Practice Model 2019, including Change Notices 1.0 and 2.0 (DOT HS 813 151, August 2021), read 2026-11-01. | Lyng J, et al., "Recommended Essential Equipment for Basic Life Support and Advanced Life Support Ground Ambulances 2020: A Joint Position Statement," Prehospital Emergency Care, 2021 (DOI 10.1080/10903127.2021.1886382), read 2026-11-01; NHTSA, National EMS Scope of Practice Model 2019, including Change Notices 1.0 and 2.0 (DOT HS 813 151, August 2021), read 2026-11-01. |
Common questions
Common questions about BLS ambulance (EMR / EMT level) vs ALS ambulance (AEMT / Paramedic level)
What is the difference between BLS and ALS?
+
In equipment terms, an ALS list is the BLS list plus additions. The 2020 joint position statement heads its ALS column "All BLS equipment PLUS the following," and ties BLS to the EMR and EMT scope levels and ALS to the AEMT and Paramedic levels.
BLS vs ALS ambulance: what does each unit carry?
+
A BLS ambulance is recommended to carry oxygen and airway adjuncts, suction, an AED, pulse oximetry and basic monitoring, bleeding-control supplies and infection-control items. An ALS ambulance adds a monitor/defibrillator with 12-lead ECG and pacing, continuous waveform capnography, laryngoscopy equipment, supraglottic airways, chest decompression needles, and IV/IO and pressure-infusion supplies.
What is BLS equipment?
+
It is the base ambulance equipment list in the 2020 joint position statement: portable and on-board oxygen, airway adjuncts, suction, manual ventilation devices, an AED, glucometer, pulse oximeter, stethoscope, blood pressure cuffs, thermometer, tourniquets, wound packing, dressings, splinting and spinal motion restriction materials, and infection-control items.
What is ALS equipment?
+
ALS equipment is what the statement lists in addition to the BLS items: a defibrillator/monitor with at least three-lead rhythm monitoring, 12-lead ECG and pacing, continuous waveform capnography, laryngoscopy equipment, Magill forceps, supraglottic airways, chest decompression needles, medication-route supplies, crystalloid fluids and tubing, and a pressure-infusion device.
Who staffs BLS and ALS units?
+
The statement uses the National EMS Scope of Practice levels to differentiate its lists: EMR and EMT as BLS, AEMT and Paramedic as ALS. The scope model says each state keeps authority to regulate EMS and set the scope of practice of its licensed clinicians, so local rules decide who may staff a unit.
BLS and ALS supplies: what is shared?
+
The statement lists no additional ALS items for infection control, newborn delivery supplies, splinting, spinal motion restriction, shears, blankets or the fire extinguisher, so an ALS unit carries the BLS version of these, including sharps containers, biohazard bags and precaution items.
Do all states require the same equipment?
+
No. The joint position statement is a set of recommendations, not a law, and it notes that some items may be optional locally under agency-defined scope and clinical guidelines. The scope model says each state regulates EMS within its borders, and state equipment lists vary.
Going deeper
