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PALS Algorithm

Pediatric Advanced Life Support Protocols

Comprehensive PALS algorithms and emergency protocols for pediatric patients. These guidelines follow the latest American Heart Association standards for pediatric advanced life support.

Pediatric Assessment Triangle (PAT)

Appearance

• Tone
• Interactiveness
• Consolability
• Look/Gaze
• Speech/Cry

Work of Breathing

• Abnormal sounds
• Abnormal positioning
• Retractions
• Flaring

Circulation to Skin

• Pallor
• Mottling
• Cyanosis

Pediatric Cardiac Arrest Algorithm

CPR Quality

Compression Guidelines

• Rate: 100-120/min
• Depth: At least 1/3 AP diameter
• Child: At least 2 inches (5 cm)
• Infant: At least 1.5 inches (4 cm)
• Allow complete recoil
• Minimize interruptions

Ventilation

• 30:2 (1 rescuer)
• 15:2 (2 rescuers)
• 1 breath every 6 seconds with advanced airway
• Avoid excessive ventilation

Shockable (VF/VT)

1. Shock
2. Resume CPR immediately
3. Give epinephrine after 2nd shock
4. Amiodarone after 3rd shock

Non-Shockable (Asystole/PEA)

1. Resume CPR immediately
2. Give epinephrine ASAP
3. Repeat epinephrine every 3-5 min
4. Treat reversible causes

Pediatric Bradycardia Algorithm

Management Steps

1. Maintain patent airway; assist breathing as necessary
2. Give oxygen
3. Monitor blood pressure and oximetry
4. Establish IV/IO access
5. 12-Lead ECG if available
6. If poor perfusion despite oxygenation and ventilation:

Treatment Options

• CPR if HR <60/min with poor perfusion
• Epinephrine
• Atropine (for increased vagal tone or cholinergic drug toxicity)
• Consider transcutaneous pacing
• Treat underlying causes

Master PALS Protocols

Pediatric emergencies require specialized knowledge and skills. Get certified in PALS to confidently manage pediatric cardiac emergencies.