PALS Systematic Approach Algorithm

This algorithm is an essential part of the Pediatric Advanced Life Support (PALS) guidelines, designed to assist healthcare providers in assessing and initiating treatment for pediatric patients in emergency situations. It incorporates a systematic approach to quickly identify life-threatening conditions and initiate appropriate interventions.

Initial Impression and Response

Assess Initial Impression: Quickly evaluate the child's level of consciousness, breathing quality, and skin color upon first encountering the patient.

Unresponsiveness and Breathing Check:

• If the child is unresponsive with no breathing or only gasping, shout for help.
• Activate the Emergency Response System appropriate to the setting.

Pulse Check and Breathing Assessment

Check Pulse and Breathing: Determine if there is a pulse while simultaneously assessing for normal breathing or gasping. This should be done within 5-10 seconds.

Action Based on Pulse Presence:

If there is no pulse or if the pulse is less than 60/min with signs of poor perfusion despite adequate oxygenation and ventilation, start CPR immediately following the CAB (Compression-Airway-Breathing) sequence.

Intervention and Ongoing Evaluation

Cardiac Arrest Identification: If cardiac arrest is identified at any point, transition to the Pediatric Cardiac Arrest Algorithm for specific resuscitation protocols.

Secondary Assessment: Conduct a thorough secondary assessment including diagnostic tests to further evaluate the child’s condition.

Evaluate-Identify-Intervene Sequence: After Return of Spontaneous Circulation (ROSC), follow the structured approach of evaluating the patient's status, identifying underlying problems, and intervening with targeted treatments based on the findings.

Systematic Management

Continuous Monitoring: Throughout the treatment process, continue to monitor vital signs and the effectiveness of interventions.

Adapt Based on Response: Adjust the treatment plan based on the ongoing evaluation and the dynamic condition of the child.