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PALS Systematic Approach Algorithm - Updated 2020

The PALS Systematic Approach is designed to provide a complete and thorough approach to the evaluation and treatment of an injured or critically ill child. It has several decision points and actions that must be committed to memory by PALS providers in order to ensure the highest standard of care.

PALS Systematic Approach Algorithm Download Printable Algorithm

Algorithm Notes

Initial Impression

The initial impression consists of what you immediately notice by visualization and auditory processing as you first see the patient. There are three primary components that should become second nature as you form your initial impression.

The components of the initial impression are:

IMPRESSION DESCRIPTION
Consciousness

Level of consciousness: Is the child irritable, alert or unresponsive?

Breathing

Is there evidence of increased work of breathing indicated by use of accessory muscles or abnormal breathing sounds? Is the pattern of breathing abnormal? Is the child gasping? You should also observe decreased respiratory effort, which can be an ominous sign. Obviously, absence of respiratory effort requires immediate intervention.

Color

Abnormal skin color is an indicator of circulatory compromise, represented by cyanosis, skin pallor, or mottled skin.

Your Initial impression consists of recognition of any life-threatening problem and subsequent action immediately taken in the form of appropriate interventions:

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ACLS Recertification

129

The Advanced Cardiac Life Support (ACLS) Recertification teaches medical professionals how to respond to nearly all cardiopulmonary emergencies.

PALS Recertification

129

The Pediatric Advanced Life Support (PALS) Recertification teaches medical professionals to manage and respond to cardiopulmonary resuscitation of pediatric patients in emergency situations.

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.

CPR Recertification

35

Cardiopulmonary Resuscitation, Automated External Defibrillator (AED) and First Aid Recertification is designed to teach adult and child CPR and AED use, infant CPR, and how to relieve choking in adults, children and infants.

ACLS Certification

179

The Advanced Cardiac Life Support (ACLS) Certification teaches medical professionals how to respond to nearly all cardiopulmonary emergencies.

PALS Certification

179

The Pediatric Advanced Life Support (PALS) Certification teaches medical professionals to manage and respond to cardiopulmonary resuscitation of pediatric patients in emergency situations.

BLS Certification

95

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

CPR Certification

39

Cardiopulmonary Resuscitation, Automated External Defibrillator (AED) and First Aid Certification is designed to teach adult and child CPR and AED use, infrant CPR, and how to relieve choking in adults, children and infants.

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All PALS Algorithms

Pediatric BLS One Rescuer Algorithm

Pediatric BLS One Rescuer Algorithm

This algorithm describes the BLS sequence specifically for children and infants. There are key differences when compared to the BLS sequence for adults. Infants are not a newborn but less than 1 year old and 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 algorithm 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 the evaluation and treatment of an injured or critically ill child. It 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 algorithm outlines the decision tree for bradycardia, which is 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 postresuscitation management immediately. The goals of postresuscitation management are supporting oxygenation and maximizing tissue and organ perfusion. This section provides a systematic approach of the postresuscitation care algorithm.

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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.

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.

View Algorithm