INTRODUCTION TO PEDIATRIC ADVANCED LIFE SUPPORT (PALS) 

Pediatric Advanced Life Support (PALS) is a structured, evidence-based approach to the recognition and management of critically ill or injured children. It equips healthcare providers with the essential skills and knowledge to rapidly assess, intervene, and stabilize pediatric patients experiencing life-threatening emergencies, including:

Respiratory failure – The most common cause of pediatric cardiac arrest.
Shock (hypovolemic, distributive, cardiogenic, obstructive) – Leads to organ dysfunction if untreated.
Cardiac arrest – Often the end result of prolonged respiratory or circulatory failure in children.

Unlike adult resuscitation, pediatric emergencies require a specialized approach due to significant anatomical, physiological, and developmental differences. Pediatric patients have:

Higher metabolic rates → Faster oxygen consumption, increasing the risk of rapid deterioration.
Unique airway considerations → Smaller airways, larger tongues, and softer tracheal structures.
Distinct cardiovascular responses → Heart rate plays a larger role in maintaining cardiac output.

Understanding these differences is critical for effective management and improving survival rates.

OBJECTIVES OF PALS

The primary goals of PALS are to prevent cardiac arrest, intervene early, and optimize patient outcomes. The course is built around five essential principles:

Early Recognition & Prevention

Key concept: Pediatric cardiac arrest is often preventable when warning signs are identified early!
Recognizing subtle signs of deterioration (e.g., increased work of breathing, poor perfusion).
Preventing progression to respiratory failure, shock, or cardiac arrest.

Systematic Assessment & Clinical Decision-Making

Key tools:
Initial Impression (Appearance, Work of Breathing, Circulation to Skin).
Primary & Secondary Assessments (Airway, Breathing, Circulation, Disability, Exposure).
Diagnostic Testing & Continuous Monitoring (ECG, capnography, lab values).

Prioritization of Interventions

Time-sensitive interventions save lives!
Oxygenation & Ventilation – Managing the airway to prevent hypoxia.
Circulatory Support – IV/IO access, fluid resuscitation, and vasopressors to restore perfusion.
Identifying & Treating Reversible Causes – Using the Hs & Ts approach.

Effective Teamwork & Communication

Resuscitation is a TEAM effort!
Establishing clear leadership and role delegation.
Using closed-loop communication to confirm orders.
Maintaining situational awareness to avoid errors and improve efficiency.

Evidence-Based Resuscitation & Post-Cardiac Arrest Care

Following the latest American Heart Association (AHA) guidelines.
High-quality CPR – Minimizing interruptions and maximizing perfusion.
Post-resuscitation stabilization – Temperature management, neurological assessment, and organ support.

WHY PALS MATTERS

FACT: Unlike adults, children rarely experience primary cardiac arrest—instead, they suffer from respiratory failure or shock that progresses to cardiac arrest if untreated.

PALS is designed to: Prevent deterioration by recognizing warning signs early.
Improve survival rates through timely interventions and systematic decision-making.
Enhance team-based resuscitation to ensure smooth and effective care.

Throughout this course, you will develop a structured, step-by-step approach to managing pediatric emergencies with confidence. By integrating knowledge, technical skills, and teamwork, healthcare providers can significantly reduce morbidity and mortality in critically ill or injured children.

FINAL TAKEAWAY: PALS IS MORE THAN RESUSCITATION!

PALS is not just about responding to cardiac arrest—it’s about:
Preventing the arrest from happening in the first place.
Intervening early to stabilize patients before they deteriorate.
Delivering timely, effective, evidence-based care to improve survival.

Your role as a PALS provider is crucial. You are the first line of defense in recognizing and treating pediatric emergencies. The knowledge and skills gained in this course will empower you to act decisively and save young lives.

Let’s get started!