PALS Cardiac Arrest
Paediatric cardiac arrest is less common than adult arrest and more often non-shockable, because it usually follows respiratory failure or shock. The algorithm taught on the PALS course shares its structure with adult ACLS but every dose and energy is weight-based.
The pathway
High-quality CPR with oxygen and monitor → shockable (VF/pVT): shock 2 J/kg, CPR 2 minutes, then 4 J/kg, adrenaline, antiarrhythmic → non-shockable (asystole/PEA): adrenaline as soon as possible, CPR in 2-minute cycles → treat reversible causes throughout.
Depth about one third of the chest (about 4 cm infant, 5 cm child), rate 100 to 120, full recoil, minimal pauses; 15:2 with two rescuers; with an advanced airway, one breath every 2 to 3 seconds with continuous compressions. See infant and child BLS.
See electrical therapy.
CPR, and adrenaline as soon as possible, then every 3 to 5 minutes; rhythm checks every 2 minutes; consider an advanced airway. Look hard for the cause: in children this is usually hypoxia or hypovolaemia.
The same H’s and T’s as adults, with hypoxia, hypovolaemia and hypoglycaemia especially important — see the H’s and T’s.
All doses are by weight — see weight-based dosing and PALS drugs. After return of circulation, move to post-arrest care.
This guide summarises what the PALS course teaches, for education only. It is not a clinical protocol: follow the current American Heart Association guidelines, linked below, and your institution’s paediatric policies.
Other life support and first aid courses: BLS Course · ACLS Course · First Aid Course · Training calendar
2 J/kg, then 4 J/kg for the second shock.
No, it is more often asystole or PEA following respiratory failure or shock.
As soon as possible in non-shockable rhythms, and after the second shock in shockable rhythms, then every 3 to 5 minutes.
About one every 2 to 3 seconds for infants and children.
Yes, when IV access is not rapidly available.
Paediatric emergencies are learned by doing. Safety First Medical Services is an American Heart Association training centre on Al Reem Island, Abu Dhabi, with HeartCode, classroom and on-site PALS and a two-year AHA PALS Provider eCard.
See PALS dates and register PALS course overview Group booking enquiry
What we teach follows the awarding body and the UAE health authorities. For the definitive position on a course or licensing question, these are the places to check.
Last reviewed by the training team at Safety First Medical Services, an American Heart Association training centre at Addax Office Tower, Al Reem Island, Abu Dhabi. Call +971 55 761 9841 or email training@safetyfirstmed.ae.