Login Cart Reviews ACLS
Certifications PALS
Certifications BLS
Certifications CPR
Certifications Blog About Groups Help ACLS
Algorithms PALS
Algorithms BLS
Algorithms

Pediatric Bradycardia With A Pulse and Poor Perfusion - Updated 2020

Bradycardia is a heart rate lower than normal for a child’s age and activity level. Usually less than 60 BPM indicates bradycardia in a child, and if the child is experiencing this low of a heart rate with adequate oxygenation and ventilation, begin CPR immediately. It is often a sign of impending cardiac arrest in infants and children especially when accompanied by hypotension or evidence of inadequate tissue perfusion.

Pediatric Bradycardia Algorithm (With a pulse and poor perfusion) Download Printable Algorithm

Algorithm Notes

STEP 1

Identify and treat underlying cause

Follow the ABC Survey:

Airway: Support or open the airway by positioning the child in a position of comfort and performing manual airway maneuvers if necessary.

Breathing: Give O2 in high concentration, utilize bag-mask ventilation if needed/available and attach a pulse oximeter to assess oxygenation.

Circulation: Connect a monitor or defibrillator, establish an IV or IO, record a 12-lead ECG, monitor blood pressure and conduct appropriate lab studies (potassium, glucose, ionized calcium, magnesium, blood gas, toxicology screen).

STEP 2

Reassess bradycardia and cardiopulmonary compromise

This step entails checking the patient to determine whether the interventions in step 1 have altered the bradycardia or cardiopulmonary compromise. Follow the procedures accordingly based on the answer to the question of whether step 1 has halted bradycardia:

No, Bradycardia/Cardiopulmonary compromise does not continue:Support the ABCs as needed, administer oxygen, conduct frequent reassessments and consult a pediatric cardiologist.

No, Bradycardia/Cardiopulmonary compromise continues:If the heart rate is less than 60 BPM and there are still indicators of poor perfusion proceed to Step 3.

STEP 3

CPR

Perform high quality CPR.

STEP 4

Reassess Rhythm

Purchase course for all algorithm steps.

STEP 5

Administer Medications

Purchase course for all algorithm steps.

STEP 6

Proceed to Pediatric Cardiac Arrest Algorithm

Purchase course for all algorithm steps.

Test Your PALS Knowledge

Our PALS practice exam includes questions about pediatric ACLS algorithms pulled directly from a real PALS exam in 2024.

Take The PALS Practice Exam

Simple, Affordable Pricing

Select your Online ACLS, PALS, BLS, or CPR Medical Certification Course below

ACLS Recertification

129

The Advanced Cardiac Life Support (ACLS) is an accredited online medical certification course that teaches medical professionals to respond to nearly all cardiopulmonary emergencies.

Learn More

PALS Recertification

129

The Pediatric Advanced Life Support (PALS) Recertification instructs medical professionals on performing pediatric cardiopulmonary resuscitation in emergencies.

Learn More

BLS Recertification

65

The Basic Life Support (BLS) Recertification is intended to teach healthcare professionals the basic steps of CPR and rescue breathing for adults, children, and infants.

Learn More

CPR Recertification

35

Our online medical certification course for CPR, Automated External Defibrillator (AED), and First Aid is designed to teach adult, child, and infant CPR and AED use. It also demonstrates ways to relieve choking in adults, children, and infants.

Learn More

ACLS Certification

179

The Advanced Cardiac Life Support (ACLS) is an accredited online medical certification course that teaches medical professionals to respond to nearly all cardiopulmonary emergencies.

Learn More

PALS Certification

179

The Pediatric Advanced Life Support (PALS) Recertification instructs medical professionals on performing pediatric cardiopulmonary resuscitation in emergencies.

Learn More

BLS Certification

95

The Basic Life Support (BLS) Recertification is intended to teach healthcare professionals the basic steps of CPR and rescue breathing for adults, children, and infants.

Learn More

CPR Certification

39

Our online medical certification course for CPR, Automated External Defibrillator (AED), and First Aid is designed to teach adult, child, and infant CPR and AED use. It also demonstrates ways to relieve choking in adults, children, and infants.

Learn More

Already Certified? Get a free reminder before it expires!

All PALS Algorithms

Pediatric BLS One Rescuer Algorithm

Pediatric BLS One Rescuer Algorithm

This PALS algorithm describes the BLS sequence specifically for children and infants. There are differences when compared to the BLS sequence for adults. Infants are not a newborn but less than 1 year old. Children are older than 1 year old but younger than puberty.

View Algorithm

Pediatric BLS Algorithm - Two-Rescuer

Pediatric BLS Two Rescuer Algorithm

There are slight differences between the one and two-rescuer algorithms for children and infants. This algorithm highlights what makes a two-rescuer situation unique.

View Algorithm

PALS Systematic Approach Algorithm

PALS Systematic Approach Algorithm

The PALS Systematic Approach is designed to provide a complete and thorough approach to evaluating and treating an injured or critically ill child. This pediatric ACLS algorithm has several decision points and actions that must be committed to memory by PALS providers to ensure a high standard of care.

View Algorithm

Pediatric Bradycardia - Pulse & Poor Perfusion

Pediatric Bradycardia With A Pulse and Poor Perfusion

This PALS algorithm for 2024 outlines the decision tree for bradycardia, a heart rate (typically 60 BPM) lower than normal for a child’s age and activity level. It is often a sign of impending cardiac arrest in infants and children.

View Algorithm

Pediatric Cardiac Arrest Algorithm

Pediatric Cardiac Arrest Algorithm

Cardiac arrest is the cessation of blood circulation due to absent or ineffective cardiac mechanical activity. Clinically, the patient is unresponsive, not breathing or only gasping, and there is no detectable pulse. Cerebral hypoxia causes LOC and failure to breathe. Agonal breaths may be observed during the first minutes after cardiac arrest.

View Algorithm

Pediatric Management of Shock After ROSC Algorithm

Pediatric Management of Shock After ROSC Algorithm

If a patient has a Return of Spontaneous Circulation (ROSC) or palpable pulse after resuscitation, start post-resuscitation management immediately. The goals of this PALS algorithm in 2024 are supporting oxygenation and maximizing tissue and organ perfusion. This section provides a systematic approach to the post-resuscitation care algorithm.

View Algorithm

Pediatric Tachycardia - Pulse & Adequate Perfusion Algorithm

Pediatric Tachycardia With A Pulse and Adequate Perfusion Algorithm

Tachycardia is a heart rate higher than normal for a child’s age and activity level. Like bradycardia, tachycardia can be life-threatening for children and infants because of the impact on cardiac output. Learn the pediatric ACLS algorithm for tachycardia with adequate perfusion with ProMed.

View Algorithm

Pediatric Tachycardia - Pulse & Poor Perfusion Algorithm

Pediatric Tachycardia With A Pulse and Poor Perfusion Algorithm

Tachycardia is a heart rate higher than normal for a child’s age and activity level. Like bradycardia, tachycardia can be life-threatening for children and infants because of the impact on cardiac output. Learn the PALS algorithm in 2024 for tachycardia with poor perfusion with ProMed.

View Algorithm