The What, When, Who, Where and Why of PALS

Pediatric advanced life support (PALS) is a widely-recognized protocol designed to help pediatric healthcare providers efficiently and effectively manage critically ill infants and children. The PALS protocol is developed based on scientific findings from the 2020 American Heart Association Guidelines for CPR and ECC. PALS involves a variety of skills and competencies necessary to address emergency assessment; respiratory distress and failure; shock; cardiac arrest; and post-resuscitation management in the pediatric patient.

When is PALS used?

PALS is used in the event of a pediatric emergency involving infants or young children. Generally, PALS is used for patients between the ages of 1 and 8, while different advanced life support protocols are used in patients over the age of 8.

Who uses PALS?

PALS certification courses are designed for all hospital or pre-hospital professionals who are required to be credentialed or re-credentialed in this subject area. PALS is a required certification for a wide variety of healthcare providers who initiate and direct advanced life support in pediatric emergencies, including pediatricians, emergency physicians, family physicians, physician assistants, nurses, nurse practitioners, paramedics and EMTs, and respiratory therapists.

Where is PALS used?

PALS is a widely recognized standard used by professional healthcare providers around the world during the stabilization and transportation phases of a pediatric emergency. While the life support techniques outlined by PALS are sometimes executed inside a hospital or medical facility, PALS is also used by first-responders on the scene of a pediatric emergency.

Why is PALS used?

The stress of managing emergency situations can be enormous, particularly when children are involved. High-stress situations lead to greater probability of error, which is one reason a widely-recognized, systematic approach to advanced life support (like PALS) for the pediatric patient is so important. PALS ensures that healthcare providers from different professional areas—including all hospital and pre-hospital professionals—are universally in agreement about necessary steps in efficiently and effectively managing critically ill infants and children. This standardization of emergency response gives patients the best possible chance for survival.

Another reason why PALS is so widely used is that pediatric advanced life support is inherently different from the advanced life support administered to adults. Pediatric patients are not simply “miniature adults.” Unlike the bones of adults with injuries, children’s bones are much more likely to bend than break, their tongues take up a larger percentage of their oral cavities and their airways are sufficiently narrow that even slight inflammation can cause distress. Children’s blood volume—which is significantly smaller than that of adults—is another differentiator. For infants or children, seemingly insignificant blood loss may actually be critical, and may necessitate blood volume replacement.

Recognizing the importance of establishing a standardized approach to pediatric advanced life support based in best practices, the American Heart Association developed this standard protocol to account for physiological differences between children and adults.

Health Education Solutions offers the cognitive portion of the PALS certification course online. Contact us for more information about PALS or sign up for a PALS certification or PALS recertification course online.

The information included in this article is based on the 2020 guidelines for CPR, first aid and advanced cardiovascular care. Read more about the 2020 changes to the online PALS course.