Introduction to PALS

The goal of Pediatric Advanced Life Support (PALS) is to save a life. For an infant or child experiencing serious illness or injury, your action can be the difference between life and death. PALS is a series of protocols to guide responses to life threatening clinical events. These responses are designed to be simple enough to be committed to memory and recalled under moments of stress. PALS guidelines have been developed from thorough review of available protocols, patient case studies and clinical research, and reflect the consensus opinion of experts in the field. The gold standard in the United States and many other countries is the course curriculum published by the American Heart Association (AHA). Approximately every five years the AHA updates the guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC). This handbook is based on the most recent AHA publication of PALS and will periodically compare old versus new recommendations for a more comprehensive review. 1

IMPORTANT: Any rescuer attempting to perform PALS is assumed to have developed and maintained competence with not only the materials presented in this document, but also certain physical skills, including Basic Life Support (BLS) interventions. Since PALS is performed on infants and children, PALS providers should be proficient in BLS for these age groups. While we review the basic concepts of pediatric cardiopulmonary resuscitation here, readers are encouraged to keep their physical skills in practice and seek additional training if needed.

Proper utilization of PALS requires rapid, accurate assessment of the patient's clinical condition, selection and delivery of the appropriate intervention. This not only applies to the provider’s initial assessment of a patient in distress, but also reassessment throughout the course of treatment utilizing PALS guidelines.

PALS protocols assume the provider may not have all of the information needed from the victim or all of the resources needed to properly use PALS in all cases. For example, if a provider is utilizing PALS on the side of the road, they will not have access to sophisticated devices to measure breathing or arterial blood pressure. Nevertheless, in such situations, PALS providers have the framework to provide the best possible care in the given circumstances. PALS algorithms are based on current understanding of best practice to deliver positive results in life-threatening cases and are intended to achieve the best possible outcome for the patient during an emergency.

1American Heart Association. Pediatric Advanced Life Support Provider Manual. AHA: 2011; p 183